PINE RIDGE TERRACE

Official classification

Type B

Official code

87303(a)

Regulation authority

CCR

What the official deficiency says

87303(a) Maintenance and Operation- 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. The LPA identified that the dining room in the memory care unit was dirty, the glass windows, and door were dirty with smudged prints and grime, the floor covered with dirt, grime, crumbs, food, and some garbage. The LPAs shoes were sticking to the floor as it was dirty and very sticky. The memory care laundry room was dirty, floor dirty with garbage, and with torn flooring, Inspection date of 3/24/26 the laundry room sink was taken out, and a bucket was hanging off the faucet pipe. The laundry room is not in good repair, though it now has a sink put back in. LPA observed large pieces of lint on the small side patio table and chair outside in the memory care courtyard. The hallways, activity rooms, and the medication room need a good floor cleaning, swept and mopped, including in the doorways, from garbage and debris seen in doorways, on the floors, and under desks/counter. This is a risk to the health & safety of residents.

Official plan of correction

Administrator will ensure the memory care unit is clean, safe, sanitary, and in good repair as required by regulation. Ensure staffing to clean and maintain all areas in the required manner per the 87303(a) regulation. Submit plan on correcting all items mentioned in the report. Submit correction plan, and continued maintainance plan for future compliance. POC due 5/26/26

Deadline recorded: May 26, 2026. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87355(e)(3)

Regulation authority

CCR

What the official deficiency says

(e) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1569.17(b) shall prior to working, residing or volunteering in a licensed facility: (3) Request a transfer of a criminal record clearance as specified in Section 87355(c) or This requirement is not met as evidenced by: Deficient Practice Statement Based on LPA's/Administrator observation, interview and record review, the licensee did not comply with the section cited above in three out of ten staff individuals (I1, I2 & I3) were fingerprint cleared, but their fingerprints have not been transferred and associated to the facility which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 01/16/2026 Plan of Correction LPA confirmed I1, I2 & I3 has cleared finger prints. Administrator agrees to email/fax required documents to CCL to associate individuals who two of them were working and present at the facility at the time of inspection to clear the citation. ***Civil Penalty assessed in the amount of $300 for each staff not associated to this facility.

Official classification

Type B

Official code

87309(a)

Regulation authority

CCR

What the official deficiency says

(a) Except as specified in subsection (b), the licensee shall ensure that disinfectants, cleaning solutions, poisonous substances, knives, matches, tools, sharp objects, and other similar items which could pose a danger to residents are in locked storage and are not left unattended if outside the locked storage. This requirement is not met as evidenced by: Deficient Practice Statement Based on LPA's/Administrator observation and interview, the licensee did not comply with the section cited above in one maintenance shop and two laundry rooms located in memory care and assisted living unit were unlocked which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 02/06/2026 Plan of Correction Administrator will provide a LIC 9098 Proof of Corrections self certifying that CCR Regulation 87309(a) was reviewed with Assisted Living staff by POC due date of 2/6/2026 to clear the citation.

Official classification

Type B

Official code

87468.2(a)(4)

Regulation authority

CCR

What the official deficiency says

87468.2(a)(4) Additional Personal Rights of Residents in Privately Operated Facilities- 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. To care, supervision, and services that meet their individual needs and are delivered by staff that are sufficient in numbers, qualifications, and competency to meet their needs. This requirement was not met as evidenced by: Per review of alarm event report on R1's pendant for the month of 10/2025, the following recorded dates, times, and elapsed time until staff responded to R1's call pendant, LPA documented calls that had a wait from 15 minutes to over 20 minutes for some, on 10/4 twice, 10/5, 10/8, 10/10, 10/12, and 10/17, see LIC9099. Facility staff failed to respond in a timely manner to R1's pendant calls listed. This is a risk to resident's personal rights & a risk to resident's health & safety.

Official plan of correction

Licensee/Administrator to ensure that facility staff/direct caregivers are responding to all resident pendant calls, on all shifts, in a timely manner. Staff to respond in a timely manner to help ensure residents' needs are met as required, including emergency response/911 to be called if needed. Staff to be in-serviced in residents 'rights, and staff responsibility in answering pendant calls timely for all residents in care. Submit proof of training with direct care staff, all staff that answer to call pendants; Submit a plan of future compliance regarding the regulation and call pendant response by staff. POC due 12/19/25.

Deadline recorded: Dec 19, 2025. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87468.2(a)(1)(3)

Regulation authority

CCR

What the official deficiency says

87468.2(a)(1)(3) Additional Personal Rights of Residents in Privately Operated Facilities- Residents in all residential care facilities for the elderly shall have all of the following personal rights: To be accorded dignity in their personal relationships with staff, residents, and other persons. To be free from punishment, humiliation, intimidation, abuse, or other actions of a punitive nature. This requirement was not met as evidenced by: LPA obtained two photos that had been taken, by S3/staff member, of resident R1 who had fallen on the ground in their apartment unit. S3 took the pictures of R1, with their personal cell phone, prior to assisting the resident off the floor, and providing needed care. stamp, and with S3's personal phone. Per investigation, and interviews, the resident/R1 photos are found to be personal, confidential, humiliating, and violate R1’s personal rights. LPA has copies of photos for the file. This is a violation of resident's personal rights.

Official plan of correction

Licensee/Administrator to ensure all staff do not violate personal rights of residents’ in care. Staff are to be in-serviced on “Elder Abuse” training, and “Personal Rights of Residents” training. Submit proof of training, and plan of correction of the deficiency citation by 11/21/2025.

Deadline recorded: Nov 21, 2025. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87705(e)(7)

Regulation authority

CCR

What the official deficiency says

87705(e)(7) Care of Persons with Dementia- Licensees that use delayed egress devices on exterior doors and perimeter fence gates shall meet the following initial and continuing requirements: Delayed egress devices shall not substitute for trained staff in sufficient numbers to meet the care and supervision needs of all residents,, including staff needed to escort residents who need supervision to leave the facility. This requirement was not met as evidenced by: Incident regarding R2 who AWOL the memory care unit from the patio/courtyard door to the outside; The door is an egress exit, pressing on it for time required will release it, alarm sounded which alerted staff, who found R2 in the parking lot,this occurred on 10/31, at 5am. Incident of R2 on 11/2 AWOL out the memory care unit door that is inside the building leading into the assisted living area. R2 approached the front lobby area, and was redirected by staff back to the memory care. Only staff have the key code to the memory care unit door in the building. This is a health & safety risk for the resident.

Official plan of correction

Licensee/Administrator to ensure that memory care unit key code door is monitored to fully close when entering andor leaving the unit to ensure residents' aren't able to go out the door without staff's knowledge. Ensure sufficient staffing, qualified with training regarding the memory care policy and procedures of residents seeking an exit, wandering and/or AWOL the facility. In-service with all staff the policy and procedures of the memory care doors and their alarm features. Proof of training to be submitted by 11/21/25. POC due by 11/21/25.

Deadline recorded: Nov 21, 2025. A deadline is not proof that correction was completed.