AA BEST CARE HOMES

Official classification

Type A

Official code

87224(a)

Regulation authority

CCR

What the official deficiency says

Type A – 87224 Eviction Procedures (a) The licensee may evict a resident for one or more of the reasons listed in Section 87224(a)(1) through (5)….Thirty (30) days written notice to the resident is required… This requirement was not met as evidenced by: Based on LPA’s record review and interviews with facility staff, the facility failed to receive R1 back from the hospital after they were discharged, without a lawful 30-day eviction letter, which poses an immediate risk to the health and safety of the resident.

Official plan of correction

The facility agrees to send a letter to CCL agreeing to comply with eviction procedure in the future and send a copy of the facility eviction procedure. Letter and facility eviction procedure to be sent to CCL by POC due date of 7/29/2026 to clear the deficiency.

Deadline recorded: Jul 29, 2026. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

1569.269(a)(5)

Regulation authority

CCR

What the official deficiency says

Type A - §1569.269 Enumerated rights; severability (a) Residents of RCFE shall have all of the following rights: (5) To be accorded safe, healthful, and comfortable accommodations, furnishings, and equipment. This requirement has not been met as evidence by: Based on LPA’s record review and interviews conducted the facility did not ensure R1 was accorded safe, healthful, and comfortable accommodations which resulted in R1 being infected with lice hair which poses an immediate health and safety risk to residents in care.

Official plan of correction

Licensee agrees to contract an outside vendor to treat all facility rooms and will submit receipt as proof of service to ensure the facility is following up on assisting resident’s needs including hygiene and grooming timely to CCL by POC due date.

Deadline recorded: Jul 8, 2026. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87303(a)

Regulation authority

CCR

What the official deficiency says

87303 Maintenance & Operation (a) The facility shall be clean, safe, sanitary and in good repair at all times. Maintenance shall include provision of maintenance services & procedures for the safety & well-being of residents, employees & visitors. This requirement has not been met as evidence by: Based on LPA’s records review and interviews conducted with the facility staff and residents (R1 & R2), the facility did not ensure R1's safety & well-being, which resulted in R1’s & R2’s shared bedroom had bedbugs, which poses an immediate health and safety risk to residents in care.

Official plan of correction

The facility will contract an outside vendor to treat all facility rooms and will submit receipt as proof of service to mitigate any potential re-occurring incident as well as a written plan describing how they will ensure the facility is offering a healthful and safe area to residents in care to CCL by POC due date. ***Civil penalties in the amount of $1000 issued for repeated violation.

Deadline recorded: Jul 8, 2026. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87465(c)(2)

Regulation authority

CCR

What the official deficiency says

(c) If the resident's physician has stated in writing that the resident is unable to determine his/her own need for nonprescription PRN medication, but can communicate his/her symptoms clearly, facility staff designated by the licensee shall be permitted to assist the resident with self-administration, provided all of the following requirements are met: (2) Once ordered by the physician the medication is given according to the physician's directions. 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 30 out of 30 residents' medications were not gven as physician's directions which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 07/08/2026 Plan of Correction Facility will contact a pharmacist consultant or nurse to ensure that all residents' medications are given as prescribed. The facility will submit a written plan including dates of when pharmacist consultant/nurse will come to review medications with staff by POC due date 7/8/26.

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 LPA's/staff observation and interview, the licensee did not comply with the section cited above in garbage cans needed to have a lid/cover in resident's bedrooms, facility walls need to be cleaned and shared bathroom mirror needs to be cleaned which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 07/21/2026 Plan of Correction Facility will provide residents' rooms with adequate garbage cans with covers to prevent the spread of any communicable disease, clean the walls and mirror by POC due date 7/21/26 and will submit pictures as proof of correction,

Official classification

Type B

Official code

1569.618(c)(3)

Regulation authority

HSC

What the official deficiency says

(c)The facility shall employ, and the administrator shall schedule, a sufficient number of staff members to do all of the following: (3) Ensure that at least one staff member who has cardiopulmonary resuscitation (CPR) training and first aid training is on duty and on the premises at all times. This paragraph shall not be construed to require staff to provide CPR. 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 staff (S2, S3 & S4) which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 07/21/2026 Plan of Correction The facility will submit self-certification (LIC9098) ensuring staff took CPR training hours by POC due date 7/21/26.

