GRANADA MANOR

Official classification

Type A

Official code

87465(h)(2)

Regulation authority

CCR

What the official deficiency says

(h) The following requirements shall apply to medications which are centrally stored: (2) Centrally stored medicines shall be kept in a safe and locked place that is not accessible to persons other than employees responsible for the supervision of the centrally stored medication. 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 multiple prescription medications were unsecured in the front living room area which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 11/25/2025 Plan of Correction Licensee or Administrator will submit an LIC 9098 Self certifying that all medications in the facility will be kept secured in the future to Community Care Licensing (CCL) by the POC due date of 11/25/2025. Additionally, Licensee or administrator will submit proof of all staff having taken medication management training to CCL by 12/15/2025.

Official classification

Type B

Official code

87202(a)

Regulation authority

CCR

What the official deficiency says

(a) All facilities shall maintain a fire clearance approved by the city, county, or city and county fire department or district providing fire protection services, or the State Fire Marshal. Prior to accepting or retaining any of the following types of persons, the applicant or licensee shall notify the licensing agency and obtain an appropriate fire clearance approved by the city, county, or city and county fire department or district providing fire protection services, or the State Fire Marshal: This requirement is not met as evidenced by: Deficient Practice Statement Based on observation & record review, the licensee did not comply with the section cited above in that the licensee did not submit an updated LIC 999 Facility Sketch showing two (2) separate rooms in the garage to Community Care Licensing (CCL) so that a Fire Inspection can be scheduled to approve the added room which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 12/15/2025 Plan of Correction Licensee or Administrator to submit an update LIC 999 Facility sketch showing two (2) separate rooms in the garage to Community Care Licensing (CCL) so that a Fire Inspection can be scheduled to approve the added room by POC due date of 12/15/2025.

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 & record review, the licensee did not comply with the section cited above in that three (3) of five (5) staff members (S1, S2 & S3) did not have proof of current year annual training in their personal files which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 12/15/2025 Plan of Correction Licensee or Administrator to submit proof that staff members S1, S2 and S3 have begun their annual training to Community Care Licensing by POC due date of 12/15/2025.

Official classification

Type B

Official code

87555(b)(8)

Regulation authority

CCR

What the official deficiency says

(b) The following food service requirements shall apply: (8) 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. 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 multiple canned and dry food products in the pantry had passed their expiration dates which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 12/15/2025 Plan of Correction Licensee or Administrator will submit an LIC 9098 Proof of Correction self certifying that all expired food products in the facility have been disposed to Community Care Licensing by POC due date of 12/15/2025.

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 observation, the licensee did not comply with the section cited above in that unsecured toxins were observed in the front living room and the staff room next to the front living room which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 12/15/2025 Plan of Correction Licensee or Administrator will submit an LIC 9098 Proof of Correction self certifying that all toxins in the facility have been secured. Additionally, the licensee will send a photograph of lock added to door of staff room if toxins are not removed from that room. All items to be submitted to Community Care Licensing by the POC due date of 12/15/2025.

Official classification

Type A

Official code

87202(a)

Regulation authority

CCR

What the official deficiency says

(a) All facilities shall maintain a fire clearance approved by the city, county, or city and county fire department or district providing fire protection services, or the State Fire Marshal. Prior to accepting or retaining any of the following types of persons, the applicant or licensee shall notify the licensing agency and obtain an appropriate fire clearance approved by the city, county, or city and county fire department or district providing fire protection services, or the State Fire Marshal: This requirement is not met as evidenced by: Deficient Practice Statement Based on LPA observation, the licensee did not comply with the section cited above in that Emergency fire exit path on right facing side of the facility is blocked by multiple items and obstructed, which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 11/19/2024 Plan of Correction Facility to submit photos of cleared emergency fire exit path on right facing side of the facility by plan of correction due date.

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 observation, the licensee did not comply with the section cited above in that ramp on deck leading to grass has a soft spot and is broken/worn through, tree house and ladder on tree in backyard is not secured, must be made inaccessible to residents, dead insects found in the window sills of bedrooms #1 and #2, which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 11/19/2024 Plan of Correction Facility to submit plan to make tree house inaccessible to residents, ramp repaired, and dead insects removed from window sills. Facility to submit photo of window sills that are free of insects by plan of correction due date. Tree house inaccessible to residents must be completed no later than 11/25/24. Deck ramp must be repaired no later than 12/2/24

Official classification

Type A

Official code

87307(d)(6)

Regulation authority

CCR

What the official deficiency says

(6) All outdoor and indoor passageways and stairways shall be kept free of obstruction. This requirement is not met as evidenced by: Deficient Practice Statement Based on LPA observation, the licensee did not comply with the section cited above in that passageways were blocked due to walkers present and blocking, poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 11/19/2024 Plan of Correction Facility to submit LIC9098 self-certifying that passageways will remain free from obstruction by plan of correction due date.

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 observation and record review, the licensee did not comply with the section cited above in that S1 and S2 did not have current 1st Aid/CPR certification, which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 12/02/2024 Plan of Correction Facility to submit to CCL current 1st Aid/CPR certification for S1 and S2 by plan of correction due date.

