QUAIL PARK MEMORY CARE RESIDENCES

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, interview, and record review, the licensee did not comply with the section cited above in one out of two resident’s records reviewed. R1 had 1 dose missed of Gabapentin 300 MG and 7 missed doses of Metoprolol Succinate ER 25 which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 08/11/2026 Plan of Correction Administrator agrees to provide a statement of intent regarding med-tech in service training. Administrator will conduct audit to ensure all residents E-MAR medications match prescribed medications. Administrator to submit proof of training and findings of audit when completed.

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 observation, interview, and record review, the licensee did not comply with the section cited above in one out of one. Last fire drill completed on 7/23/2025 which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 08/17/2026 Plan of Correction Administrator agrees to submit statement of intent to conduct fire drill with each shift and submit records when all staff have completed training.

Official classification

Type B

Official code

87465(h)(6)

Regulation authority

CCR

What the official deficiency says

87465 Incidental Medical and Dental Care (h)The following requirements shall apply to medications which are centrally stored: (6) The licensee shall be responsible for assuring that a record of centrally stored prescription medications for each resident is maintained for at least one year and includes: 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 3 out of 3 residents centrally stored medication log was incomplete or medication was not logged which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 08/17/2026 Plan of Correction Administrator agrees to conduct in-service training and submit records of training by due date and log missing information into Centrally Stored Medication Log with medications and submit copies of logs when updated.

Official classification

Type A

Official code

87303(e)(2)

Regulation authority

CCR

What the official deficiency says

(2) Faucets used by residents for personal care such as shaving and grooming shall deliver hot water. Hot water temperature controls shall be maintained to automatically regulate the temperature of hot water used by residents to attain a temperature of not less than 105 degree F (41 degrees C) and not more than 120 degree F (49 degrees C). 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 4 rooms water temperature tested at Room 2 - 85.3, Room # -123.3, Room 4 - 122.4, Room 6 122.4 which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 08/01/2026 Plan of Correction Administrator / Licensee agrees to have technician check the water heaters to adjust water temperatures to be within range and submit invoice/ pictures by due date.

Official classification

Type A

Official code

87309(d)(1)

Regulation authority

CCR

What the official deficiency says

(d) Residents may have access to items specified in subsection (c) for personal use unless there is documentation as specified in Section 87457, Pre-Admission Appraisal or Section 87463, Reappraisals, that indicates the resident's or other residents’ safety would be at risk if allowed access. (1) The licensee shall implement reasonable interventions in order to ensure that access to the items specified in subsection (c) does not pose a hazard to other residents. 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, Resident's room observed with unlocked hygiene items. Resident’s door was wide open, allowing access to other residents which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 08/01/2026 Plan of Correction Licensee/ Administrator agrees to submit statement of intent to review resident’s files to determine which items are allowed per resident’s medical assessment and prepare a plan to safeguard other residents from items.

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 and record review, the licensee did not comply with the section cited above in one out of staff was not assoicated with the facility which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 08/01/2026 Plan of Correction Licensee agrees to submit documentation to associate staff by due date to CCLD

Official classification

Type A

Official code

87465(a)(4)

Regulation authority

CCR

What the official deficiency says

87465(a)(4) The licensee shall assist residents with self-administered medications as needed. This requirement was not met as evidenced by: Based on incident report Resident (R1) was given extra doses of medication then prescribed and administered medication incorrectly due to MAR error.

Official plan of correction

Administrator to provide a statement of intent regarding med-tech in service training. Administrator will conduct audit to ensure all residents E-MAR medications match prescribed medications. Administrator to submit proof of training and findings of audit when completed.

Deadline recorded: May 23, 2026. 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) The licensee shall assist residents with self-administered medications as needed. This requirement was not met as evidenced by: Medication audit revealed (R1) resident’s medication pill count 3 pills that were missing and not documented administrated.

Official plan of correction

Administrator to provide a statement of intent regarding med-tech in service training and review the requirements of proper documentation to support medication pill count. Administrator to submit proof of training to CCLD by due date.

Deadline recorded: Oct 18, 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 1 out of 6 residents rooms were observed with chemicals which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 08/09/2024 Plan of Correction Items were removed or locked during inspection. Administrator to visit all resident rooms to ensure no chemicals are kept in rooms. Administrator to submit a report of findings to LPA when completed.

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 & record review, the licensee did not comply with the section cited above in 3 out of 3 medications were missed, which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 08/09/2024 Plan of Correction Administrator agrees to submit plan of intent by due date. Administrator will complete medication audit, medication training, & process for documenting medication administration. Plan will include the date all phases of plan will be complete. Once all areas are reviewed documentation of records will be submitted to CCLD

Official classification

Type B

Official code

87465(c)(3)

Regulation authority

CCR

What the official deficiency says

87465(c)(3) (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 record review of the MAR, medications, and CSMDR the licensee did not comply with the section cited above which poses/posed a potential health, safety or personal rights risk to persons in care. PRN medications are being documented on the routine MAR, identified as PRN being administrated in place of routine medication due to medications not being refilled. PRN medications that are being given are not documented with required information.