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 2 out of 4 staff (S3 & S4) which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 07/21/2026 Plan of Correction The facility staff (S3 & S4) needs to take additional training hours, the facility will submit self-certification (LIC9098) ensuring staff took additional training hours by POC due date 7/21/26.

Official classification

Type B

Official code

87555(b)(26)

Regulation authority

CCR

What the official deficiency says

(26) Supplies of nonperishable foods for a minimum of one week and perishable foods for a minimum of two days shall be maintained on the premises. 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 not having enough fruits and vegetables available for residents in care which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 07/21/2026 Plan of Correction The facility will obtain fresh fruits and vegetables and will submit receipt as proof of correction by POC due date 7/21/26.

Official classification

Type B

Official code

87465(h)(5)

Regulation authority

CCR

What the official deficiency says

(h) The following requirements shall apply to medications which are centrally stored: (5) Each resident's medication shall be stored in its originally received container. No medications shall be transferred between containers. 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 all residents' medications can't be pre-poured which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 07/21/2026 Plan of Correction The facility will conduct training with staff involved in passing medications about not to pre-pour medications and will submit training roster including date and subject to CCL by POC due date 7/21/26.

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/staff observation, interview and record review, the licensee did not comply with the section cited above in 10 out of 30 residents care plans needed to be updated which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 07/21/2026 Plan of Correction The facility will submit self-certification (LIC9098) ensuring that all residents' care plans were updated by POC due date 7/21/26.

Official classification

Type B

Official code

87507(c)

Regulation authority

CCR

What the official deficiency says

(c) Admission agreements shall be signed and dated, acknowledging the contents of the document, by the resident or the resident's representative, if any, and the licensee or the licensee's designated representative no later than seven days following admission. Attachments to the agreement may be utilized as long as they are also signed and dated as prescribed above. 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 30 out of 30 residents need to sign the addendum regarding surveillance cameras which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 07/21/2026 Plan of Correction The facility will submit self-certification (LIC9098) ensuring that residents signed and dated addendum reflecting presence of surveillance cameras by POC due date 7/21/26.

Official classification

Type B

Official code

1569.695(c)

Regulation authority

HSC

What the official deficiency says

(c) A facility shall conduct a drill at least quarterly for each shift. The type of emergency covered in a drill shall vary from quarter to quarter, taking into account different emergency scenarios. An actual evacuation of residents is not required during a drill. While a facility may provide an opportunity for residents to participate in a drill, it shall not require any resident participation. Documentation of the drills shall include the date, the type of emergency covered by the drill, and the names of staff participating in the drill. 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 by not performing disaster drills every quarter which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 07/21/2026 Plan of Correction The facility will submit self-certification (LIC9098) ensuring disaster drills are conducted every quarter by POC due date 7/21/26.

Official classification

Type A

Official code

87465

Regulation authority

CCR

What the official deficiency says

Type A – 87465 Incidental Medical & Dental Care (c) If the resident's physician has stated in writing that the resident is unable to determine his/her own need for...medication but can communicate his/her symptoms clearly, facility staff designated by the licensee shall be permitted to assist the resident with self-administration, provided all of the following requirements are met. (2) Once ordered by the physician the medication is given according to the physician's directions. This requirement has not been met as evidence by: Based on LPA’s observations, records review and interviews with S1, R1 has not been assisted with their psychiatric medications between 4/20/26 through 5/28/26, which poses an immediate risk to the health and safety of residents in care.

Official plan of correction

The administrative assistant agrees to review all residents’ medications to ensure that they have medications for all residents, then they will submit a written plan which addresses how facility will ensure compliance with 87465(c)(2) moving forward. The plan will be submitted to CCL by POC date in order to clear the deficiency.

