HOEN'S CARE HOME

Official classification

Type B

Official code

87405(d)(2)

Regulation authority

CCR

What the official deficiency says

Qualifications and Duties 87405(d)(2) The administrator shall have the qualifications specified in Sections 87405(d)(1) through (7). If the licensee is also the administrator, all requirements for an administrator shall apply. (2) Knowledge of and ability to conform to the applicable laws, rules and regulations. This regulation was not met as evidenced by Licensee/Administrators not engaging in the CHOW process as directed in the 9/15/2025 Office meeting.

Official plan of correction

Licensee to provide letter self-certifying that they will provide monthly updates on status of submitted application by plan of correction due date. This will be due every 22nd of the month. Facility to review Administrator qualifications and duties regulation and provide a monthly update on status of submitted application.

Deadline recorded: Jul 24, 2026. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

1569.625(b)(1)

Regulation authority

HSC

What the official deficiency says

(1) The department shall adopt regulations to require staff members of residential care facilities for the elderly who assist residents with personal activities of daily living to receive appropriate training. This training shall consist of 40 hours of training. A staff member shall complete 20 hours, including six hours specific to dementia care, as required by subdivision (a) of Section 1569.626 and four hours specific to postural supports, restricted health conditions, and hospice care, as required by subdivision (a) of Section 1569.696, before working independently with residents. The remaining 20 hours shall include six hours specific to dementia care and shall be completed within the first four weeks of employment. The training coursework may utilize various methods of instruction, including, but not limited to, lectures, instructional videos, and interactive online courses. The additional 16 hours shall be hands-on training. This requirement is not met as evidenced by: Deficient Practice Statement Based on LPA record review, the licensee did not comply with the section cited above in that S1, S2, and S3 did not have the requried hours of training completed, which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 04/02/2026 Plan of Correction Facility to submit proof of training requried per regulation including a medication test for S1, S2, and S3 by the plan of corerction due date.

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 documentation of a medical assessment, signed by a licensed medical professional acting within the scope of their practice and made within the last year, to be kept in the resident's record. This requirement is not met as evidenced by: Deficient Practice Statement Based on LPA record review, the licensee did not comply with the section cited above in that R1 did not have a current physician report on file which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 04/02/2026 Plan of Correction Facility to submit current physician's report for R1 by plan of correction due date.

Official classification

Type B

Official code

87109(b)

Regulation authority

CCR

What the official deficiency says

87109 Transferability of License (b)The licensee shall notify the licensing agency and all residents receiving services, or their representatives, in writing as soon as possible and in all cases at least thirty (30) days prior to the transfer of the property or business... This requirement is not met as evidenced by:Based on interview & record review, the licensee did not comply with the section cited above in the licensee did not notify Community Care Licensing within thirty (30) business days of the transfer of the facility to a Limited Liability Corporation which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

Licensee to notify CCL regarding their choice to either remove facilities form LLC or keep them in the LLC by no later than plan of correction due date 9/29/25. If they choose to keep in the LLC, licensee will provide proof to Community Care Licensing that an application has been submitted to the Centrailized Application Bureau by plan of correction due date of 10/13/2025.

Deadline recorded: Sep 29, 2025. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87211(a)

Regulation authority

CCR

What the official deficiency says

87211 Reporting Requirements (a) Each licensee shall furnish to the licensing agency such reports as the Department may require, including, but not limited to, the following: (1) A written report shall be submitted to the licensing agency and to the person responsible for the resident within seven days of the occurrence of any of the events specified in (A) through (D) below…(A) Death of any resident from any cause regardless of where the death occurred…(B) Any serious injury…(C) The use of an Automated External Defibrillator. (D) Any incident which threatens the welfare, safety or health of any resident…This requirement was not met by licensee as evidenced by: Based on LPA record review licensee failed to submit an incident report for R1’s hospitalization, which poses a potential health, safety, and personal rights risk to residents in care.

Official plan of correction

Facility to submit LIC9098 self-certifying they will submit an incident report to licensening within 7 days for any occurances outlined in regulation by plan of correction due date.

Deadline recorded: Aug 5, 2025. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87303(a)

Regulation authority

CCR

What the official deficiency says

(a) 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 LPAs/Licensee observation and interview, the licensee did not comply with the section cited above in LPAs observed fences next to the shaded area in the backyard needs to be repaired; Common area bathroom sink hose and hot water pressure need to be fixed, which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 03/13/2025 Plan of Correction Licensee agrees to perform repairs to items of concern and will submit pictures as proof of correction to CCL by POC due date 3/13/25.

Official classification

Type B

Official code

87555(b)(27)

Regulation authority

CCR

What the official deficiency says

87555 General Food Service Requirements (b) The following food service requirements shall apply: (27) All kitchen areas shall be kept clean and free of litter, rodents, vermin and insects. This requirement was not met by licensee as evidenced by: Based on LPA and LPM observed rodent droppings present in food pantry and in kitchen drawer to the right hand side of the range/oven, which poses a potential health, safety, and personal rights risk to residents in care.

Official plan of correction

Facility to submit LIC9098, service order from pest control company, and pictures of cleaned up drawer and pantry where dropping where observed by plan of correction due date.

Deadline recorded: May 6, 2024. A deadline is not proof that correction was completed.

