OAK TREE RANCH

Official classification

Type B

Official code

87628(a)

Regulation authority

CCR

What the official deficiency says

(a) The licensee shall be permitted to accept or retain a resident who has diabetes if the resident is able to perform his/her own glucose testing with blood or urine specimens, and is able to administer his/her own medication including medication administered orally or through injection, or has it administered by an appropriately skilled professional. This requirement is not met as evidenced by: Deficient Practice Statement Based on LPA's records review and interviews with staff, the licensee failed to ensure that resident (R1) was retained at the facility while not able to administer injections as per physician's report, but the facility did not ensure to hire an appropriate skilled professional or followed up with R1's physician to obtain updated physician order, which poses an immediate risk to the health and safety of residents in care.

Official plan of correction

POC Due Date: 09/01/2026 Plan of Correction The Administrator agrees to ensure administration of injections are either performed by skilled professional or they will obtain updated doctor's order indicating that R1 is able to administer own injections and submit proof to CCL by POC due date.

Official classification

Type B

Official code

1569.625(b)(2)

Regulation authority

HSC

What the official deficiency says

(2) In addition to paragraph (1), training requirements shall also include an additional 20 hours annually, eight hours of which shall be dementia care training, as required by subdivision (a) of Section 1569.626, and four hours of which shall be specific to postural supports, restricted health conditions, and hospice care, as required by subdivision (a) of Section 1569.696. This training shall be administered on the job, or in a classroom setting, or both, and may include online training. This requirement is not met as evidenced by: Deficient Practice Statement Based on LPA's/staff observation, interview and record review, the licensee did not comply with the section cited above in 1 out of 2 staff did not have complete required additional treaining hours which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 08/08/2025 Plan of Correction Licensee will have staff to complete additional required training hours and send to CCL the LIC9098 form ensuring that additional required training hours were completed by POC due date to clear deficiency.

Official classification

Type B

Official code

87468.2(a)

Regulation authority

CCR

What the official deficiency says

(a) In addition to the rights listed in Section 87468.1, Personal Rights of Residents in All Facilities, residents in privately operated residential care facilities for the elderly shall have all of the following personal rights: This requirement is not met as evidenced by: Deficient Practice Statement Based on LPA's/staff observation, interview and record review, the licensee did not comply with the section cited above by having a monitor was being used to monitor resident's room, which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 08/08/2025 Plan of Correction Staff immediately removed and discarded monitor. Licensee to submit self certification LIC9098 that they have read and understand regulation 87468.2 (a) to CCL by POC due date.

Official classification

Type B

Official code

87465(a)(6)

Regulation authority

CCR

What the official deficiency says

(6) When requested by the prescribing physician or the Department, a record of dosages of medications which are centrally stored shall be maintained by the facility. This requirement is not met as evidenced by: Deficient Practice Statement Based on LPA's/staff observation, interview and record review, the licensee did not comply with the section cited above in 4 out of 4 resident's medications were not entered into the centrally stored medication log, which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 08/08/2025 Plan of Correction Staff entered medication information into the centrally stored log during LPA's visit. Facility to submit LIC 9098 self certification as proof that all staff have reviewed how to document centrally store medications to CCL by POC due date.

Official classification

Type B

Official code

87465(h)

Regulation authority

CCR

What the official deficiency says

(h) The following requirements shall apply to medications which are centrally stored: This requirement is not met as evidenced by: Deficient Practice Statement Based on LPA's/staff observation, interview and record review, the licensee did not comply with the section cited above in 3 out of 4 residents had medication expired on resident's medication box which poses a potential health and safety risk to persons in care.

Official plan of correction

POC Due Date: 08/08/2025 Plan of Correction Licensee to ensure that facility is following required destruction procedures at all times. Items must be immediately destroyed according to Title 22 procedures. Staff immediately reviewed all medications for residents; expiration dates and discarded expired medications. Licensee to submit LIC 9098 self certification as proof that expired & dicontinued medications have been destroyed by POC date.