Official plan of correction

POC Due Date: 08/29/2024 Plan of Correction Administrator to conduct an audit to determine if resident medications are ordered/filled on time and submit results of audit to CCLD. Administrator to review process/procedures of refills and provide in service training to staff and submit records when completed.

Official classification

Type A

Official code

87458(b)(1)

Regulation authority

CCR

What the official deficiency says

87458 Medical Assessment (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 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, interview, and record review, the licensee did not comply with the section cited above in 1 out of 5 residents did not have records of TB test/results which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 08/09/2024 Plan of Correction Administrator to schedule doctor’s appointment for tuberculosis by due date and submit results when completed

Official classification

Type A

Official code

87465(a)(4)

Regulation authority

CCR

What the official deficiency says

87465(a)(4) The licensee shall assist residents with self-administered medications as needed. This requirement was not met as evidenced by: Medication audit revealed (R1) resident’s medication pill count had an extra 28 pills in a packet that should have been given.

Official plan of correction

Administrator to provide a statement of intent regarding med-tech in service training and review the requirements of proper documentation to support medication pill count. Administrator to submit proof of training to CCLD by due date.

Deadline recorded: Jul 3, 2024. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87465(h)(6)

Regulation authority

CCR

What the official deficiency says

87465(h)(6). (h) The following requirements shall apply to medications which are centrally stored: (6) The licensee shall be responsible for assuring that a record of centrally stored prescription medications for each resident is maintained …. This requirement was not met as evidenced by: Medication audit reviled (R1) resident’s medication was not logged in the centrally stored list and or was incomplete.

Official plan of correction

Administrator to submit completed centrally stored records by due date.

Deadline recorded: Jul 9, 2024. 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

(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 & record review, the licensee did not comply with the section cited above in 2 out of 2 medications reviews which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 08/15/2023 Plan of Correction Administrator agrees to submit a plan in writing for correction of error, including complete medication audit, medication training, & process for documenting medication administration. Plan should include Continued maintenance. Plan will include the date all phases of plan will be complete.

Official classification

Type A

Official code

87203

Regulation authority

CCR

What the official deficiency says

87203 FIRE SAFETY: All facilities shall be maintained in conformity with the regulations adopted by the State Fire Marshal for the protection of life and property against fire and panic. 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. Fire extinguisher was expired with a service date of 7/20/2022, which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 08/16/2023 Plan of Correction Administrator had fire extinguishers serviced during inspection. Citation cleared during inspection

Official classification

Type B

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 observed to have buildup in need of cleaning which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 08/29/2023 Plan of Correction Ice Machine was emptied and cleaned during inspection. Facility to submit pictures as POC

Official classification

Type B

Official code

87465(a)(6)

Regulation authority

CCR

What the official deficiency says

(6) When requested by the prescribing physician or the Department, a record of dosages of medications which are centrally stored shall be maintained by the facility. This requirement is not met as evidenced by: Deficient Practice Statement Based on record reviews, the licensee did not comply with the section cited above in 2 out of 2 which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 08/29/2023 Plan of Correction Administrator shall ensure all current centrally stored list are completed accurately and completely. Administrator shall provide training and complete centrally stored list and submit records/pictures to CCLD by due as POC.

Official classification

Type A

Official code

87411(a)

Regulation authority

CCR

What the official deficiency says

(a) Facility personnel shall at all times … competent to provide the services necessary to meet resident needs… staff shall be employed to ensure provision of personal assistance and care as required … the extent of services provided, or the physical arrangements of the facility require such additional staff for the provision of adequate services. This requirement was not met: Based on interviews conducted and records reviewed, R1 sustained fracture while in care that required R1 to be hospitalization. Residents change of condition was not reported immediately which possess an immediately health and safety and personal rights risk to the resident in care.

Official plan of correction

Adminsitrator stated all staff in-service traiing was completed per regulation guidelines on 10/27/22. The department received copies of the training and rooster of staff attendance during visit. POC cleared during visit.

Deadline recorded: Dec 22, 2022. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87465(a)(5)

Regulation authority

CCR

What the official deficiency says

87465(a)(5) Incidental Medical and Dental Care The licensee shall assist residents with self-administered medications as needed. This requirement was not met as evidenced by: Based on interviews and records review, the licensee did not ensure staff administered medication at 8:00 p.m. to five residents on 04/04/22 which poses an immediate health and safety risks to persons in care.

Official plan of correction

On 4/07/22, S1 was retrained on administering medication. LPA received copy of re-training. POC cleared during visit.

Deadline recorded: May 31, 2022. A deadline is not proof that correction was completed.