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

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.