WINDSOR GOLDEN LIVING

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 the door to the garage in Bedroom #1 was unlocked. Within the garage were unsecured toxins which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 12/01/2025 Plan of Correction Licensee will submit an LIC 9098 Proof of Correction form self certifying that the door to the garage in Bedroom #1 will be locked at all times to Community Care Licensing by POC due date of 12/1/2025.

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 observation, the licensee did not comply with the section cited above in that two (2) of four (4) staff members (S1 and S2) did not have an LIC 503 Health Screening document which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 12/01/2025 Plan of Correction Licensee to submit valid LIC 503 Health Screening documentation for staff members S1 and S2 to Community Care Licensing by POC due date of 12/1/2025.

Official classification

Type A

Official code

87411(c)(1)

Regulation authority

CCR

What the official deficiency says

87411(c )(1) Personnel Requirements – General- 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 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 Per record reviews, three (3) out of four (4) staff lacked first aid as required. S3 is a direct caregiver, and is a staff that has been on their own working with residents in care. LPA observed this upon arriving to the facility today, 12/9/24., the licensee did not comply with the section cited above in [1] out of [4] staff, which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 12/10/2024 Plan of Correction Licensee/Administrator to ensure S3 obtains first aid certification, as well as cpr, as required by regulation. Ensure that S3 is not left alone with residents in care until receiving recertification as requested above. Submit copy of first aid and cpr certification of S3 by POC due date of 12/10/24.

Official classification

Type B

Official code

87468.1(a)(9)

Regulation authority

CCR

What the official deficiency says

87468.1 Personal Rights of Residents in All Facilities (a) Residents in all residential care facilities for the elderly shall have all of the following personal rights: (9) To have communications to the licensee from their representatives answered promptly and appropriately. This requirement was not met as evidenced by: Based on interviews, the Licensee did not ensure responsible party was adequately communicated with regarding the level of care change and status of the eviction. This is an immediate risk to personal rights of residents in care.

Official plan of correction

Licensee agrees to submit a policy regarding how they will effectively communicate with residents and their responsible parties per regulation by POC due date, 9/2/2022.

Deadline recorded: Sep 2, 2022. 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

87303 Maintenance and Operation (a) The facility shall be clean, safe, sanitary and in good repair at all times. This requirement was not met as evidenced by: Based on interviews and review of picture, the Licensee did not ensure residents are safe by ensuring that the door to the laundry room is closed. This is a potential risk to health and safety of residents in care.

Official plan of correction

Licensee has changed the lock on the door and spoken with staff regarding closing and locking the door. Deficiency is cleared.

Deadline recorded: Sep 5, 2022. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87411(a)

Regulation authority

CCR

What the official deficiency says

87411 Personnel Requirements – General- (a) Facility personnel shall at all times be sufficient in numbers, and competent to provide the services necessary to meet resident needs. This requirement was not met as evidenced by: Based on interviews, the Licensee did not ensure resident’s incontinence was managed appropriately. This is an immediate risk to personal rights.

Official plan of correction

Licensee agrees to conduct an in-service with staff to ensure the proper incontinence products are used and that residents are checked as often as needed to manage their incontinence. Proof of inservice training to be submitted to LPA no later that 8/31/2022.

Deadline recorded: Aug 31, 2022. 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 Personal Rights of Residents in All Facilities (a) 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. This requirement was not met as evidenced by: Based on interviews, the Licensee did not ensure resident’s personal rights. This is an immediate risk to personal rights.

Official plan of correction

Licensee agrees to conduct an in-service with staff regarding regulation 87468.1 to ensure resident's personal rights. Proof of inservice training to be submitted to LPA no later that 8/31/2022.

Deadline recorded: Aug 31, 2022. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87219(a)

Regulation authority

CCR

What the official deficiency says

87219 Planned Activities (a) Residents shall be encouraged to maintain and develop their fullest potential for independent living through participation in planned activities. This requirement was not met as evidenced by: Based on interviews, the Licensee did not ensure residents are provided adequate activities. This is a potential risk to health and safety of residents in care.

Official plan of correction

Licensee agrees to provide a written plan on how they will ensure that they have enough staff to engage residents in activities by POC due date, 9/5/2022.

Deadline recorded: Sep 5, 2022. A deadline is not proof that correction was completed.