Deadline recorded: Jun 9, 2026. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87303(a)

Regulation authority

CCR

What the official deficiency says

87303 Maintenance & Operation (a) The facility shall be clean, safe, sanitary and in good repair at all times. Maintenance shall include provision of maintenance services & procedures for the safety & well-being of residents, employees & visitors. This requirement has not been met as evidence by: Based on LPA record review and interviews conducted the facility did not ensure R1's safety & well-being, which resulted in R1 have bedbugs bite which poses an immediate health and safety risk to residents in care.

Official plan of correction

The facility will submit a written plan including treatment schedule of residents' rooms to ensure facility is offering a healthful and safe area to residents in care to CCL by POC due date. ***Civil penalties in the amount of $250 issued for repeated violation.

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

Official classification

Type A

Official code

87202(a)

Regulation authority

CCR

What the official deficiency says

Type A 87202 Fire Clearance (a) All facilities shall maintain fire clearance approved by the city, county, or city & county fire department, or district providing fire protection services, or the State Fire Marshal...This requirement was not met as evidenced by: Based on LPA’s records review and interviews with facility staff, the facility failed to ensure that smoke detectors were functioning, padlocks were not installed in exit doors, exposed electrical wiring & nonfunctional emergency lighting which poses an immediate health and safety risk to residents in care.

Official plan of correction

Administrator agrees to repair/replace areas of concern identified by third agency report and will submit pictures as proof of corrections to clear the citation. ***An immediate civil penalty of $500 is assessed at time of visit.

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

Official classification

Type A

Official code

1569.269(a)(6)

Regulation authority

CCR

What the official deficiency says

Type A §1569.269 Enumerated rights; severability (a) Residents of RCFE shall have...the following rights: (6) To care, supervision, & services that meet their individual needs & are delivered by staff that are competency to meet their needs. This requirement has not been met as evidence by: Based on LPAs record review and interview with facility staff, the facility failed to meet R1's individual care needs, R1 had two incidents of falls where on the 1st incident, R1 remained on the floor since 2am until S2 found them at 6am, then a 2nd fall resulted in R1 sustained a fracture which poses an immediate health and safety risk to residents in care.

Official plan of correction

Administrator will have training conducted focusing on resident care plans and submit to CCL planned training date by POC due date to clear the citation.

Deadline recorded: May 13, 2026. 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

Type B 87303 Maintenance & Operation (a) The facility shall be clean, safe, sanitary and in good repair at all times. Maintenance shall include provision of maintenance services & procedures for the safety and well-being of residents, employees and visitors. This requirement has not been met as evidence by: Based on LPA’s records review and interviews with facility staff, the facility failed to ensure that the facility is clean and sanitary by having mold in the bathroom’s ceiling used by residents in care and hanging excessive clothing at staff room preventing the door from opening completely which poses a potential health and safety risk to residents in care.

Official plan of correction

Administrator agrees to repair/replace areas of concern identified by third agency report and will submit pictures as proof of corrections to clear the citation.

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

Official classification

Type A

Official code

1569.269(a)(1)

Regulation authority

HSC

What the official deficiency says

Type A - §1569.269 Enumerated rights; severability (a) Residents of RCFE facilities for the elderly shall have all of the following rights: (1) To be accorded dignity in their personal relationships with staff, residents, and other persons. This requirement has not been met as evidence by: Based on interviews with residents and staff, the facility staff (S1) yells at residents resulting in residents keeping their heads down and withdrawing from conversations to prevent S1 from raising their voice at them, which poses an immediate risk to the health and safety of clients in care.

Official plan of correction

Licensee will conduct staff training ensuring all residents are always treated with dignity and respect. Licensee agrees to sign LIC9098 attesting understanding of Health and Safety Code 1569.269, Enumerated Rights by POC due date of 9/19/25.

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

Official classification

Type A

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 LPA/back up Administrator the licensee did not comply with the section cited above there were electrical face plates in the dining room exposing cables, ceiling holes are exposing cables, walls in room #6, bathroom #6 ceiling has mold, debris of bed in the backyard, corner wall in the corner of wing B needs to be repaired, wall in room #15 needs to be painted, shared bathroom #27 in wing B mirror needs to be replaced it has mold, hallway restroom in wing B floor needs to be repaired. There were insects: ants, spiders and spider webs inside of resident's bedrooms. Two window screens needs to be repaired or replaced which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 07/25/2025 Plan of Correction Licensee/administrative asst. agreed to submit pictures as proof of repairs needed were resolved to CCL by POC due date to clear the citation.

