GOLDEN AGE LIVING NEWMAN

Official classification

Type A

Official code

87465(a)

Regulation authority

CCR

What the official deficiency says

87465 Incidental Medical and Dental Care(a) A plan for incidental medical and dental care shall be developed by each facility. The plan shall encourage routine medical and dental care and provide for assistance in obtaining such care, by compliance with the following:(1) The licensee shall arrange, or assist in arranging, for medical and dental care appropriate to the conditions and needs of residents. (2) The licensee shall provide assistance in meeting necessary medical and dental needs. This requirement was not met as evidenced by: record review of the MAR: one client is out of a routine drug and staff report in interview a family thats refusing to cooperate with aquiring the drug. Not following this requirement poses a risk for the clients health, saftey, and personal rights.

Official plan of correction

LPA suggested that its time to have a conversation with the family and the perscribing doc, because a families refusal does not negate the facilitys legal obligation to ensure a residents health needs are met, if an agreement cant be reached that either the family will be more responsible with delivering drugs on time or the facility should manage the clients medications, the LPA belives matter needs to be escalated to the ombudsman or APS as a medical neglect by the family. the facility will develop a plan of action regarding this matter and inform the LPA by end of day 7/23/26.designated representitve agrees.

Deadline recorded: Jul 23, 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

87303 Maintenance and Operation (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 was not met as evidenced by: a lot(8+) of garbage bags of flamable biological matter in the pathway of the evacuation route gate. Not following this requirement poses a risk for the clients health, saftey, and personal rights.

Official plan of correction

LPA is suggesting that matieral be immediately removed by the poc date (7/23/26) and the facility enact regular(semi annual) sweep of the emergency route gates for hazzards and obstructions. picures to the lpa(noel.wolfpetersen@dss.ca.gov) designated representitve agrees.

Deadline recorded: Jul 23, 2026. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87202(a)

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: 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 2 out of 2 fire extinguishers being out of date which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 04/30/2026 Plan of Correction they are scheduled to be serviced tomorrow, send a picture to your lpa of the new tags by end of day 4/30/26

Official classification

Type A

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 interview and record review the licensee did not comply with the section cited above in 1out of 6 employees which did not finish thier fingerprinting prior to working/volenteering/residing in the facility which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 04/30/2026 Plan of Correction no immediate poc,Transfer is in process. Facility should follow along with the transfer, if it does not succeed then pursue refringerprinting. licensee should update the lpa via email as to the status of the employee in 1 week, 5/6/2026. noel.wolfpetersen@dss.ca.gov

Official classification

Type B

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 many weeds blocking the side gate identified as an evacuation route on the 610d/e form which posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 05/06/2026 Plan of Correction Licensee will maintence the gounds such that the gate is accessable, the activity space is free of trip hazzards, and any excessive biological inflamable matter is removed. send a picture to the LPA in a week, 5/6/26

Official classification

Type B

Official code

87307(d)(6)

Regulation authority

CCR

What the official deficiency says

(6) All outdoor and indoor passageways and stairways shall be kept free of obstruction. 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 4 out of 4 locks and latches on two doors into the kitchen presenting an obstruction of a passageway to exterior doors and also to a bathroom which is used as a shower for both residents which posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 05/06/2026 Plan of Correction Take the locks and latches off, increase nighttime supervision if necessary, in the case of dementia folks at least one awake staff has to be on the premesis. send a picture of the locks and latches removed to the lpa by the poc date.

Official classification

Type B

Official code

87465(c)(2)

Regulation authority

CCR

What the official deficiency says

(c) If the resident's physician has stated in writing that the resident is unable to determine his/her own need for nonprescription PRN medication, but can communicate his/her symptoms clearly, facility staff designated by the licensee shall be permitted to assist the resident with self-administration, provided all of the following requirements are met: (2) Once ordered by the physician the medication is given according to the physician's directions. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, iterview, record review, the licensee did not comply with the section cited above in 1 out of three medications which was being given to a client without a documentation line. the medication was observed to have a full dose count at 28 and substantially less pills in its container, which posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 05/27/2026 Plan of Correction retrain staff on the prn documentation process. Schedule a training for all staff, by the poc date. turn in a copy of the training participants with thier signature when the training is complete.

Official classification

Type B

Official code

87465(e)

Regulation authority

CCR

What the official deficiency says

(e) For every prescription and nonprescription PRN medication for which the licensee provides assistance there shall be a signed, dated written order from a physician on a prescription blank, maintained in the resident's file, and a label on the medication. Both the physician's order and the label shall contain at least all of the following information. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation,nterview,record review, the licensee did not comply with the section cited above in 3 out of 3 medications which were not labeled on a perscription blank. which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 05/06/2026 Plan of Correction No immeadiate poc, as part of the above training, the facility should get the topic of reciving medications and maintaining and administrative medication record.

Official classification

Type B

Official code

87463(a)

Regulation authority

CCR

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 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 2 out of 2 client files that did not have an up to date appraisal of needs and services which posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 05/27/2026 Plan of Correction no imediate poc, provide updated needs and services plans to the LPA and the client file for both residents, after below medical assessment.

Official classification

Type B

Official code

87463(h)

Regulation authority

CCR

What the official deficiency says

(h) The licensee shall request that all residents receive an annual routine visit with a licensed medical professional once every twelve months, either in person or by video appointment. 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 2 out of 2 client files which did not contain 602 medical assesments for the clients in the last year which posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 05/27/2026 Plan of Correction Get both clients scheduled for a 602 annual routine medical assessment before the poc date. send confirmation of the apointments to the LPA by the poc date.

Official classification

Type B

Official code

1569.695(a)(7)(G)

Regulation authority

HSC

What the official deficiency says

(a)In addition to any other requirement of this chapter, a residential care facility for the elderly shall have an emergency and disaster plan that shall include, but not be limited to, all of the following: (7) Procedures that address, but are not limited to, all of the following: (G) A process for identifying residents with special needs, such as hospice, and a plan for meeting those needs. 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 1 out of 1 emergency and disaster plan which posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 05/06/2026 Plan of Correction The 610d/e form should be updated to include specific needs of the clients in care, which include o2 concentrator consideratons for the client with hospice care, specificly medical transport companies should be on file who can handle emergency transport of her and her supplies.

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 record review, the licensee did not comply with the section cited above in 8 out of 8 of the last quartly drills by way of not being conducted which posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 05/06/2026 Plan of Correction Conduct a quarterly fire drill before the poc date, send the lpa a list of the participating staff and an short assesment of thier performance during the drill by the poc date.

Official classification

Type B

Official code

87608(a)(5)(B)

Regulation authority

CCR

What the official deficiency says

(B) Bed rails that extend the entire length of the bed are prohibited except for residents who are currently receiving hospice care and have a hospice care plan that specifies the need for full bed rails. 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 1 out of 1 beds equiped with full bedrails for the hospice client, whos order on 9/10/25 was for half rails, which posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 05/06/2026 Plan of Correction Remove the bottom rail from the bed, get an order for full rails from a doctor, or use the second bed in her room which only has the half rail. when the choice is made, describe the action taken and send a picture to the LPA by the poc date.