VARENITA OF SIMI VALLEY

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: Based on medication review, the licensee did not comply with the section cited above as R1's medications Melatonin 3mg and Carbamazepine 200 mg each missing one extra dose, which poses an immediate health and safety risk to residents in care.

Official plan of correction

The Licensee has agreed to have an in-house training on properly administering medications to residents and submit proof to CCL no later than POC due date.

Deadline recorded: Aug 1, 2025. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87465(h)(6)(A-F)

Regulation authority

CCR

What the official deficiency says

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: name of resident, physician, drug name, strength, quantity, date filled, prescription number and the name of the issuing pharmacy. This requirement is not met as evidenced by: Based on medication review, the licensee did not comply with the section cited above as meds for 3 out of 5 residents were not documented on the CSMDR and meds for 2 out of 5 residents were missing start dates, which poses a potential health and safety risk to residents in care.

Official plan of correction

The Licensee has agreed to have an in-house training on properly documenting medications on the CSMDR and submit proof to CCL no later than POC due date.

Deadline recorded: Aug 1, 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 as S1 was hired by the facility on 04/29/2023 but have not been associated to the facility since 02/21/2024, which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 01/27/2025 Plan of Correction S1 was re-associated to the facility during today's visit. POC has been met.

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 as three out of ten staff do not have the required annual training completed, which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 02/28/2025 Plan of Correction The Licensee will ensure all staff completes necessary yearly training and submit proof to CCLD no later than POC due date.

Official classification

Type A

Official code

87468.1(a)(1)(3)

Regulation authority

CCR

What the official deficiency says

87468.1(a)(1)(3) 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… and to be free from... punishment, humiliation, intimidation, abuse, or other actions of a punitive nature… This requirement was not met as evidenced by:

Official plan of correction

The Licensee has agreed to conduct an in-house training on residents’ personal rights and submit proof to CCL no later than 01/19/2024. Based on the information obtained and reviewed, the Licensee did not comply with the section cited above as S1 slapped R1 while providing care, which posed an immediate safety risk to residents in care.

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

Official classification

Type B

Official code

87555(b)(8)

Regulation authority

CCR

What the official deficiency says

(b) The following food service requirements shall apply: (8) All food shall be of good quality. Commercial foods shall be approved by appropriate federal, state and local authorities. Food in damaged containers shall not be accepted, used or retained. This requirement is not met as evidenced by: Deficient Practice Statement Based on LPAs observation during inspection, the licensee did not comply with the section cited above as a substantial amount of non-perishable items were in poor condition as they were observed past their expiration date, which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 01/18/2024 Plan of Correction Licensee discarded all expired items and ordered new items during the inspection. POC has been met.

Official classification

Type B

Official code

87465(h)(6)(A-F)

Regulation authority

CCR

What the official deficiency says

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... This requirement is not met as evidenced by: Based on LPA observation and record review, the licensee did not comply with the section cited above as R1’s centrally stored medication and destruction record is missing centrally stored medication expiration and start date, which poses a potential health and safety to residents in care.

Official plan of correction

The Licensee has agreed to conduct a training with staff on properly and completely filling out CSMDR and submit proof to CCL by 08/31/2023.

Deadline recorded: Aug 31, 2023. A deadline is not proof that correction was completed.