Official classification

Type A

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/Back up administrator measured water temperature in resident's bathrooms, the licensee did not comply with the section cited above inmeasured at 121.8 and 121.6 degrees F, which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 07/25/2025 Plan of Correction Facility to ensure hot water temperature is maintainted within regulation of 105 to 120 F. Facility to submit a LIC 9098 self certification that hot water has been adjusted to be within regulation by POC date & initiate monitoring for the next 7 days.

Official classification

Type B

Official code

1569.618(c)(3)

Regulation authority

HSC

What the official deficiency says

(c)The facility shall employ, and the administrator shall schedule, a sufficient number of staff members to do all of the following: (3) Ensure that at least one staff member who has cardiopulmonary resuscitation (CPR) training and first aid training is on duty and on the premises at all times. This paragraph shall not be construed to require staff to provide CPR. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation and record review, the licensee did not comply with the section cited above in that staff member (S1, S2, S3 & S4) did not have current First Aid or CPR certification on file which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 07/31/2025 Plan of Correction Licensee to obtain 1st Aid/CPR certification for staff members (S1, S2, S3 & S4). Facility to submit LIC9098 form ensuring compliance with regulation to CCL by POC due 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/Licensee observation, interview and record review, the licensee did not comply with the section cited above in 9 out of 9 residents (R1, R2, R3, R4, R5, R6, R7, R8 & R9) needs their care plan to be updated, which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 07/31/2025 Plan of Correction Licensee to update and complete resident's Needs & Services Plan, with appropriate signatures of Licensee and Resident or resident's responsible party. Facility to submit LIC9098 form ensuring compliance with regulation to CCL by POC due date.

Official classification

Type B

Official code

1569.695(a)(2)

Regulation authority

HSC

What the official deficiency says

(a)In addition to any other requirement of this chapter, a residential care facility for the elderly shall have an emergency and disaster plan that shall include, but not be limited to, all of the following: (2) Plans for the facility to be self-reliant for a period of not less than 72 hours immediately following any emergency or disaster, including, but not limited to, a short-term or long-term power failure. If the facility plans to shelter in place and one or more utilities, including water, sewer, gas, or electricity, is not available, the facility shall have a plan and supplies available to provide alternative resources during an outage. This requirement is not met as evidenced by: Deficient Practice Statement Based on record review, the licensee did not comply with the section cited above in that the facility is not conducting fire and emergency drills per regulation with the last disaster drill having taken place in July, 2024 which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 07/31/2025 Plan of Correction Licensee to conduct a disaster drill every quarter as stated per regulation. Facility to submit LIC9098 form ensuring compliance with regulation to CCL by POC due date.

Official classification

Type B

Official code

87156(b)(1)(F)

Regulation authority

HSC

What the official deficiency says

87156(b)(1)(F) Licensing Fees. In addition to fee set forth in subdivision , the department shall charge the following.. licensee fails to pay the annual licensing fee on or before the due date as indicated by postmark on the payment. This requirement is not met as evidenced by: Deficient Practice Statement Based on records review, the licensee did not comply with the section cited above in not paying the annual fee. As of 7/24/2025, licensing fees and late fees equals a total of $1,238.00 which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 07/31/2025 Plan of Correction The licensee shall pay the annual fee and then submit LIC9098 ensuring the annual fees are paid to CCL by POC due date.

Official classification

Type A

Official code

87465(c)(2)

Regulation authority

CCR

What the official deficiency says

Type A – 87465 Incidental Medical and Dental Care (c) If the resident's physician has stated in writing that the resident is unable to determine his/her own need for nonprescription PRN medication but can communicate his/her symptoms clearly, facility staff designated by the licensee shall be permitted to assist the resident with self-administration, provided all of the following requirements are met. (2) Once ordered by the physician the medication is given according to the physician's directions. This requirement has not been met as evidence by: Based on LPA’s observations, records review and interviews with Administrative Assistant, R1 has not been assisted with their psychiatric medications since 12/17/24, which poses an immediate risk to the health and safety of residents in care.

