A BRADLEY HOUSE II

Official classification

Type B

Official code

1569.682(a)(2)(A-F)

Regulation authority

HSC

What the official deficiency says

A licensee, prior to transferring a resident as a result of the forfeiture of a license shall, at a minimum, do the following: Provide each resident or the resident’s responsible person with a written notice no later than 60 days before the intended eviction…This requirement was not met as evidenced by: Based on record review and interviews, the Licensee did not comply with the section cited above as a written notice no later than 60 days from eviction date was issued to residents or resident’s responsible person, which posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC met as the facility will be closed effective today.

Deadline recorded: Jul 22, 2026. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87202(a)

Regulation authority

CCR

What the official deficiency says

(a) All facilities shall maintain a fire clearance approved by the city, county, or city and county fire department or district providing fire protection services, or the State Fire Marshal. Prior to accepting or retaining any of the following types of persons, the applicant or licensee shall notify the licensing agency and obtain an appropriate fire clearance approved by the city, county, or city and county fire department or district providing fire protection services, or the State Fire Marshal: This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, the licensee did not comply with the section cited above as Room #1 is occupied by Resident #1 which poses an immediate safety risk to persons in care.

Official plan of correction

POC Due Date: 04/15/2026 Plan of Correction Licensee shall to write a statement of understanding on regulation prior to POC due date. Also, Resident #1 shall be moved to a different room until a new Fire Clearance grants a resident to sleep in room #1. If new fire clearance is granted, new sketch is required.

Official classification

Type A

Official code

87204(a)

Regulation authority

CCR

What the official deficiency says

(a) A licensee shall not operate a facility beyond the conditions and limitations specified on the license, including specification of the maximum number of persons who may receive services at any one time. An exception may be made in the case of catastrophic emergency when the licensing agency may make temporary exceptions to the approved capacity. 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 the licensee currently has three (3) residents that are receiving hospice services which poses an immediate safety risk to persons in care.

Official plan of correction

POC Due Date: 04/15/2026 Plan of Correction Licensee shall to write a statement of understanding on regulation prior to POC due date. Also, a hospice increase waiver shall be submitted by 4/17/2026 to retain more than 2 residents under hospice. If waiver is not approved one resident receiving services shall be moved out.

Official classification

Type A

Official code

87412(d)

Regulation authority

CCR

What the official deficiency says

(d) The licensee shall maintain documentation that an administrator has met the certification requirements specified in Section 87406, Administrator Certification Requirements or the recertification requirements in Section 87407, Administrator Recertification Requirements. 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 their administrator certificate expired in 2023 which poses an immediate personal rights risk to persons in care.

Official plan of correction

POC Due Date: 04/15/2026 Plan of Correction Licensee will write a statement of understanding and will submit proof of application renewal paperwork was sent to Sacramento for processing by 4/17/2026.

Official classification

Type B

Official code

87463(a)

Regulation authority

CCR

What the official deficiency says

(a) The pre-admission appraisal, as specified in Section 87457, Pre-Admission Appraisal, shall be updated, in writing as frequently as necessary or once every 12 months, whichever occurs first, to note significant changes in condition, as defined in Section 87101, Definitions, and to keep the appraisal accurate. For the purposes of this section, the updated pre-admission appraisal shall be referred to as the reappraisal. 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 two residents did not have a currnet and signed needs and service plan on file which poses a potential health risk to persons in care.

Official plan of correction

POC Due Date: 04/29/2026 Plan of Correction Licensee will complete a new Needs and Service plan for both residents, gather signatures of responsible parties and submit a copy to LPA before 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 as they have full bed rails and they are not receiving hospice services which poses a potential safety risk to persons in care.

Official plan of correction

POC Due Date: 04/29/2026 Plan of Correction Licensee or staff will remove the full bed rails and use 1/2 rails as the resident is not receiving hospice services.

Official classification

Type B

Official code

87412(g)

Regulation authority

CCR

What the official deficiency says

(g) All personnel records shall be maintained at the facility. This requirement is not met as evidenced by: Deficient Practice Statement Based on records review and LPA observation, the licensee did not comply with the section cited above as the Administrator's file was not available during the inspection, which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 04/30/2024 Plan of Correction Staff stated the Administrator well email copy of Administrator's fille to LPA by poc due date.

Official classification

Type B

Official code

87507(c)

Regulation authority

CCR

What the official deficiency says

(c) Admission agreements shall be signed and dated, acknowledging the contents of the document, by the resident or the resident's representative, if any, and the licensee or the licensee's designated representative no later than seven days following admission. Attachments to the agreement may be utilized as long as they are also signed and dated as prescribed above. This requirement is not met as evidenced by: Deficient Practice Statement Based on records review and LPA observation, the licensee did not comply with the section cited above as five (5) out of six (6) residents admissions agreement were missing the Administrator's signature and date, which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 04/30/2024 Plan of Correction Staff stated Administrator will sign and date admissions agreement and send proof to LPA by poc due date.

