REESEJOY CARE HOME

Official classification

Type B

Official code

87625(b)(8)

Regulation authority

CCR

What the official deficiency says

87625 Managed Incontinence (b)In addition to Section 87611, General Requirements for Allowable Health Conditions, the licensee shall be responsible for the following:(8)Privacy shall be afforded when care is provided.This requirement is not met as evidence by: Based on observation during todays visit LPA observed staff assisting resident #1 with incontinent care in the living room without taking any precaution to protect the privacy of resident.

Official plan of correction

Administrator agreed to provide in-service training pertaining to incontinent care assistance and residents privacy. Submit copy of in-service training record to LPA by due date.

Deadline recorded: Mar 20, 2026. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87458(c)(1)(A)

Regulation authority

CCR

What the official deficiency says

(c) The medical assessment shall include, but not be limited to: (1) A physical examination of the resident indicating the licensed medical professional's diagnosis or diagnoses and results of an examination for all of the following: (A) Communicable tuberculosis. This requirement is not met as evidenced by: Deficient Practice Statement Based on record review, the licensee did not comply with the section cited above in one out of five residents which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 03/06/2026 Plan of Correction Administrator agreed to obtain a negative TB test for the identified individual and agreed to submit proof of the negative TB tests to CCLD no later than POC due date.

Official classification

Type B

Official code

87463(h)

Regulation authority

CCR

What the official deficiency says

(h) The licensee shall request that all residents receive an annual routine visit with a licensed medical professional once every twelve months, either in person or by video appointment. This requirement is not met as evidenced by: Deficient Practice Statement Based on record review, the licensee did not comply with the section cited above in one out of five residents which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 03/06/2026 Plan of Correction The Licensee will ensure that the identified residents conduct an annual routine visit with a licensed medical professional and provide the Department evidence that the visits were conducted and completed by 3/6/26. If due to difficulty in getting an appointment to see the medical professional, Licensee will provide the Department with the scheduled appointment date and provide evidence once the visit has been completed.

Official classification

Type B

Official code

87609(b)(4)(A)

Regulation authority

CCR

What the official deficiency says

(b)...care may be provided to residents through a licensed home health agency provided the following conditions are met:(4) The licensee and home health agency agree in writing on the responsibilities...(A)The written agreement shall reflect the services, frequency and duration of care. This requirement was not met as evidenced by: Based on interviews and records review, the licensee did not comply with the section cited above as R1 was on homehealth, but there were no records onsite available to review, which poses a postential health, safety or personal rights

Official plan of correction

Administrator agreed to review section cited and create a written plan on how they will ensure future compliance then send to LPA. risk to residents in care.

Deadline recorded: Dec 19, 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

Incidental Medical and Dental (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... This requirement was not met as evidenced by: Based on observation, Resident 1 had access to their medicine without any supervision, which poses an immediate health and safety risk to persons in care.

Official plan of correction

Administrator removed the medication during the visit and agrees to submit a plan on how they will ensure they are in compliance with regulation 87465 to CCL by 12/10/25.

Deadline recorded: Dec 10, 2025. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87507(f)

Regulation authority

HSC

What the official deficiency says

87507 Admission's Agreement (f)The licensee shall comply with all applicable terms and conditions set forth in the admission agreement, including all modifications and attachments. This requirement is not met as evidence by: Based on records review and interviews, licensee did not comply with section cited as the facility failed to comply with the specific terms written in its own resident admission agreement, by charging R1 a full month instead of a prorated amount which posed a potential health and safety risk to residents in care.

Official plan of correction

Administraor agreed to calculate the correct prorated amount based on the date R1 was admitted to the facility and issue a refund. Administrator will submit proof of refund to the LPA by 12/05/2025.