Official plan of correction

Administration to submit written plan which addresses how facility will ensure compliance with 87465(c)(2) going forward. To be submitted to CCL by POC date in order to clear the deficiency.

Deadline recorded: Apr 11, 2025. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

1569.269(a)(5)

Regulation authority

HSC

What the official deficiency says

Type A §1569.269 Enumerated rights; severability (a) Residents of RCFE shall have all of the following rights: (5) To be accorded safe, healthful, and comfortable accommodations, furnishings, and equipment. This requirement has not been met as evidence by: Based on LPA record review and interviews conducted the facility did not ensure R1 was accorded safe, healthful, and comfortable accommodations which resulted in R1 have a bug infestation which poses an immediate health and safety risk to residents in care.

Official plan of correction

Licensee agrees to contract a pest control vendor to come to the facility to treat all resident’s rooms to ensure facility is offering a healthful and safe area to residents in care. Licensee will submit receipts as proof of service to CCL by POC due date.

Deadline recorded: Apr 11, 2025. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87405(a)

Regulation authority

CCR

What the official deficiency says

87405 Administrator - Qualifications and Duties 87405 (a) All facilities shall have a qualified and currently certified administrator. This requirement is not met as evidenced by: Based on LPA's/Licensee observation, interviews and record review, the licensee did not comply with the section cited above in that Licensee/Administrator keeps failing to follow up with the Department Certification Unit, which poses an immediate health, safety, or personal rights risk to persons in care.

Official plan of correction

Licensee will appoint a certified administrator for this facility and will submit required documentation to perform this change to the Department by POC due date 2/28/25. Licensee have been informed that if they don't comply with regulations civil penalties will be warrant until this issue gets resolved. A civil penalty in the amount of $250 issued.

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

Official classification

Type A

Official code

1569.269(a)(5)

Regulation authority

CCR

What the official deficiency says

§1569.269 Enumerated rights; severability (a) Residents of RCFE shall have all of the following rights: (5) To be accorded safe, healthful, and comfortable accommodations, furnishings, and equipment. This requirement has not been met as evidence by: Based on LPA record review and interviews conducted the facility did not ensure R1 was accorded safe, healthful, and comfortable accommodations which resulted in R1 have a bug infestation which poses an immediate health and safety risk to residents in care.

Official plan of correction

Licensee agrees to submit a plan/schedule to ensure facility is following up on resident’s needs, observation of the resident and treating all resident's rooms timely to CCL by POC due date. ** Civil Penalty assessed in the amount of $250.

Deadline recorded: Feb 14, 2025. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87405(a)

Regulation authority

CCR

What the official deficiency says

87405 Administrator - Qualifications and Duties 87405 (a) All facilities shall have a qualified and currently certified administrator. This requirement is not met as evidenced by: Based on LPA's/Licensee observation, interviews and record review, the licensee did not comply with the section cited above in that Licensee/Administrator Nick Aquino does not have a certified administrator from CCL, which poses a immediate health, safety or personal rights risk to persons in care.

Official plan of correction

Licensee will appoint a certified administrator for this facility and will submit required documentation to perform this change to the Department by POC due date 12/16/24. Licensee have been informed that if they don't comply with regulations civil penalties will be warrant until this issue gets resolved.

Deadline recorded: Dec 16, 2024. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

1569.269(a)(5)

Regulation authority

HSC

What the official deficiency says

§1569.269 Enumerated rights; severability (a) Residents of RCFE shall have all of the following rights: (5) To be accorded safe, healthful, and comfortable accommodations, furnishings, and equipment. This requirement has not been met as evidence by: Based on LPA record review and interviews conducted the facility did not ensure R1 was accorded safe, healthful, and comfortable accommodations which resulted in R1 sustained extreme matted, and lice infested hair which poses an immediate health and safety risk to residents in care.

