Medication handling and storage
Cited in 2 reports, with 2 deficiencies in total.
AUTUMN MANOR, LLC #3
2747 ATHERWOOD AVENUE, Simi Valley CA 93065
6 bedsLatest official report Jul 21, 2026Licensed
Additional info
- Telephone
- (805) 527-8281
- Licensee
- AUTUMN MANOR, LLC.
- Administrator
- FULGENTES, JENNIFER
- Contact
- FULGENTES, JENNIFER
- License first date
- Jul 13, 2007
- License effective date
- Jul 13, 2007
- District office
- WOODLAND HILLS N.ASC · (818) 596-4334
- Regional office
- 29
- Clients served
- 935 - ELDERLY
Summary
The available records show 3 Type A and 7 Type B deficiencies for this facility.
- Most recent inspection
- Jul 21, 2026
- Most recent deficiency
- Jul 21, 2026
No later report is available, so the records do not show what happened afterward.
What Type A and Type B mean
- Type A
- Violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
- Type B
- Violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care.
Both classifications are published by California CDSS and are shown as published. SeniorLivingFacts does not rename them or add a severity level of its own.
At a glance
Counts cover the five-year public record. Typical figures are the median for the 218 Ventura County facilities licensed for 6 or fewer beds.
In the available public five-year record, CCLD published 6 reports for this facility: 6 inspections, 0 complaint investigations, and 0 licensing or administrative records.
Those records contain 3 Type A and 7 Type B deficiencies.
0 deficiencies have explicit official correction or clearance evidence in the loaded records.
- Official inspections
- 6
- Recorded deficiencies
- 10
- Type A deficiencies
- 3
- Type B deficiencies
- 7
- Substantiated complaints
- 0
- Repeated topics
- 1
More than the typical 4
1 in the last 12 months
Well above the typical 2
1 in the last 12 months
More than the typical 1
1 in the last 12 months
Well above the typical 1
0 in the last 12 months
Most this size also have none
0 in the last 12 months
Last 36 months
Repeated topics
Topics cited in more than one report during the last 36 months. A repeat may show a pattern worth asking about. Each date opens its report below.
Official report history
All preserved reports from the most recent to the oldest, sortable by report type.
Inspection
Medication handling and storageType A
- Official classification
- Type A
- Official code
- 87465(c)(2)
- Regulation authority
- CCR
What the official deficiency says
(c) If the resident's physician has stated in writing that the resident is unable to determine his/her own need for nonprescription PRN medication, but can communicate his/her symptoms clearly, facility staff designated by the licensee shall be permitted to assist the resident with self-administration, provided all of the following requirements are met: (2) Once ordered by the physician the medication is given according to the physician's directions. 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 Sertraline medication was not being given as prescribed which poses an immediate health risk to persons in care.
Official plan of correction
POC Due Date: 07/23/2026 Plan of Correction The Licensee will contact R1's primary care physician and/or hospice nurse to verify the correct medication dosage and time. Once verified the facility will administer the medication accordingly or update documentation to reflect correct directions and dosage. A copy of current medication list from the hospice agency will be sent to LPA before POC due date.
Plan of correction recorded
Correction not verified in available records
Inspection
No deficiencies recorded in this report
Inspection
Medication handling and storageType B
- Official classification
- Type B
- Official code
- 87465(h)(4)
- Regulation authority
- CCR
What the official deficiency says
(h) The following requirements shall apply to medications which are centrally stored: (4) All centrally stored medications shall be labeled and maintained in compliance with state and federal laws. No persons other than the dispensing pharmacist shall alter a prescription label. This requirement is not met as evidenced by: Deficient Practice Statement Based on medication review/ LPAs observation, the licensee did not comply with the section cited above as R2 had an unlabeled medication of albuterol Sul. Which posed a potential health, and safety to persons in care.
Official plan of correction
POC Due Date: 07/01/2024 Plan of Correction Staff discarded medication at time of visit. POC has been met.
Plan of correction recorded
Correction not verified in available records
Inspection
Staffing, personnel, and trainingType B
- Official classification
- Type B
- Official code
- 1569.625(c)
- Regulation authority
- HSC
What the official deficiency says
(c) The training shall include, but not be limited to, all of the following: This requirement is not met as evidenced by: Deficient Practice Statement Based on staff training record review, the licensee did not comply with the section cited above in two out of two staff training records reviewed - this poses/posed a potential health, safety or personal rights risk to persons in care.
Official plan of correction
POC Due Date: 08/03/2023 Plan of Correction Licensee/Administrator agrees to audit all staff training records and ensure that all staff receive the required hours and training topics according to Health and Safety Code 1569.625c. Submit proof of audit, staff #1 and staff #2 's training according to regulation.
