Fire safety and emergency preparednessType B
- Official classification
- Type B
- Official code
- 87202(a)(2)
- 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: (2) Bedridden persons 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 one (1) of six (6) residents LIC 602A Physician's Report (for resident R3) was observed to have their ambulatory status marked as Bedridden. The Facility is not currently licensed to accept Bedridden residents. which poses a potential health, safety or personal rights risk to persons in care.
Official plan of correction
POC Due Date: 06/17/2026 Plan of Correction Licensee to Submit an LIC 200 and Updated facility drawings requesting bedridden status for their residents. LIC 200 to state how many bedridden residents the facility wants to retain. Documents to be submitted to Community Care Licensing (CCL) by POC due date of 6/17/2026.
Hazardous items and storageType B
- 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 toxins were observed unsecured in the shower room, kitchen, bathroom in room #9 and the bathroom between rooms #10 & #11. which poses a potential health, safety or personal rights risk to persons in care.
Official plan of correction
POC Due Date: 06/17/2026 Plan of Correction Licensee to submit an LIC 9098 Self Certification stated that going forward all toxins will be kept secured to CCL by POC due date of 6/17/2026.
Admission, assessment, and evictionType B
- Official classification
- Type B
- Official code
- 87456(a)(2)
- Regulation authority
- CCR
What the official deficiency says
(a) Prior to accepting a resident for care and in order to evaluate his/her suitability, the facility shall, as specified in this article 8: (2) Perform a pre-admission appraisal. 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 five (5) of six (6) resident files (for residents R1, R2, R3, R4 and R5) were observed not to have LIC 603 Preplacement Appraisal Forms which poses a potential health, safety or personal rights risk to persons in care.
Official plan of correction
POC Due Date: 06/17/2026 Plan of Correction Licensee to submit completed and signed LIC 603 Preplacement Appraisals for residents R1, R2, R3, R4 and R5 to Community Care Licensing by POC due date of 6/17/2026.