Official plan of correction

Licensee/Administrator agrees to submit a plan/schedule to ensure facility is following up on assisting resident’s needs including hygiene and grooming timely to CCL by POC due date. **Immediate Civil Penalty assessed in the amount of $250.

Deadline recorded: Aug 30, 2024. A deadline is not proof that correction was completed.

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's/Admin Asst. observation, interview and record review, the licensee did not comply with the section cited above in bathroom #2 windowsill have paint bubbles need to be cleaned; bathroom #1 sink needs to be cleaned; Resident's room (room # 10, 11, 13 and 17) window screens are missing. Face plate needs to be replaced in room #10, which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 07/24/2024 Plan of Correction Licensee/administrative asst. agreed to submit pictures as proof of repairs needed were resolved to CCL by POC due date to clear the citation.

Official classification

Type A

Official code

87405(d)

Regulation authority

CCR

What the official deficiency says

(d) 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. This requirement is not met as evidenced by: Deficient Practice Statement Based on LPA's/acting administrator observation, records review and interview, the licensee did not comply with the section cited above by not obtaining a valid administrator certification after informal meeting conducted on 6/28/23 with the Department or appointing an individual who had a valid administrator certificate, which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 07/24/2024 Plan of Correction Licensee agreed to submit supporting documentation to the Department's certification unit and will send proof of submission to CCL by POC due date to clear the citation. The Department will be reviewing the information obtained to determine if further actions are needed.

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/Administrative Asst observation, interview and record review, the licensee did not comply with the section cited above in four out of four staff have not completed their additional 20 hours annually, which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 08/13/2024 Plan of Correction Licensee agreed to have all staff complete required 20 hours annual training. Licensee will submit a self-certification form (LIC9098) to CCL ensuring that staff have completed required annual training hours. LPA will return to review training records.

Official classification

Type B

Official code

1569.695(c)

Regulation authority

HSC

What the official deficiency says

(c) A facility shall conduct a drill at least quarterly for each shift. The type of emergency covered in a drill shall vary from quarter to quarter, taking into account different emergency scenarios. An actual evacuation of residents is not required during a drill. While a facility may provide an opportunity for residents to participate in a drill, it shall not require any resident participation. Documentation of the drills shall include the date, the type of emergency covered by the drill, and the names of staff participating in the drill. This requirement is not met as evidenced by: Deficient Practice Statement Based on LPA's/Administrative Asst observation, interview and record review, the licensee did not comply with the section cited above by not conducting a drill at least quarterly for each shift, which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 08/13/2024 Plan of Correction Licensee/Admin Asst agreed to perform a disaster drill at least quarterly for each shift. Licensee will submit a self-certification form (LIC9098) to CCL ensuring that staff have completed required annual training hours.

Official classification

Type A

Official code

1569.269(a)(5)

Regulation authority

CCR

What the official deficiency says

Type A §1569.269 Enumerated rights; severability (a) Residents of RCFE shall have all of the following rights: (5) To be accorded safe, healthful, and comfortable accommodations, furnishings, and equipment. This requirement has not been met as evidence by: Based on LPA record review and interviews conducted the facility did not ensure R1 was accorded safe, healthful and comfortable accommodations which resulted in R1 and R2 sustaining injuries which poses an immediate health and safety risk to residents in care.

Official plan of correction

Licensee/Administrator agrees to submit a plan/schedule to ensure facility is following up on resident’s needs, observation of the resident and treating all resident's rooms timely to CCL by POC due date.

Deadline recorded: May 22, 2024. A deadline is not proof that correction was completed.

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: Based on observation, the licensee did not comply with the section cited above because LPA/staff observed one resident's bedroom door was missing, which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

Licensee agreed to repair the door to ensure resident's privacy. Licensee will submit self-certification LIC9098 form along with picture to indicate that repairs are within CCL regulations by POC due date. *civil penalties are issued for repeated violation in the amount of $250.

Deadline recorded: Dec 9, 2023. A deadline is not proof that correction was completed.

