BUCKINGHAM RESIDENTIAL CARE HOME

Official classification

Type B

Official code

87411(c)(1)

Regulation authority

CCR

What the official deficiency says

(1) Staff providing care shall receive appropriate training in first aid from persons qualified by such agencies as the American Red Cross. 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 one (1) of four (4) staff members (for staff member S1) has an expired First Aid certification which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 01/16/2026 Plan of Correction Licensee will submit proof that staff member S1 has a received a valid First Aid certification to Community Care Licensing (CCL) by POC due sate of 1/16/2025.

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 interview and record review, the licensee did not comply with the section cited above in that there is no Emergency Disaster Drill log at the facility to prove that Emergency Disaster Drills are being conducted quarterly which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 01/16/2026 Plan of Correction Licensee will submit an LIC 9098 Self Certification stating that going forward the facility will conduct quarterly Emergency Disaster Drills. Licensee will also submit an Emergency Disaster Drill log showing that an Emergency Disaster Drill has been conducted after inspection date of 12/19/2025. The two (2) items are to be submitted to CCL by POC due date of 1/16/2025.

Official classification

Type B

Official code

87412(a)

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: This requirement is not met as evidenced by: Deficient Practice Statement Based on record review, LPA observed that S1 did not have a complete LIC 501 Personnel Record. The second (2nd) page was missing. LPA further observed that S2's LIC 501 Personnel Record was not signed. The licensee did not comply with the section cited above in that two (2) Personnel records did not have required documentation which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 02/11/2025 Plan of Correction Administrator will submit to Community Care Licensing (CCL) the completed LIC 501 Personnel records for S1 and S2 by POC Due Date of 2/11/2025. Administrator will self certify that she has reviewed all employee files to ensure that they are in compliance with regulations by the POC Due date of 2/11/2025.

Official classification

Type B

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 observation and record review, the licensee did not comply with the section cited above in that S3 was not associated with the facility in the Guardian Background Check system. S3 did have background clearance but was not associated to the facility.

Official plan of correction

POC Due Date: 02/11/2025 Plan of Correction Administrator will self certify that S3 will not work in the facility until S3 has been properly associated to the facility in the Guardian back ground check system. Administrator will provide CCL with the self certification by POC Due Date of 2/11/2025.

Official classification

Type A

Official code

87355(e)(2)

Regulation authority

CCR

What the official deficiency says

Criminal Record Clearance. 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: Request a transfer of a criminal record clearance as specified in Section 87355(c)... This requirement has not been met as evidenced by: Based upon statements and record review, S1 who is not associated to the facility and has been working as caregiver at facility. This poses an immediate risk to the safety and personal rights of the residents in care.

Official plan of correction

Administration shall remove S1 from the facility or associate S1 to the facility as required by Title Twenty Two regulations. Proof of compliance due to CCL by POC date in order to clear the deficiency.

Deadline recorded: Nov 7, 2022. A deadline is not proof that correction was completed.