DAGO RESIDENTIAL FACILITY #2 ELDERLY

Official classification

Type A

Official code

1569.605

Regulation authority

HSC

What the official deficiency says

On and after July 1, 2015, all residential care facilities for the elderly, except those facilities that are an integral part of a continuing care retirement community, shall maintain liability insurance covering injury to residents and guests in the amount of at least one million dollars ($1,000,000) per occurrence and three million dollars ($3,000,000) in the total annual aggregate, caused by the negligent acts or omissions to act of, or neglect by, the licensee or its employees. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, interview, record review, the licensee did not comply with the section cited above in 1 out of 1 which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 10/11/2024 Plan of Correction Licensee agrees to reinstate Liability insurance as soon as possible and submit documentation of new policy by due date.

Official classification

Type A

Official code

87555(b)(26)

Regulation authority

CCR

What the official deficiency says

(b) The following food service requirements shall apply: (26) Supplies of nonperishable foods for a minimum of one week and perishable foods for a minimum of two days shall be maintained on the premises. 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; LPA did not observe 7-day nonperishable foods which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 10/11/2024 Plan of Correction Licensee agrees to restock canned foods and submit pictures of receipt of purchase.

Official classification

Type B

Official code

87303(a)

Regulation authority

CCR

What the official deficiency says

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 4 out of 4 areas dust buildup on fan and walls, and AC vent and residue streaks on bathroom walls. Residue streaks on bathroom walls, which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 10/17/2024 Plan of Correction Licensee agrees to complete a deep cleaning of all walls and ceiling fans and change and clean AC vent and grate.

Official classification

Type A

Official code

80087(g)

Regulation authority

CCR

What the official deficiency says

80087(g)Disinfectants, cleaning solutions, poisons, firearms and other items that could pose a danger if readily available to clients shall be stored where inaccessible to clients. This requirement was not met: Based on observation, LPA observed chemicals and knife unlock under resident's bathroom, this posses an immediately health and safety and personal rights risk to the client.

Official plan of correction

Administrator immediately removed chemicals and knife to a secured and locked garage cabinet. POC cleared during inspection.

Deadline recorded: Nov 8, 2021. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

80022(b)(7)

Regulation authority

CCR

What the official deficiency says

A sketch of the building(s) to be occupied, including a floor plan which describes the capacities of the buildings for the uses intended, room dimensions, and a designation of the rooms to be used for nonambulatory clients, if any. This requirement was not met: Based on observation and interviews conducted, resident was moved into a bedroom designated for staff which posses a potential health and safety and personal rights risk to the client.

Official plan of correction

Administrator states that facility sketch will be updated to reflect correct designated rooms for resident. Updated facility sketch will be submitted to CCL by due date.

Deadline recorded: Nov 14, 2021. A deadline is not proof that correction was completed.