MARBELLA VISALIA

Official classification

Type A

Official code

87309(a)

Regulation authority

CCR

What the official deficiency says

(a) Disinfectants, cleaning solutions, poisons, firearms and other items which could pose a danger if readily available to clients shall be stored where inaccessible to clients. This requirement is not met as evidenced by: Based on observation, the licensee did not comply with the section cited above LPA observed cleaning cart was left unlocked in the facility hallway with chemicals/ cleaning supplies accessible to residents.

Official plan of correction

Licensee / Administrator agrees to submit a statement of intent by due date to complete an in-service training with all staff regarding keeping disinfectants, cleaning solutions unaccusable to residents and submit records when completed

Deadline recorded: Aug 8, 2026. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

1569.153(i)

Regulation authority

HSC

What the official deficiency says

1569.153 Theft and loss program; standards, property inventories and surrender of personal effects; secured areas (i) Reports to the local law enforcement agency within 36 hours when the administrator of the facility has reason to believe resident property with a then current value of one hundred dollars ($100) or more has been stolen. Copies of those reports for the preceding 12 months shall be made available to the State Department of Social Services and law enforcement agencies. This requirement was not met as evidence by: record review. The licensee did not comply with the section cited above in that incidents of theft of $100 or more were not reported appropriately. This poses a potential health safety and or personal rights risk to residents in care.

Official plan of correction

Training to be completed with all staff on theft and loss program standards, property inventories and surrendering personal effects. In-service sign in sheet and training material will be provided to CCL by POC date as proof of correction.

Deadline recorded: Dec 12, 2025. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87211(a)

Regulation authority

CCR

What the official deficiency says

87211 Reporting Requirements (a) Each licensee shall furnish to the licensing agency such reports as the Department may require, including, but not limited to, the following:… This requirement was not met as evidence by: records reviewed. The licensee did not comply with the section cited above in that special incident report(s) were not submitted to Community Care Licensing as required. This poses a potential health safety and or personal rights risk to residents in care.

Official plan of correction

Training will be completed with all staff on reporting requirements and mandated reporting. In-service sign in sheet and training material will be provided to CCL by POC date as proof of correction.

Deadline recorded: Dec 12, 2025. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87506(a)

Regulation authority

CCR

What the official deficiency says

87506 Resident Records. (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 was not observed as evidenced by. The facility staff failed to keep at the facility and provide requested documents for R1 which were requested and agreed upon due date, of November 14th, 2025 which poses potential health and safety risk to persons in care.

Official plan of correction

The facility staff will review and follow regulations regarding residents records. A plan with detailing steps the facility will take to ensure the requirements for Resident records are met will be submitted to the Fresno CCL by the POC due date 11/29/2025.

Deadline recorded: Nov 29, 2025. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87411(d)(4)

Regulation authority

CCR

What the official deficiency says

87411(d)(4) Knowledge required to safely assist with prescribed medications which are self-administered. This requirement was not met as evidenced by: Based on observation, records reviewed, and interview conducted, R1 was given evening medication Atorvastatin and staff recorded that medication was administered. Atorvastatin medication tablet was found the following day. S1 did not ensure R1’s evening medication was administered as prescribed prior to recording that medication was administered, which poses/posed an immediate health and safety risk for the person in care.

Official plan of correction

S1 received in-services training on medication on 11/04/25. Record of S1’s in-service training was received. POC cleared during visit.

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

Official classification

Type B

Official code

87211(a)(1)

Regulation authority

CCR

What the official deficiency says

87211(a)(1) A written report shall be submitted to the licensing agency and to the person responsible for the resident within seven days of the occurrence of any of the events specified in (A) through (D) below. This report shall include the resident's name, age, sex and date of admission; date and nature of event; attending physician's name, findings, and treatment, if any; and disposition of the case. This requirement was not met as evidenced by: Based on record review and interview conducted, a written report was not reported to the department within 7 days of incident when R1’s Atorvastatin medication tablet was found the following day after medication was recorded administered, this poses a potential health and safety risk to residents in care.

Official plan of correction

A plan detailing steps the facility will take to ensure the requirements for Reporting requirements are met will be submitted to the Fresno CCL by the POC due date 11/21/25.

Deadline recorded: Nov 24, 2025. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87468(c)

Regulation authority

CCR

What the official deficiency says

87468 Personal Rights (c) Licensees shall prominently post personal rights, nondiscrimination notice, and complaint information in areas accessible to residents, representatives, and the public. This requirement was not met as evidence by LPA observation. The licensee did not comply with the section cited above in that required postings are not posted in the facility. This poses a potential health safety and or personal rights risk to residents in care.

Official plan of correction

RCD stated they will have posting placed up in the facility. RCD stated they will take pictures showing the posting were placed as proof of correction.