Official classification

Type B

Official code

87463(a)

Regulation authority

CCR

What the official deficiency says

(a) The pre-admission appraisal, as specified in Section 87457, Pre-Admission Appraisal, shall be updated, in writing as frequently as necessary or once every 12 months, whichever occurs first, to note significant changes in condition, as defined in Section 87101, Definitions, and to keep the appraisal accurate. For the purposes of this section, the updated pre-admission appraisal shall be referred to as the reappraisal. This requirement is not met as evidenced by: Deficient Practice Statement Based on LPA's/staff observation, interview and record review, the licensee did not comply with the section cited above in 3 out of 4 residents care plans were not updated which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 08/08/2025 Plan of Correction Licensee will review regulation 87463(a),then they will update the reappraisals for residents R1, R2 and R3, and send to CCL the LIC9098 form ensuring that care plans were updated by POC due date to clear deficiency.

Official classification

Type A

Official code

87303(a)

Regulation authority

CCR

What the official deficiency says

The facility shall be clean, safe, sanitary and in good repair at all times. Maintenance shall include provision of maintenance services and procedures for the safety and well-being of residents, employees and visitors. This requirement is not met as evidenced by: Deficient Practice Statement Based on LPA/staff observation toilet located in bathroom #2 was not properly flushing. Also, upon entering to bathroom #3 located in the hallway, LPA/staff smelled a strong odor and it was apparently due to bathroom does not have adequate ventilation, the licensee did not comply with the section cited above in two bathrooms used by residents in care, which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 08/28/2024 Plan of Correction Licensee/Administrator will send a written plan regarding how the facility plans to address the repairs in a timely manner and they will follow up with proof of repairs of the toilet located in bathroom #2 and installation of ventilation in bathroom #3 by not later than 9/3/24.

Official classification

Type B

Official code

87303(e)(2)

Regulation authority

CCR

What the official deficiency says

(e) Water supplies and plumbing fixtures shall be maintained as follows: (2) Faucets used by residents for personal care such as shaving and grooming shall deliver hot water. Hot water temperature controls shall be maintained to automatically regulate the temperature of hot water used by residents to attain a temperature of not less than 105 degree F (41 degrees C) and not more than 120 degree F (49 degrees C). This requirement is not met as evidenced by: Deficient Practice Statement Based on LPA's/staff observation, interview and record review, the licensee did not comply with the section cited above in three out of three faucets used by residents, water measured at 101.3, 103.1 and 101.8 degrees F, which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 09/03/2024 Plan of Correction Licensee/Administrator to ensure the hot water is monitored between 105 and 120.degrees Fahrenheit. Monitor the hot water for a period of one week (7 days). Submit a copy of the hot water log, and a plan on how the facility will ensure the hot water is maintained in compliance with regulation. Submit plan of correction by 9/3/24, and follow up with copy of hot water log and maintenance plan by 9/3/24.

Official classification

Type B

Official code

87211(a)(1)(D)

Regulation authority

CCR

What the official deficiency says

87211 Reporting Requirements (a) Each licensee shall furnish to the licensing agency such reports as the Dpt may require…(1) A written report shall be submitted to the licensing agency & person responsible for the resident within 7 days of the occurrence of any of the events…(D) Any incident which threatens the welfare, safety or health of any resident...unexplained absence of any resident. This requirement has not been met as evidence by: Based on LPA’s records review and interviews conducted with Administrator confirmed that they did not ensure that CCL was notified of incident involving R1 after AWOL, which poses a potential health & safety risk to residents in care.

Official plan of correction

Administrator to ensure all incidents that threaten the safety of residents are reported to CCL per regulation. Administrator to review regulation, conduct training for all staff on reporting requirements. Signed statement that the regulation was reviewed & sign in sheet for all staff trained to be submitted by POC due date.

Deadline recorded: Apr 19, 2024. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

1569.618(c)(3)

Regulation authority

HSC

What the official deficiency says

1569.618 Administration/management of RCFE: c) The facility shall employ, & the administrator shall schedule...: (3) Ensure that at least 1 staff member who has cardiopulmonary resuscitation (CPR) training & 1st first aid training is on duty/on the premises at all times....This requirement is not met as evidenced by: Based on observation, the licensee did not comply with the section cited above in 2 out of 2 staff not having proof of a First Aid and CPR Certificate, which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

Facility agrees to maintain staff files in this facility including proof of First Aid and CPR Certificates by POC due date.

Deadline recorded: Aug 18, 2023. A deadline is not proof that correction was completed.