GRACEFUL LIVING AT RIVERBANK

Official classification

Type A

Official code

87202(a)(2)

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: (2) Bedridden persons 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 in that there was a resident deemed to be bedridden currently receiving care and supervision without the proper notification to Licensing and proper bedridden fire clearance in order to accept and retain such a resident which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 09/23/2025 Plan of Correction The facility designated Administrator stated that a proper bedridden fire clearance request will be completed and submitted into CCL for review by this LPA. A statement of correction, along with updated bedridden fire clearance request, will be completed and submitted into CCL by the due date.

Official classification

Type A

Official code

87204(a)

Regulation authority

CCR

What the official deficiency says

(a) A licensee shall not operate a facility beyond the conditions and limitations specified on the license, including specification of the maximum number of persons who may receive services at any one time. An exception may be made in the case of catastrophic emergency when the licensing agency may make temporary exceptions to the approved capacity. 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 in [3] out of [4] residents were currently receiving care and supervision through a hospice agency but this facility only held a waiver approved for (2) residents under hospice care which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 09/23/2025 Plan of Correction The facility designated Administrator stated that an updated hospice waiver increase will be completed and submitted into CCL for review by this LPA. A statement of correction, along with updated hospice waiver request, will be completed and submitted into CCL by the due date.

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 record review, the licensee did not comply with the section cited above in [1] out of [4] facility personnel files did not have the proper transfer, and association, of criminal record clearance which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 09/19/2024 Plan of Correction The facility designated representative stated that all facility staff providing care and supervision to the residents will always be properly fingerprint cleared and associated to this facility at all times. A statement of correction, along with proof of proper association of all facility staff, will be completed and submitted into CCL by the due date.

Official classification

Type A

Official code

87705(f)(1)

Regulation authority

CCR

What the official deficiency says

(f) The following shall be stored inaccessible to residents with dementia: (1) Knives, matches, firearms, tools and other items that could constitute a danger to the resident(s). This requirement was not met as evidenced by: Based on LPA's observation of two sets of scissors in an unlocked drawer located in the kitchen under the microwave. This poses an immediate risk to the health, safety and personal rights of residents in care.

Official plan of correction

The scissors were immediately relocated to a locked cabinet in the presence of the LPA. No further plan of correction is required at this time.

Deadline recorded: Sep 10, 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

(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: Based on LPA's observation of the stained carpets and obstruction in teh backyard pathway including inoperable appliances, a mattress and shower glass door and frame plus various debris. This poses a potential health, safety and personal rights risk to residents in care.

Official plan of correction

The licensee agrees to have the carpets cleaned and the debris removed from the backyard pathway to the exit by the POC due date. The licensee will email photos as proof of correction to maja.jensen@dss.ca.gov. The wall scuffs will addressed at a later date during an anticipated remodel.

Deadline recorded: Oct 7, 2022. A deadline is not proof that correction was completed.