Official classification

Type B

Official code

87219(h)

Regulation authority

CCR

What the official deficiency says

(h) Facilities shall provide sufficient space to accommodate both indoor and outdoor activities. Activities shall be encouraged by provision of: This requirement is not met as evidenced by: Deficient Practice Statement Based on LPA observation, the licensee did not comply with the section cited above in that the only indoor area accessible to residents for activiies and for recreation does not provide sufficientt space for residents to use for activities and leisure, which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 11/25/2024 Plan of Correction Facility to submit plan to CCL for approval of how they will make the facility living room accessible to residents to use for visititaion, activities, and lesiure by plan of correction due date. If plan is approved, implementaion of plan to be completed no later than 12/9/2024.

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 observation, the licensee did not comply with the section cited above in R1 and R2 did not have current appraisal, which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 11/25/2024 Plan of Correction Facility to submit to CCL current appraisal signed by all parties for R1 and R2 by plan of correction due date.

Official classification

Type B

Official code

87705(c)(7)

Regulation authority

CCR

What the official deficiency says

(c) Licensees who accept and retain residents with dementia shall be responsible for ensuring the following: (7) An activity program shall address the needs and limitations of residents with dementia and include large motor activities and perceptual and sensory stimulation. This requirement is not met as evidenced by: Deficient Practice Statement Based on LPA observation, the licensee did not comply with the section cited above in that activities are not provided in compliance with regulation, which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 11/25/2024 Plan of Correction Facility to submit activity program that meets the above regulation requirements to CCL by plan of correction due date. The program shall address specific activities that address the needs and limitations of residents with dementia and include large motor activities and perceptual and sensory stimulation. The plan for the program to be sumitted to CCL for approval by plan of correction due date.

Official classification

Type B

Official code

87307(a)(2)

Regulation authority

CCR

What the official deficiency says

87307(a)(2)B) Personal Accommodations and Services - No room commonly used for other purposes shall be used as a sleeping room for any resident. This includes any hall, stairway, unfinished attic, garage storage area, shed or similar detached building. This requirement is not met as evidenced by: Based on LPA and Administrator interview, the licensee did not comply with the section cited above as resident (NCR1) is currently using room designated as living room as a sleeping room, which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

Facility to submit updated facility sketch with room currently designated as living room updated to show it is a sleeping room for NCR1. Facility to submit by POC date of 12/20/2023. Once updated facility sketch received, CCLD will submit request for fire clearance.

Deadline recorded: Dec 20, 2023. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87411(c)

Regulation authority

CCR

What the official deficiency says

87411(c) All RCFE staff who assist residents with personal activities of daily living shall receive initial and annual training as specified in Health and Safety Code sections 1569.625 and 1569.69. This requirement is not met as evidenced by: Based on LPA and Administrator interview, Licensee provides care to residents but has not completed required trainings. Required trainings not current.

Official plan of correction

Administrator to provide proof of completed required trainings for Licensee, Clayton Anderson by POC due date of 01/03/2023.

Deadline recorded: Jan 3, 2024. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87705(c)(4)(A)

Regulation authority

CCR

What the official deficiency says

87705(c)(4)(A)Care of Persons with Dementia Licensees who retain residents with dementia shall be responsible for ensuring the following:...have at least one night staff person awake and on duty... This requirement is not met as evidenced by: Based on LPA and Administrator interview the only staff currently working with residents are herself and Clayton Anderson, Licensee. Administrator confirmed there are no overnight awake staff currently working.

Official plan of correction

Administrator to hire staff, ensuring at least one night staff person is awake and on duty. Administrator to provide proof to CCLD that hired staff has completed all required trainings, obtained background and fingerprint clearance, and are associated to the facility before working with clients in any capacity. Proof to be submitted by POC due date of 1/9/2023.

Deadline recorded: Jan 9, 2024. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87705(5)

Regulation authority

CCR

What the official deficiency says

87705 Care of Persons with Dementia 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: R1, R2, and R3 all have dementia diagnosis but their LIC602 are not current within 12 months Deficient Practice Statement Based on LPA and Administrator record review, the licensee did not comply with the section cited above in [3] out of [5] resident records with a diagnosis of dementia, which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 11/28/2023 Plan of Correction Adminsitrator agrees to request each resident, with a diagnosis of dementia, have a current LIC602 updated/brought current by POC due date of 11/28/2023.

Official classification

Type A

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… ***This requirement has not been met as evidenced by: Based upon observations and statements made, the front porch railing is in disrepair in that the railing is loose. This poses an immediate risk to the residents in care.

Official plan of correction

Cleared at time of visit. Licensee has made repairs to the railing which is now fully functional.

Deadline recorded: Sep 9, 2021. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87468.1(a)(1)

Regulation authority

CCR

What the official deficiency says

87468.1(a)(1) PERSONAL RIGHTS OF RESIDENTS. Residents in all residential care facilities for the elderly shall have all of the following personal rights: (1)To be accorded dignity in their personal relationships with staff, residents, and other persons. ***Based upon statements made, this requirement has not been met as evidenced by: Residents state that the residents are told to go to bed at 8:00 or 8:30 each night by staff. This is an immediate violation of the residents’ personal rights.

Official plan of correction

Administrator shall immediately cease the practice of requiring residents to retire at 8:00 or 8:30 at night and will train staff in the requirements of 87468 regulation. Any proposed rules or schedules addressing resident bedtimes or evening schedules should be submitted to CCL in proposal form as a requested amendment to the Program Plan. Staff training proof to be submitted by POC date in order to clear the deficiency.

Deadline recorded: Sep 6, 2021. A deadline is not proof that correction was completed.