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 observation, the licensee did not comply with the section cited above because LPA/staff observed one out of four bathrooms used by residents located in wing " A " had a urine smell, ceiling in the bathtub area was peeling off, the bathtub was dirty and unsanitary including curtain that needs to be replaced, which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 07/21/2023 Plan of Correction Licensee agreed to repair items that were dirty including, curtain, bathtub area and ceiling, staff cleaned the bathroom during LPA inspection. Licensee/Administrator will submit self-certification LIC9098 form along with pictures to indicate that repairs are within CCL regulations by POC due date. LPA will return to inspect areas of concerns.

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 observation, interview and record review, the licensee did not comply with the section cited above in 3 out of 6 staff have not complete 20 additional hours training requirements, which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 07/24/2023 Plan of Correction Licensee/Administrator agreed to have staff complete training and send to CCL with form LIC9098 by POC due date to clear deficiency.

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 ***duplicate. Citation already issued under CCR 87465 (h)(6)

Official plan of correction

POC Due Date: 07/24/2023 Plan of Correction ***duplicate. Citation already issued under CCR 87465 (h)(6)

Official classification

Type B

Official code

87465(h)(5)

Regulation authority

CCR

What the official deficiency says

(h) The following requirements shall apply to medications which are centrally stored: (5) Each resident's medication shall be stored in its originally received container. No medications shall be transferred between containers. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, the licensee did not comply with the section cited above by having the evening medications already poured and being stored in a separate container, which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 07/24/2023 Plan of Correction Facility will stop pre-pouring medications immediately and submit self-certification that medication will be stored in it's original container per regulation by POC due date 7/24/2023.

Official classification

Type B

Official code

87465(h)(6)

Regulation authority

CCR

What the official deficiency says

87465 (h) The following requirements shall apply to medications which are centrally stored: (6) The licensee shall be responsible for assuring that a record of centrally stored prescription medications for each resident is maintained for at least one year and includes: (A) The name of the resident for whom prescribed. (B) The name of the prescribing physician. (C) The drug name, strength and quantity. (D) The date filled. (E) The prescription number and the name of the issuing pharmacy. This requirement is not met as evidenced by: Deficient Practice Statement Based on record review, the licensee did not comply with the section cited above by not maintaining a 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: 07/24/2023 Plan of Correction Facility to review and update the Centrally Stored Medication Log by POC due date, 7/24/2023. LPA will return to review.

Official classification

Type B

Official code

87463(c)

Regulation authority

CCR

What the official deficiency says

87463(c) Reappraisals- (c)The licensee shall arrange a meeting with the resident, the resident’s representative... when there is significant change in the resident’s condition, or once every 12 months, whichever occurs first... This requirement has not been met as evidenced by: Based on LPA/Administrator's file review showing that resident's care plans for 2 out of 2 residents (R1 & R2) were not been performed and signed by the resident of their representative within last 12 months. This is a potential risk to the health and safety of residents in care.

Official plan of correction

Administrator agreed to review all resident's care plans, update them accordingly and send self-certification that this process had been done to CCL by POC due date.

Deadline recorded: Apr 17, 2023. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87470(a)(2)

Regulation authority

CCR

What the official deficiency says

Type A 87470 Infection Control Requirements. A licensee shall ensure that inf. control practices are maintained as follows: a) when 1 or more residents in the facility are diagnosed with a communicable disease...: (2) All staff providing direct care to a resident who has a communicable disease shall wear appropriate PPE...This req has not met as evidence by Based on observations made during a tele-visit on 5/5/22 with Administrator did not ensure to follow their current Mitigation Plan dated 1/14/21 and were observed not wearing a mask after one or more residents in the facility were diagnosed with a communicable disease which poses an immediate risk to the health and safety of residents in care.

Official plan of correction

Administrator agrees to retrain all staff and submit self-certification LIC9098 as proof of staff were notified and will be trained on proper PPE wearing as stated on their current mitigation plan by POC due date.

Deadline recorded: Jun 14, 2022. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87465(e)(1)(C)

Regulation authority

CCR

What the official deficiency says

Type B 87465 Incidental Medical and Dental Care (e) For every prescription & nonprescription PRN med…there shall be a signed, dated written order from a physician maintained in the residents file, & label on the med.1)Meds shall be centrally stored...: (C) Because of potential dangers related to the med itself & to be a safety hazard to others. This requirement has not been met as evidence by: Based on records review and interviews conducted with Administrator, the facility did not ensure that two out of four residents that smoke marijuana in the facility obtained a doctor’s order prior to be used by residents which poses a potential risk to the health and safety of residents in care.