Official classification

Type B

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 and Admin observation, the licensee did not comply with the section cited above in that the main hallway bathroom had smears of a dark brown substance in multiple places on the wall and by the toilet paper roll. LPA and Admin also observed darkened wet pieces of wood under peeling wallpaper present on frame at the bottom of the shower. Sink in main bathroom also needs repair as layers upon layers of caulking harboring a brown and orange-yellow substance. Flaking around the sink in bathroom in room #3. LPA and Admin observed front door knob not to work, the door does not latch shut. LPA and Admin observed electrical wall faceplate broken, leaving outlet exposed. which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 03/08/2024 Plan of Correction Admin to submit pictures of all repairs needed for: Main hallway bathroom had smears of a dark brown substance in multiple places on the wall and by the toilet paper roll. Flaking around the sink in bathroom in room #3 repaired. Darkened wet pieces of wood replaced, sink in main bathroom repaired, front door knob working and able to latch, electrical wall faceplate repaired.

Official classification

Type B

Official code

87303(a)(1)

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. (1) Floor surfaces in bath, laundry and kitchen areas shall be maintained in a clean, sanitary, and odorless condition. This requirement is not met as evidenced by: Deficient Practice Statement Based on LPA and Admin observation, the licensee did not comply with the section cited above in that bathroom in room #1 smelled of urine and brownish yellow pool film of a substance was located on back side of toilet, sticky and yellow film in front of toilet, and spatters of a dark substance on the wall. Also, bathroom in room #5 and room in general had strong smell of urine, 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 Admin to submit LIC9098 that all bathrooms are clean and free from urine odor.

Official classification

Type B

Official code

87303(e)(4)

Regulation authority

CCR

What the official deficiency says

(e) Water supplies and plumbing fixtures shall be maintained as follows: (4) Grab bars shall be maintained for each toilet, bathtub and shower used by residents. This requirement is not met as evidenced by: Deficient Practice Statement Based on LPA and Admin observation, the licensee did not comply with the section cited above in LPA and Admin observed bathroom in room #5 did not have grab bars, which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 03/08/2024 Plan of Correction Admin to submit picture of grab bar installed in bathroom #5 by POC due date

Official classification

Type B

Official code

87303(e)(5)

Regulation authority

CCR

What the official deficiency says

(e) Water supplies and plumbing fixtures shall be maintained as follows: (5) Non-skid mats or strips shall be used in all bathtubs and showers. This requirement is not met as evidenced by: Deficient Practice Statement Based on LPA and Admin observation, the licensee did not comply with the section cited above in that all bathrooms did not have non-skid bath mats, bathroom in room #5 had a mat but the non-skid did not work and would slide with ease once stepped onwhich poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 02/21/2024 Plan of Correction Admin to submit pictures of non-skid bath mats for each bathroom by POC due date..

Official classification

Type B

Official code

87412(a)(11)

Regulation authority

CCR

What the official deficiency says

(a) The licensee shall ensure that personnel records are maintained on the licensee, administrator and each employee. Each personnel record shall contain the following information: (11) A health screening as specified in Section 87411, Personnel Requirements - General. This requirement is not met as evidenced by: Deficient Practice Statement Based on LPA and Admin observation, the licensee did not comply with the section cited above in that S1 Health Screen not available. Per LPA interview with S1, they never completed a Health Screen. 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 Admin to submit Health Screen with TB clearance by plan of correction due date.

Official classification

Type B

Official code

1569.625(b)(1)

Regulation authority

HSC

What the official deficiency says

(1) The department shall adopt regulations to require staff members of residential care facilities for the elderly who assist residents with personal activities of daily living to receive appropriate training. This training shall consist of 40 hours of training. A staff member shall complete 20 hours, including six hours specific to dementia care, as required by subdivision (a) of Section 1569.626 and four hours specific to postural supports, restricted health conditions, and hospice care, as required by subdivision (a) of Section 1569.696, before working independently with residents. The remaining 20 hours shall include six hours specific to dementia care and shall be completed within the first four weeks of employment. The training coursework may utilize various methods of instruction, including, but not limited to, lectures, instructional videos, and interactive online courses. The additional 16 hours shall be hands-on training. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, the licensee did not comply with the section cited above in that S1 did have have all required trainingwhich 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 Admin to submit all required training for S1 by plan of correction due date.

Official classification

Type B

Official code

87507(a)

Regulation authority

CCR

What the official deficiency says

(a) The licensee shall complete an individual written admission agreement, as defined in Section 87101(a), with each resident or the resident's representative, if any. This requirement is not met as evidenced by: Deficient Practice Statement Based on LPA and Admin observation, the licensee did not comply with the section cited above in that R4 and R5 did not have admission agreement and R2's agreement not dated by either party, which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 02/21/2024 Plan of Correction Admin to submit Admin agreements for R4 and R5 as well as dates on R2's admission agreement by plan of correction due date.

Official classification

Type B

Official code

87608(a)(5)(A)

Regulation authority

CCR

What the official deficiency says

(A) A bed rail that extends from the head half the length of the bed and used only for assistance with mobility shall be allowed. This requirement is not met as evidenced by: Deficient Practice Statement Based on LPA and Admin observation, the licensee did not comply with the section cited above in tht doctor order for side rails not present for R2, R4, and R5 which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 03/08/2024 Plan of Correction Admin to submit doctor's orders for half rails for R2, R4, and R5 by plan of correction due date.

Official classification

Type B

Official code

87705(c)(5)

Regulation authority

CCR

What the official deficiency says

(c) Licensees who accept and retain residents with dementia shall be responsible for ensuring the following: (5) Each resident with dementia shall have an annual medical assessment as specified in Section 87458, Medical Assessment, and a reappraisal done at least annually, both of which shall include a reassessment of the resident's dementia care needs. This requirement is not met as evidenced by: Deficient Practice Statement Based on LPa and Admin observation, the licensee did not comply with the section cited above in that R2 and R3 did not have current Physician's report, most recent for both dated 2022 and 2019, which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 03/08/2024 Plan of Correction Admin to submit pictures of current Physician's Reports for R2 and R3 by plan of correction due date.