Deadline recorded: Nov 7, 2025. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87468(c)(2)(A)

Regulation authority

CCR

What the official deficiency says

87468 Personal Rights (c) Licensees shall prominently post personal rights, nondiscrimination notice, and complaint information in areas accessible to residents, representatives, and the public. (2) Information on the appropriate reporting agency in case of a complaint or emergency, including procedures for filing confidential complaints, shall be posted as follows: (A) Licensees may use the Residential Care Facility for the Elderly (RCFE) Complaint Poster (PUB 475) or may develop their own poster as provided in this section. A poster developed by the licensee shall contain the same content as the PUB 475. The poster that is posted shall be 20 " x 26 " in size and be posted in the main entryway of the facility. PUB 475 may be accessed, downloaded, and printed from the www.ccld.ca.gov website. This requirement was not met as evidence by LPA observation. The licensee did not comply with the section cited above in that the RCFE complaint poster was not posted at the facility. This poses a potential health safety and or personal rights risk to residents in care.

Official plan of correction

RCD stated they will have the RCFE complaint poster placed up. A picture will be sent to CCL as proof of correction by POC date.

Deadline recorded: Nov 7, 2025. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87405(d)(1)

Regulation authority

CCR

What the official deficiency says

87405 Administrator - Qualifications and Duties (d) The administrator shall have the qualifications specified in Sections 87405(d)(1) through (7). If the licensee is also the administrator, all requirements for an administrator shall apply. (1) Knowledge of the requirements for providing care and supervision appropriate to the residents. This requirement was not met as evidence by residents file review. The licensee did not comply with the section cited above in that review of special incident reports disclosed R3 had an allergic reaction on 5/14/25 and R1 had medication in their room unlocked and accessible on 5/15/25. This poses a potential health safety and or personal right risk to residents in care.

Official plan of correction

RCD stated they will update the board in the kitchen to include type of diet, food texture type and allergies. An in-sevice will be completed with all kitchen staff and care staff. In-service sign in sheet and traiing material will be sent to CCL as proof of correction.

Deadline recorded: Nov 7, 2025. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87468.1(a)(3)

Regulation authority

CCR

What the official deficiency says

87468.1 Personal Rights of Residents in All Facilities (a) Residents in all residential care facilities for the elderly shall have all of the following personal rights: (3) To be free from punishment, humiliation, intimidation, abuse, or other actions of a punitive nature, such as withholding residents’ money or interfering with daily living functions such as eating, sleeping, or elimination. This requirement was not met as evidence by LPA observations on 6/10/25 and 10/25/25. The licensee did not comply with the section cited above in that a gate with lock to kitchenette preventing access to food/drink and posing a tripping hazard observed in memory care. This poses a potential health safety and or personal rights risk to residents in care.

Official plan of correction

RCD stated that gate and lock will be removed by maintenence.RCD stated they will also have staff remove knobs/place a locking mechanism on stove when not in use. Pictures will be provided to CCL by POC date as proof of correction.

Deadline recorded: Nov 7, 2025. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87211(a)(2)

Regulation authority

CCR

What the official deficiency says

87211 Reporting Requirements (a) Each licensee shall furnish to the licensing agency such reports as the Department may require, including, but not limited to, the following:2) Occurrences, such as epidemic outbreaks, poisonings, catastrophes or major accidents which threaten the welfare, safety or health of residents, personnel or visitors, shall be reported within 24 hours either by telephone or facsimile to the licensing agency and to the local health officer when appropriate. This requirement was not met by: Licensee did not report R1's contagious prohibited condition, which poses a potential health, safety and or personal rights risk to residents in care.

Official plan of correction

Licensee agrees to submit a written understanding of the regulation by POC due date 5/30/25.

Deadline recorded: May 30, 2025. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87465(a)(4)

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: (4) The licensee shall assist residents with self-administered medications as needed. This requirement was not met as evidenced by: Licensee did not ensure R1 swallowed administered AM medication which was later found in the afternoon which poses an immediate health safety and or personal rights risk.

Official plan of correction

Plan of Correction Licensee agrees to conduct a staff training on administering medications. POC was cleared during visit. Training was conducted on 5/16/25 by LVN.

Deadline recorded: May 24, 2025. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87465(a)(4)

Regulation authority

CCR

What the official deficiency says

87465(a)(4) Incidental Medical and Dental Care. The licensee shall assist residents with self-administered medications as needed. This requirement is not met as evidenced by: Based on the interviews conducted Staff missed medicaiton or missed dosage for residents.

Official plan of correction

POC – Discussed during the NCC.

Deadline recorded: Jul 31, 2024. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87309(a)

Regulation authority

CCR

What the official deficiency says

(a) Disinfectants, cleaning solutions, poisons, firearms and other items which could pose a danger if readily available to clients shall be stored where inaccessible to clients. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, record review, the licensee did not comply with the section cited above in 3 out of 6 residents rooms were observed with sharps, chemicals which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 07/17/2024 Plan of Correction Items were removed or locked during inspection. Administrator to visit all resident rooms to ensure no sharps or chemicals are kept in rooms. Administrator to submit a report of findings to LPA when completed.