Official plan of correction

Administrator will update doctor’s order for two out of four residents that smoke marijuana in the designated place in the facility and will centrally store the prescribed drug. Administrator will submit proof of doctor’s order on file by POC due date.

Deadline recorded: Jun 27, 2022. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87355(e)(1)

Regulation authority

CCR

What the official deficiency says

87355 Criminal Record Clearance (e)All individuals... shall prior to working, residing or volunteering in a licensed facility: (1)Obtain a California clearance or a criminal record exemption as required by the Dpt...This requirement is not met as evidenced by: Deficient Practice Statement Based on LPA observation, record review and interview with Licensee did not ensure to obtain a criminal record clearance for individual (I1) prior to work, reside or provide care to residents in care which poses an immediate health, safety and personal rights risk to residents in care. ***Civil Penalty is being assessed for the amount of $100 per day.

Official plan of correction

POC Due Date: 06/14/2022 Plan of Correction Licensee removed individual (I1) from the facility until I1 has a clearance as required by regulation. Licensee will associate individual and will submit a LIC9098 self-certification that I1 was removed from facility to CCL by POC due date.

Official classification

Type A

Official code

87555(a)(8)(28)

Regulation authority

CCR

What the official deficiency says

General Food Service Requirements (a)(8(28) All food shall be of good quality. Commercial foods shall be approved by appropriate federal, state and local authorities. Food in damaged containers shall not be accepted, used or retained. All food shall be protected against contamination. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation and interviews conducted with Licensee, the facility did not ensured that expired food located in the pantry closet and in the refrigerator was discarded which is an immediate health and safety risk to residents in care.

Official plan of correction

POC Due Date: 06/14/2022 Plan of Correction Licensee/Administrator to submit a written plan of maintenance regarding ensuring all food is of good quality at all times-and refrigerator is checked regularly for this. Licensee/Administrator to check refrigerator and discard any expired food and submit written confirmation of doing this by POC due date.

Official classification

Type A

Official code

87465(h)(6)(D)

Regulation authority

CCR

What the official deficiency says

87465 (h)(6)(D) Incidental Medical & Dental Care.The following requirements shall apply to medications which are centrally stored: (6) The licensee shall be responsible for assuring that a record of centrally stored prescription medications for each resident is maintained for at least 1 yr & includes: (D) The date filled. This requirement has not been met as evidence by: Based on observation, records review & interviews with staff, Licensee did not ensure proper management of medication. LPA/Licensee conducted a medication audit & found multiple medication errors for R1's meds which poses an immediate health & safety risk to resident in care.

Official plan of correction

Licensee agrees to conduct a medication audit for all residents, retrain staff on medication management from an outside vendor & will write a plan to ensure resident medications are logged into the Centrally Stored Medication Records daily. Licensee to submit the updated plan to CCL by POC due date 9/3/21. Civil Penalties issued today in the amount of $250.00

Deadline recorded: Sep 3, 2021. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

80072(a)(2)

Regulation authority

CCR

What the official deficiency says

80072 Personal Rights (a)... residential facilities, each client shall have personal rights which include, but are not limited to, the following: (2) To be accorded safe, healthful and comfortable accommodations, furnishings and equipment to meet his/her needs. This requirement has not been met as evidence by: Based on interviews and record review, Licensee did not ensure the personal rights of persons in care to safe & health accomodations. Staff did not screen LPA for Covid19 symptoms to prevent entry of possible infected persons and to be in compliance with CCL guidelines which poses/posed an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

Licensee/Administrator will ensure Personal Rights of residents are maintained. Licensee agrees to submit proof of training for all staff to conduct screening of all visitors for Covid19 symptoms to CCL by close of business 9/3/2021.

Deadline recorded: Sep 3, 2021. A deadline is not proof that correction was completed.