SAFE HAVEN OAKDALE LLC

Official classification

Type A

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...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 observations and interviews, the licensee did not comply with the section cited above, as staff left chemical disinfectants in storage cabinets with broken locks in the kitchen and garage, which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 08/15/2025 Plan of Correction Staff immediately transferred the chemicals under the kitchen sink to a locked office and locked the door to the garage with a key. The Administrator scheduled a handyman to fix the locks tomorrow. Administrator will send LPA LIndstrom a statement that the locks have been fixed, a copy of the invoice for the work performed, and a picture of the new locks.

Official classification

Type A

Official code

87465(a)

Regulation authority

CCR

What the official deficiency says

Incidental Medical and Dental Care A plan for incidental medical and dental care shall be developed by each facility. The licensee shall assist residents with self administered medications as needed. This requirement was not met as evidenced by: Based on a review of the facility medication administration record (MAR) and Controlled Medication Administration Record, it was observed that required names/initials for medication dispersal were not filled out which poses/posed an immediate risk to the health, safety, and personal rights of the residents in care.

Official plan of correction

The lincensee will establish a procedure for auditing the MAR to ensure established procedures are followed and read and present a memorandum of understanding for regulation 87465.

Deadline recorded: Mar 21, 2025. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87355(e)(1)

Regulation authority

CCR

What the official deficiency says

87355(e)(1) Criminal Record Clearance. Prior to working,... in a licensed facility, all individuals subject to a criminal record review shall obtain a clearance or criminal record exemption. This requirement is not met as evidenced by: Based on record review, the licensee did not ensure a criminal record clearance was obtained for 1 of 2 staff members (S2) present in the facility, which poses an immedicated Health, Safety or Personal Rights risk to persons in care.

Official plan of correction

Effective Immediately, but no later than 01/17/2025; the Administrator shall remove S2 from the facility and have all employees fingerprinted, complete a health screening and TB test prior to returning to work by POC date. Written certification is required to show Administrator has read regulation by POC date.

Deadline recorded: Jan 27, 2025. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87412(g)

Regulation authority

CCR

What the official deficiency says

87412 (g) All personnel records shall be maintained at the facility and shall be available to the licensing agency for review. This requirement is not met as evidenced by: LPA and staff were unable to find complete staff files on premises for review. Of the one file found, the paperwork is incomplete.

Official plan of correction

Administrator will ensure staff files are present, complete and easily available to staff and LPA for review by POC date.

Deadline recorded: Jan 27, 2025. A deadline is not proof that correction was completed.