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 and interview, the licensee did not comply with the section cited above in 1 out of 1 nonperishable foods did not meet 7 day requirements which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 07/17/2024 Plan of Correction Administrator to re-stock non-perishable food to meet requirements and submit pictures, receipts of purchase by due date.

Official classification

Type A

Official code

87465(c)(3)

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: (3) A record of each dose is maintained in the resident's record. The record shall include the date and time the PRN medication was taken, the dosage taken, and the resident's response. 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 1 out of 3 residentsr response was not documented to PRN medication which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 07/17/2024 Plan of Correction Administrator to submit a statement of intent for implementation of new process to complete the required documentation of PRN medication and complete an in service training of change of processes.

Official classification

Type A

Official code

87458(b)(1)

Regulation authority

CCR

What the official deficiency says

(b) The medical assessment shall include, but not be limited to: (1) A physical examination of the resident indicating the physician's primary diagnosis and secondary diagnosis, if any and results of an examination for communicable tuberculosis, other contagious/infectious or contagious diseases or other medical conditions which would preclude care of the person by the facility. 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 5 residents records reviewed, which poses an immediate health, safety or personal rights risk to persons in care. R1's physicians report does not contain accurate diagnoses of Diabetes, medication management regarding insulin and glucose testing. R2’s Physicians report missing ambulatory status.

Official plan of correction

POC Due Date: 07/17/2024 Plan of Correction AD has agreed to obtain an updated physician’s report for R1. Additionally, an audit will be conducted of all physicians reports to ensure current/accurate information. Written statement of audit will be submitted for documentation of correction. All resident identified as needing updated Physicians report will obtain a current report.

Official classification

Type A

Official code

87309(a)

Regulation authority

CCR

What the official deficiency says

87309(a) Disinfectants, cleaning solutions, poisons, firearms and other items which could pose a danger if readily available to clients shall be stored where inaccessible to clients. This requirement is not met as evidenced by: Based on observation, the licensee did not comply with the section cited above in 1 out of 1 unlocked maintenance room that contained Clorox Bleach Cleaner, Bleach Wipes, sharp tools, aerosol cans which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

Administrator to submit a statement in writing regarding plans to provide an in-service training to all staff and submit by due date. Training records to be submitted as completed.

Deadline recorded: Mar 14, 2024. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87555(b)(29)

Regulation authority

CCR

What the official deficiency says

(b) The following food service requirements shall apply: (29) All equipment, fixed or mobile, and dishes, shall be kept clean and maintained in good repair and free of breaks, open seams, cracks or chips. 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 Ice Machine to have brown buildup underneath the door lift area which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 09/06/2023 Plan of Correction Administrator to have staff unplug, defrost and deep clean ice machine and complete routine cleaning to prevent future issues.

Official classification

Type A

Official code

87465(a)(4)

Regulation authority

CCR

What the official deficiency says

(4) The licensee shall assist residents with self-administered medications as needed. 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 2 out of 4 person medication audit revealed for Resident 1 (R1) 2 dosages missed with no notes on MARS and Resident 2 (R2) one pill was missing which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 09/06/2023 Plan of Correction Administrator to submit a statement of intent to provide training to all staff in regard to correct documentation of Centrally stored medication and destruction record (CSMDR) and MARs. Administrator to conduct medication audit to ensure medications are given as prescribed

Official classification

Type B

Official code

87468.1(a)(1)

Regulation authority

CCR

What the official deficiency says

Personal Rights of Residents in All Facilities(a) Residents in all residential care facilities for the elderly shall have all of the following personal rights: (1) To be accorded dignity in their personal relationships with staff, residents, and other persons. This requirement is not met as evidenced by: Based on records reviewed and interview conducted, on 06/01/22 Staff 1 (S1) removed resident 1 (R1) items from resident room without resident’s permission which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

Licensee shall submit a plan of steps that will be taken to ensure the regulation is met by the due date.

Deadline recorded: Aug 30, 2022. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87309(a)

Regulation authority

CCR

What the official deficiency says

87309(a) Disinfectants, cleaning solutions, poisons, firearms and other items which could pose a danger if readily available to clients shall be stored where inaccessible to clients. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, at 12:00PM LPA and Administrator observed a Clorox Bleach Germicidal Cleaner bottle on top of counter in the dining room while 18 residents were sitting in the dining room. At 12:10 PM, LPA and Administrator observed five cleaning chemicals stored under sink in the activity room unlock accessible to residents in care this poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 08/25/2022 Plan of Correction Administrator immediately removed the cleaning chemical bottles and locked in housekeeping storage room. POC cleared during visit