QUAIL PARK RETIREMENT VILLAGE, LLC

Official classification

Type B

Official code

87211(a)(1)(D)

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: (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. (D) Any incident which threatens the welfare, safety or health of any resident…etc This requirement is not met as evidenced by: Facility failed to report incident of Resident (R1) being stuck in the elevator.

Official plan of correction

LPA and Administrator reviewed reporting requirements and discussed incidents that should be reported. POC completed during visit.

Deadline recorded: Mar 27, 2026. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87468.1

Regulation authority

CCR

What the official deficiency says

87468.1 Personal Rights of Residents in All Facilities (11) To have their visitors, including ombudspersons and advocacy representatives, permitted to visit privately during reasonable hours and without prior notice, provided that the rights of other residents are not infringed upon. This requirement is not met as evidenced by: Based on interviews Facility limited and prevented resident (R1) from receiving visitors which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

Licensee agrees to provide in service training for all staff on personal rights and submit training when completed.

Deadline recorded: Apr 18, 2025. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87465(h)(2)

Regulation authority

CCR

What the official deficiency says

(h) The following requirements shall apply to medications which are centrally stored: (2) Centrally stored medicines shall be kept in a safe and locked place that is not accessible to persons other than employees responsible for the supervision of the centrally stored medication. 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 3 out of 6 resident's rooms were observed with unlocked medication, which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 11/22/2024 Plan of Correction Administrator agrees to schedule in-service training for all staff by due date and submit records when 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, interview, the licensee did not comply with the section cited above in 4 out of 4 areas; laundry room and maintenance rooms were unlocked with chemicals. Housekeeping cart had chemicals that were unlocked and several resident rooms had chemicals which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 11/08/2024 Plan of Correction Staff locked chemicals immediately. Staff will follow up with maintenance regarding doors that were not locking and submit results to CCLD when corrected.

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 observed to have brown and pink buildup in crevices; which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 11/08/2024 Plan of Correction Staff immediately stopped use of ice and placed for deep cleaning. Dinning Director will look for deep cleaning services.

Official classification

Type A

Official code

87555(a)

Regulation authority

CCR

What the official deficiency says

87555 General Food Service Requirements (a) The total daily diet shall be of the quality and in the quantity necessary to meet the needs of the residents and shall meet the Recommended Dietary Allowances of the Food and Nutrition Board of the National Research Council. All food shall be selected, stored, prepared and served in a safe and healthful manner. This requirement was not met as evidenced by: Based on observation the facility had expired food in the kitchen

Official plan of correction

Administrator to ensure facility food expiration dates are reviewed on an on-going basis. In-service training will need to be provided to kitchen staff and submitted to CCLD by due date.

Deadline recorded: Jan 18, 2024. A deadline is not proof that correction was completed.

Official classification

Type A

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.

Official plan of correction

Administrator to provide in-service training to med-techs and submit proof of training to CCLD by due date.

Deadline recorded: Jan 18, 2024. A deadline is not proof that correction was completed.

Official classification

Type A

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: Based on records review a medication was not documented in the centrally stored prescription medications list.

Official plan of correction

Administrator shall insure going forward record of centrally stored prescription medications for each resident is maintained

Deadline recorded: Apr 11, 2023. 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 (a)A plan for incidental medical and dental care shall be developed by each facility... by compliance with the following: (4) The licensee shall assist residents with self-administered medications as needed. This requirement was not met as evidence by: Based on records reviewed and interviews, staff failed to administer medication to resident in care, which poses an immediate Health and Safety risk to the residents.

Official plan of correction

The Administrator agrees to place checks to ensure if medication is missed by Med-Techs a lead person will review the medications and ensure they are dispensed in a timely manner to all residents. A re-training of all Med-Techs has already been completed on 1/5/2023 and all staff training will be completed by 1/27/23.

Deadline recorded: Jan 19, 2023. 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

Incidental Medical and Dental Care Once ordered by the physician the medication is given according to the physician's directions. This requirement was not met as evidenced by: Based on interview conducted and record review, the licensee did not comply with the section cited above when R2 was administered one medication in the wrong dosage, two medication was not administered to R2 for six days and two medications was not administered to R2 for three days. Interview with Administrator confirmed staff had administered a wrong dosage for one medication, two medications were not administered for six days and two medications were not administered for three days which poses an immediate health, safety or personal rights ricks to persons in care.

Official plan of correction

On 10/13/22, S2 was retrained on administering medication and S3 removed from administering medications. LPA received copy of re-training and documents of resident removed to caregiver status. Licensee agreed to submit documentation detailing steps the facility will take to ensure the requirements of Health-Related Services are met by the due date.

Deadline recorded: Nov 8, 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, the licensee did not comply with the section cited above when LPA and Administrator observed at 09:40AM, cleaning chemical bottles stored and unlocked under R1’s 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: 11/08/2022 Plan of Correction Administrator immediately removed the chemical bottles into locked staff medication room. POC cleared during visit.

Official classification

Type A

Official code

87465(h)(2)

Regulation authority

CCR

What the official deficiency says

Incidental Medical and Dental Care (h) The following requirements shall apply to medications which are centrally stored: (2) Centrally stored medicines shall be kept in a safe and locked place that is not accessible to persons other than employees responsible for the supervision of the centrally stored medication. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, the licensee did not comply with the section cited above when LPA and Administrator observed R1’s medications stored in resident’s under bathroom sink and shelf unlocked 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: 11/08/2022 Plan of Correction Administrator immediately removed the medications into locked staff medication room. POC cleared during visit.