Official classification

Type B

Official code

87307(a)

Regulation authority

CCR

What the official deficiency says

87307 Personal Accommodations and Services (a) Living accommodations and grounds shall be related to the facility's function. The facility shall be large enough to provide comfortable living accommodations and privacy for the residents, staff, and others who may reside in the facility. The following provisions shall apply: This requirement is not met as evidenced by: Deficient Practice Statement Based on observation and interview with staff, the licensee did not comply with the section cited above as a section of the common living area was used as a staff sleeping area which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 04/28/2023 Plan of Correction Staff shall inform Administrator of the above and Administrator shall provide updated staff schedule to reflect 24 hour care services due to not having a designated staff room. Also remove mattresses and any bed like items from the office/common area. Provide photo of cleared room. Plan of correction due 4/28/2023.

Official classification

Type B

Official code

87303(a)

Regulation authority

CCR

What the official deficiency says

87303(a) Maintenance and Operation. The facility shall be clean, safe, sanitary and in good repair at all times. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, the licensee did not comply with the section cited above. Sliding door in living/dining area observed not opening and closing properly; much force is needed to open and close door; also sliding door handle from inside is not in good repair and the outside handle is broken. This poses safety risk to persons in care.

Official plan of correction

POC Due Date: 05/04/2023 Plan of Correction Administrator shall have the sliding door repaired to open and close properly with properly installed handles. Provide proof of service completed and include photos. Plan of correction due by 5/4/2023.

Official classification

Type A

Official code

87468.1(a)(2)

Regulation authority

CCR

What the official deficiency says

(a) Residents in all residential care facilities for the elderly shall have all of the following personal rights: (2) To be accorded safe, healthful and comfortable accommodations, furnishings and equipment. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation the licensee did not comply with the section cited above as two (2) staff upon arrival who were providng care and supervision to residents were observed without a face mask which poses an immediate health and safety risk to persons in care.

Official plan of correction

POC Due Date: 03/25/2022 Plan of Correction Administrator agreed to the following: 1. To remind staff of masking guidlines and ensure that they wear their face masks at all times no later than 3/25/2022. Plan of correction met at time of the visit.

Official classification

Type A

Official code

87355(e)(2)

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: (2) 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 has not been associated to the facility, which poses an immediate health and safety risk to residents in care..

Official plan of correction

POC Due Date: 03/25/2022 Plan of Correction Administrator agreed to do the following: 1. Submit association paperwork to CCL no later than 3/25/2022. Plan of correction met at time of the visit.

Official classification

Type A

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 observation, the licensee did not comply with the section cited above, as expired canned food was observed in the dining room pantry and expired cooking spices were observed on the kitchen counter, which poses a potential health and safety risk to persons in care.

Official plan of correction

POC Due Date: 03/28/2022 Plan of Correction The administrator agreed to do the following: 1. Audit all non perishable and perishable food and ensure all expired canned food, spices and pershiables are discarded. 2. The Administrator will notify CCL of food audit completion no later than 3/28/22.

Official classification

Type A

Official code

87705(f)(1)

Regulation authority

CCR

What the official deficiency says

(f) The following shall be stored inaccessible to residents with dementia: (1) Knives, matches, firearms, tools and other items that could constitute a danger to the resident(s). This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, the licensee failed to ensure that kitchen knives were inaccessible. During the physical plant tour, the LPA observed an unsecured drawer in the kitchen containing knives. This poses an immediate health and safety risk to residents in care.

Official plan of correction

POC Due Date: 03/25/2022 Plan of Correction The Administrator has agreed to do the following: 1) Secure the drawer and ensure that it remains locked at all times. Plan of correction met at time of visit.

Official classification

Type A

Official code

87705(f)(2)

Regulation authority

CCR

What the official deficiency says

(f) The following shall be stored inaccessible to residents with dementia: (2) Over-the-counter medication, nutritional supplements or vitamins, alcohol, cigarettes, and toxic substances such as certain plants, gardening supplies, cleaning supplies and disinfectants. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, the licensee did not comply with the section cited above, as cleaning supplies and over the counter medications were accessible through the unlcoked garage which poses an immediate health and safety risk to persons in care.

Official plan of correction

POC Due Date: 03/25/2022 Plan of Correction Staff secured the garage at the time of the visit.

Official classification

Type B

Official code

87208(a)(7)

Regulation authority

CCR

What the official deficiency says

Plan of Operation. Any significant changes in the plan of operation which would affect the services to residents shall be submitted to the licensing for approval. The plan and related materials shall contain the following: sketches, showing dimensions. This requirement is not met as evidenced by: Deficient Practice Statement Based on interview and records review, the licensee failed to inform Licensing about the changes within the facility layout, which poses a potential health and safety risk to residents in care.

Official plan of correction

POC Due Date: 04/08/2022 Plan of Correction The Administrator has agreed to do the following: 1. Submit a Plan of Action, describing how the licensee will keep the department up to date on all changes 2. Submit an updated facility sketch, with an LIC200