GOLDEN AGE 9

Official classification

Type A

Official code

87405(a)

Regulation authority

CCR

What the official deficiency says

Administrator-Qualifications and Duties All facilities shall have a qualified and currently certified administrator. The licensee and the administrator may be one and the same person. The administrator shall have sufficient freedom from other responsibilities and shall be on the premises a sufficient number of hours to permit adequate attention to the management and administration of the facility as specified in this section. When the administrator is not in the facility, there shall be coverage by a designated substitute who shall have qualifications adequate to be responsible and accountable for management and administration of the facility as specified in this section. The Department may require that the administrator devote additional hours in the facility to fulfill his/her responsibilities when the need for such additional hours is substantiated by written documentation. This facility was found to be deficient as evidenced by not having a designated facility Administrator appointed at this time. There weren't any forms or documents submitted into CCL to properly designate a new Administrator which posed an immediate threat to the Health, Safety, and Personal Rights of all residents in care.

Official plan of correction

The facility representative stated that all forms, with relevant documents, will be updated to properly appoint a new Administrator with submission into CCL for review by this LPA by the due date. Note: The designated representative did provide all updated forms and documents to this LPA on this visit date to update and appoint a new facility designated Administrator. No further POC required at this time.

Deadline recorded: Mar 26, 2026. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87303(a)

Regulation authority

CCR

What the official deficiency says

(a) 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 observation, the licensee did not comply with the section cited above in that the side fence was falling over, with missing wood planks, in need of repair/replacement which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 03/26/2026 Plan of Correction The facility representative stated that facility side fence will be contracted for repair/replacement by a licensed entity and submit proof of contracted work into CCL. A statement of correction, along with proof of contracted work with completion date, will be completed and submitted into CCL by the due date.

Official classification

Type A

Official code

87303(e)(2)

Regulation authority

CCR

What the official deficiency says

(2) Faucets used by residents for personal care such as shaving and grooming shall deliver hot water. Hot water temperature controls shall be maintained to automatically regulate the temperature of hot water used by residents to attain a temperature of not less than 105 degree F (41 degrees C) and not more than 120 degree F (49 degrees C). 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 hot water was measured in the facility resident restrooms (2) and observed to be measured at 140 degrees which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 03/26/2026 Plan of Correction The facility representative stated that a plan will be implemented to measure the hot water temperature for the next (3) days, at various shifts throughout the day, and document the measurements at that time. A statement of correction, along with readings of the hot water temperatures, will be completed and submitted into CCL for review by this LPA by the due date.

Official classification

Type A

Official code

87412(a)(6)(A)

Regulation authority

CCR

What the official deficiency says

(A) For administrators this shall include verification that he/she meets the educational requirements in Section 87405(d) through (g). This requirement is not met as evidenced by: Deficient Practice Statement Based on record review, the licensee did not comply with the section cited above in that there was not a current certified Administrator appointed to this facility at this time which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 03/26/2026 Plan of Correction The facility representative stated that all forms, with relevant documents, will be updated to properly appoint a new Administrator with submission into CCL for review by this LPA by the due date.

Official classification

Type A

Official code

87411(d)

Regulation authority

CCR

What the official deficiency says

(d) All personnel shall be given on the job training or have related experience in the job assigned to them. This training and/or related experience shall provide knowledge of and skill in the following, as appropriate for the job assigned and as evidenced by safe and effective job performance: This requirement is not met as evidenced by: Deficient Practice Statement Based on record review, the licensee did not comply with the section cited above in [4] out of [4] facility personnel records did not have current initial/annual training courses and hours which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 03/26/2026 Plan of Correction The facility representative stated that all facility personnel will be scheduled for training to complete the required areas of training, with corresponding hours, with statement of correction, along with copies of all updated trainings, to be completed and submitted into CCL for review by this LPA by the due date.

Official classification

Type A

Official code

87465(h)(5)

Regulation authority

CCR

What the official deficiency says

(h) The following requirements shall apply to medications which are centrally stored: (5) Each resident's medication shall be stored in its originally received container. No medications shall be transferred between containers. 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 resident medications were set up in a weekly dispensing box set up for several days in advance which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 03/26/2026 Plan of Correction The facility representative stated that all facility staff handling, dispensing, and documenting the resident medications will be trained from a third party vendor, for no less than (1) hour in duration, on the topic of proper storage and dispensing of the medications to all residents in care. A statement of correction, along with proof of updated training, will be completed and submitted into CCL for review by this LPA by the due date.

Official classification

Type B

Official code

87506(a)

Regulation authority

CCR

What the official deficiency says

(a) The licensee shall ensure that a separate, complete, and current record is maintained for each resident in the facility or in a central administrative location readily available to facility staff and to licensing agency staff. This requirement is not met as evidenced by: Deficient Practice Statement Based on record review, the licensee did not comply with the section cited above in that several resident records were incomplete missing required signatures and information which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 04/01/2026 Plan of Correction The facility representative stated that all resident records will be updated to make sure that they are complete and accurate at this time. A statement of correction, along with copies of the updated forms and documents, will be completed and submitted into CCL for review by this LPA by the due date.

Official classification

Type B

Official code

87755(c)

Regulation authority

CCR

What the official deficiency says

87755(c) Inspection Authority of the Licensing Agency 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 facility Licensee failed to meet the set deadlines for submission of all requested forms and documents into CCL.

Official plan of correction

This facility representative stated that all requested forms and documents will be completed and submitted into CCL by the required due date of 02/02/2022.

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