VICTORIA'S PLACE

Official classification

Type A

Official code

87468.2(a)(1)

Regulation authority

CCR

What the official deficiency says

Additional Personal Rights of Residents in Privately Operated Facilities - To have a reasonable level of personal privacy in accommodations, medical treatment, personal care & assistance, visits, communications, telephone conversations, use of the Internet...This requirement has not been met as evidenced by LPA's/administrator observation an auditory monitor was being used to monitor R1's room. This does not allow for privacy. This is an immediate risk to the personal rights of residents in care.

Official plan of correction

Administrator agrees to remove monitor immediately by POC due date. Administrator will conduct staff training with all staff subsequently and submit proof of training to CCL within two weeks.

Deadline recorded: Jun 10, 2026. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87465(g)

Regulation authority

CCR

What the official deficiency says

87465 Incidental Medical and Dental Care (g) The licensee shall immediately telephone 9-1-1 if an injury or other circumstance has resulted in an imminent threat to a resident’s health including, but not limited to, an apparent life-threatening medical crisis...This requirement has not been met as evidence by: Based on interviews conducted with facility staff and records reviews of fire department service calls, the facility staff failed to seek medical attention after observing R1’s significant change of condition at 7:30am, which poses an immediate risk to the health and safety of the residents in care.

Official plan of correction

The Licensee agrees to develop a procedure that it will be attached to the facility plan of operation indicating how the facility will ensure that facility staff will immediately telephone 9-1-1 after learning that a resident sustain an injury or other circumstance that could resulted in an imminent threat to a resident’s health or any significant change of condition and care needs by POC due date. ***Failure to seek medical care resulted in violation causing injury to person in care $500 immediate civil penalty issued.

Deadline recorded: Feb 13, 2026. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87211(a)(2)

Regulation authority

CCR

What the official deficiency says

87211 Reporting Requirements (a) Each licensee shall furnish to the licensing agency such reports.: (2) Occurrences, such as...major accidents which threaten the welfare, safety or health of residents..., shall be reported within 24 hours either by telephone or facsimile to the licensing agency and to the local health officer when appropriate. This requirement was not met as evidence by: Based on LPA’s records review and interviews with the Licensee, the facility failed to notify the Department about R1’s hospitalization on 9/10/25 and R1’s death on 10/31/25, which could pose a potential risk to the health and safety of residents in care.

Official plan of correction

Licensee agrees to review reporting requirements regulation, conduct training with all staff about reporting requirements, and will submit a written policy about the process that staff will follow to ensure that incidents are reported timely to CCL as proof of correction to clear the deficiency by POC due date.

Deadline recorded: Feb 27, 2026. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87463

Regulation authority

CCR

What the official deficiency says

87463 Reappraisals (i) When there is significant change in condition, ...or once every 12 months, whichever occurs first, the licensee shall arrange an in-person or virtual meeting or conference call to share the reappraisal with the resident, the resident's representative, if applicable, and appropriate facility staff...This requirement was not met as evidence by: Based on LPA’s records review and interviews with the Licensee, the Licensee failed to update R1’s care after they had a significant change of condition, which poses a potential risk to the health and safety of the residents.

Official plan of correction

Licensee agrees to review all residents’ care plans to ensure that any change of condition observed is documented and once every 12 months, whichever occurs first is notified to the residents’ responsible party, then the Licensee will submit a self-certification form (LIC9098) to CCL by POC due date to clear the deficiency.

Deadline recorded: Feb 27, 2026. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87466

Regulation authority

CCR

What the official deficiency says

87466 Observation of the Resident The licensee shall ensure that residents are regularly observed for changes in physical, mental..., the licensee shall ensure that such changes are documented & brought to the attention of the resident's physician and the resident's responsible person, This requirement has not been met as evidence by: Based on LPA’s records review and interviews with the Licensee, LPA learned that Licensee failed to obtain an updated physician’s report (LIC602) for R1 after they have a significant change of condition and ambulatory status, which poses a potential risk to the health and safety of the residents in care.

Official plan of correction

Licensee agrees to review all residents’ care plans to ensure that all the residents have updated medical assessments including any change of condition are documented and brought to the attention of the resident’s physician and resident’s responsible person. Licensee will submit self-certification form (LIC9098) that all residents have current medical assessments on file by POC due date.

Deadline recorded: Feb 27, 2026. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87456(a)(3)

Regulation authority

CCR

What the official deficiency says

(a) Prior to accepting a resident for care and in order to evaluate his/her suitability, the facility shall, as specified in this article 8: (3) Obtain and evaluate a recent medical assessment. This requirement is not met as evidenced by: Deficient Practice Statement Based on LPA's/back up administrator observation, interview and record review, the licensee did not comply with the section cited above in two out of four rsidents medical assessment 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: 02/20/2026 Plan of Correction The facility will obtain current medical assessment for residents (R1 & R2) and will submit a self certification form (LIC9098) ensuring that they have obtain one for each resident to clear the citation by POC due date 2/20/26.

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/back up administrator observation, interview and record review, the licensee did not comply with the section cited above in two out of four residents didn't have current care plans, which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 02/20/2026 Plan of Correction The facility will draft care plans for residents (R1 & R2) and will submit a self certification form (LIC9098) ensuring that they have obtain one for each resident to clear the citation by POC due date 2/20/26.

Official classification

Type B

Official code

87458(a)

Regulation authority

CCR

What the official deficiency says

(a) Prior to a person's acceptance as a resident, the licensee shall obtain and keep on file, documentation of a medical assessment, signed by a physician, made within the last year. The licensee shall be permitted to use the form LIC 602 (Rev. 9/89), Physician's Report, to obtain the medical assessment. This requirement is not met as evidenced by: Deficient Practice Statement Based on LPA's/Licensee observation, interview and record review, the licensee did not comply with the section cited above in one out of six residents's medical assessments was not current within the last 12 months, which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 02/28/2024 Plan of Correction Licensee agreed to obtain a current medical assessment for resident (R3) and will submit a self-certification LIC9098 form to CCL to clear the citation.

Official classification

Type B

Official code

87463(c)

Regulation authority

CCR

What the official deficiency says

(c) The licensee shall arrange a meeting with the resident, the resident's representative, if any, appropriate facility staff, and a representative of the resident's home health agency, if any, when there is significant change in the resident's condition, or once every 12 months, whichever occurs first, as specified in Section 87467, Resident Participation in Decision Making. This requirement is not met as evidenced by: Deficient Practice Statement Based on LPA's/Licensee observation, interview and record review, the licensee did not comply with the section cited above in 5 out of 6 residents (R1,R2, R3, R4 & R5) care plan was not updated within the last 12 months, which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 02/28/2024 Plan of Correction Licensee agreed to update care plans for 5 out of six residents (R1, R2, R3, R4 & R5) and will submit a self-certification LIC9098 form to CCL to clear the citation.