Deadline recorded: Dec 5, 2025. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87705(b)(2)

Regulation authority

CCR

What the official deficiency says

(2) For facilities with fewer than 16 residents, ensuring there is at least one night staff person awake and on duty if any resident with dementia is determined through ...observation, to require awake night supervision. ...This requirement is not met as evidenced by: Based on interviews, the licensee did not comply with the above section by not having awake staff to ensure R1 did not elope the facility after observing wandering and eloping behavior, & elopement resulted in injury which poses an immediate health and safety risk to resident in care.

Official plan of correction

Administrator agrees to place awake staff during overnight shifts and will submit schedule to CCL by 4/22/25.

Deadline recorded: Apr 22, 2025. A deadline is not proof that correction was completed.

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 record review, the licensee did not comply with the section cited above in two out of six staff that were not associated to the facility which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 02/22/2025 Plan of Correction Licensee agreed to submit a transfer of a criminal record clearance for all staff not associated to the facility by 02/22/2025. Licensee will submit proof of clearance to LPA via email by end 02/22/2025.

Official classification

Type B

Official code

87412(a)

Regulation authority

CCR

What the official deficiency says

(a) The licensee shall ensure that personnel records are maintained on the licensee, administrator and each employee. Each personnel record shall contain the following information: This requirement is not met as evidenced by: Deficient Practice Statement Based on record review, the licensee did not comply with the section cited above in one out of five staff that did not have a staff file at the facility which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 04/04/2025 Plan of Correction Licensee will submit a complete employee file for the identified employee to CCLD no later than POC due date

Official classification

Type B

Official code

1569.625(b)(2)

Regulation authority

HSC

What the official deficiency says

(2) In addition to paragraph (1), training requirements shall also include an additional 20 hours annually, eight hours of which shall be dementia care training, as required by subdivision (a) of Section 1569.626, and four hours of which shall be specific to postural supports, restricted health conditions, and hospice care, as required by subdivision (a) of Section 1569.696. This training shall be administered on the job, or in a classroom setting, or both, and may include online training. This requirement is not met as evidenced by: Deficient Practice Statement Based on record review, the licensee did not comply with the section cited above in one out of five staff that did not have annual training on file which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 04/04/2025 Plan of Correction Licensee agrees staff will complete all required annual training and submit proof to licensing by POC due date.

Official classification

Type B

Official code

87458(c)(1)(A)

Regulation authority

CCR

What the official deficiency says

(c) The medical assessment shall include, but not be limited to: (1) A physical examination of the resident indicating the licensed medical professional's diagnosis or diagnoses and results of an examination for all of the following: (A) Communicable tuberculosis. This requirement is not met as evidenced by: Deficient Practice Statement Based on record review, the licensee did not comply with the section cited above in one out of five residents that had a positive TB test on file and no chest X-ray which posesa potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 04/04/2025 Plan of Correction Licensee will submit proof of a negative chest X-ray to CCL no later than POC due date.

Official classification

Type B

Official code

87608(a)(5)(B)

Regulation authority

CCR

What the official deficiency says

(B) Bed rails that extend the entire length of the bed are prohibited except for residents who are currently receiving hospice care and have a hospice care plan that specifies the need for full bed rails. 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 out of 5 which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 03/04/2022 Plan of Correction Admin stated they will contact the hospice agency to obtain bed rail orders for the 4 residents that are missing. Admin will send the bed rail orders to LPA via email at: angel.ascencio@dss.ca.gov.

Official classification

Type B

Official code

87705(g)

Regulation authority

CCR

What the official deficiency says

(g) As required by Section 87468(a)(12), residents with dementia shall be allowed to keep personal grooming and hygiene items in their own possession, unless there is evidence to substantiate that the resident cannot safely manage the items. 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 as hydrogen peroxide, Norisc Cream, body lotion, and Aquaphor in an unlocked restroom accesible to residents which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 03/04/2022 Plan of Correction Admin locekd up teh personal grooming items during the tour. Admin will provide training on Section 87468(a)(12). Admin will send LPA training meterials and attendees to email: Angel.ascencio@dss.ca.gov.