GOLDEN AGE III

Official classification

Type A

Official code

87405(a)

Regulation authority

CCR

What the official deficiency says

87405 Administrator - Qualifications and Duties (a) All facilities shall have a qualified and currently certified administrator. The licensee and the administrator may be one and the same person. 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 but not ensuring that the facility has an administrator with an active administrator certificate on file. This poses an immediate health, safety, and personal rights risks to persons in care.

Official plan of correction

POC Due Date: 01/14/2026 Plan of Correction Licensee states they will send paperwork to appoint a new administrator by POC date.

Official classification

Type A

Official code

87355(e)(3)

Regulation authority

CCR

What the official deficiency says

(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, interview, and record review, the licensee did not comply with the licensee did not comply with the section cited above by not ensuring that 2 out 2 staff members present at the time of the LPA's visit were properly transferred to be associated to the facility. This poses an immediate health, safety, personal rights risks to persons in care.

Official plan of correction

POC Due Date: 01/14/2026 Plan of Correction Licensee states that a background clearance will be sent to the department by the POC date.

Official classification

Type B

Official code

Not listed

Regulation authority

Not listed

What the official deficiency says

(2) Eight hours of in-service training per year on the subject of serving residents with dementia. This is not met as evidenced by: Based on observation and record review, this licensee did not ensure that 3 out 3 staff members did not have annual dementia training. This poses a potential health, safety, and personal rights risks in persons in care.

Deadline recorded: Feb 6, 2025. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

Not listed

Regulation authority

Not listed

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 is not met as evidenced by: Based on observation and record review, this licensee did not ensure that 3 out 5 residents did not have an updated reappraisal. This poses a potential health, safety, and personal rights risks in persons in care.

Deadline recorded: Feb 6, 1987. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

Not listed

Regulation authority

Not listed

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. This is not met as evidenced by: Based on observation, the Licensee did not ensure that the sliding glass door was not easily opened. LPA observed a wood plank that was prohibiting the sliding glass door from opening. This poses an immediate health, safety, and personal rights risk to persons in care.

Deadline recorded: Jan 7, 2025. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87755(c)

Regulation authority

CCR

What the official deficiency says

The licensing agency shall have the authority to inspect, audit, and copy resident or facility records upon demand during normal business hours. Records may be removed if necessary for copying. Removal of records shall be subject to the requirements in Sections 87412(f), 87506(d), and 87508(b). This requirement is not met as evidenced by: The Department requested paperwork from the license by 10/15/21 and did not receive paperwork . This posed a potential health and safety risk to residents in care.

Official plan of correction

Licesnsee will turn requested paperwork by 2/2/2022

Deadline recorded: Feb 2, 2022. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

Not listed

Regulation authority

Not listed

What the official deficiency says

Fingerprint Clearance: A licensee or applicant for a license may request a transfer of a criminal record clearance from one state licensed facility to another by providing the following documents to the Department: (1) A signed Criminal Transfer Request, LIC 9182 (2) A copy of the individual's (a) drivers license (b) valid ID card issued by DMV (c) valid photo ID by another state of the US *Fingerprint clearance requirement was not met as evidenced by two staff not having fingerprint transfer clearance. They were associated to another home owned by the same company.*

Deadline recorded: Nov 16, 2021. A deadline is not proof that correction was completed.