Plan of correction recorded
Correction not verified in available records
Medical and dental careType B
- Official classification
- Type B
- Official code
- 87465(d)
- Regulation authority
- CCR
What the official deficiency says
(d) If the resident is unable to determine his/her own need for a prescription or nonprescription PRN medication, and is unable to communicate his/her symptoms clearly, facility staff designated by the licensee, shall be permitted to assist the resident with self-administration, provided all of the following requirements are met: This requirement is not met as evidenced by: Deficient Practice Statement Based on resident record review, the licensee did not comply with the section cited above in one (1) out of 3 resident records reviewed - this poses/posed a potential health, safety or personal rights risk to persons in care.
Official plan of correction
POC Due Date: 08/03/2023 Plan of Correction Licensee agreed to review all resident records; obtain and retain PRN authorization letter for R1. Licensee/Administrator agreed to do an audit of all resident PRN medication and ensure that residents PRN medication is dispensed according to regulations. Provide completed PRN medication audit and copy of the PRN authorization letter for each resident. Submit correction by due date.
Plan of correction recorded
Correction not verified in available records
Inspection
No deficiencies recorded in this report
Inspection
Dementia careType A
- 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 did not comply with the section cited above, as sharp objects were accessible in the kitchen, which poses an immediate health and safety risk to residents in care.
Official plan of correction
POC Due Date: 09/24/2021 Plan of Correction The Administrator agreed to do the following: 1. These items were disposed of during today's visit. Plan of Correction met.
Plan of correction recorded
Correction not verified in available records
Medical and dental careType A
- Official classification
- Type A
- Official code
- 87465(a)(5)
- Regulation authority
- CCR
What the official deficiency says
(5) The licensee shall assist residents with self-administered medications as needed. This requirement is not met as evidenced by: Deficient Practice Statement Based on medication review, the licensee did not comply with the section cited above in 2 out of 4 medication record reviews, which poses an immediate health and safety risk to residents in care.
Official plan of correction
POC Due Date: 09/27/2021 Plan of Correction The Administrator agreed to do the following: 1. Obtain the order for R1's allergy medication, and will administer medications to all residents as prescribed. 2. Facility recently completed an in-service medications training on 9/22/2021; sign-in sheets and documents sent to LPA.
Plan of correction recorded
Correction not verified in available records
Fire safety and emergency preparednessType B
- Official classification
- Type B
- Official code
- 1569.69(a)(2)
- Regulation authority
- HSC
What the official deficiency says
(a) Each residential care facility for the elderly licensed under this chapter shall ensure that each employee of the facility who assists residents with the self-administration of medications meets all of the following training requirements: (2) In facilities licensed to provide care for 15 or fewer persons, the employee shall complete 10 hours of initial training. This training shall consist of 6 hours of hands-on shadowing training, which shall be completed prior to assisting with the self-administration of medications, and 4 hours of other training or instruction, as described in subdivision (f), which shall be completed within the first two weeks of employment. This requirement is not met as evidenced by: Deficient Practice Statement Based on records review, the licensee did not comply with the section cited above in 1 out of 3 (S1) staff records, which poses a potential health and safety risk to residents in care.
Official plan of correction
POC Due Date: 10/01/2021 Plan of Correction The Administrator agreed to do the following: 1. S1 will receive the additional medication hours by 10/1/2021
Citation dismissed - not a correction
Deficiency Dismissed Type B Section Cited HSC 1569.69(a)(2)
Plan of correction recorded
Correction not verified in available records
Staffing, personnel, and trainingType B
- Official classification
- Type B
- Official code
- 87411(f)
- Regulation authority
- CCR
What the official deficiency says
(f)All personnel, including the licensee and administrator, shall be in good health, and physically and mentally capable of performing assigned tasks. Good physical health shall be verified by a health screening, including a chest x-ray or an intradermal test, performed by a physician not more than six (6) months prior to or seven (7) days after employment or licensure. This requirement is not met as evidenced by: Deficient Practice Statement Based on records review, the licensee did not comply with the section cited above in 1 out of 3 staff records (S2), as S2 needs a TB test, which poses a potential health and safety risk to residents in care.
Official plan of correction
POC Due Date: 10/01/2021 Plan of Correction The Administrator has agreed to do the following: 1. Submit proof of S2's TB test by 10/1/2021
Plan of correction recorded
Correction not verified in available records
Staffing, personnel, and trainingType B
- Official classification
- Type B
- Official code
- 87411(c)(1)
- Regulation authority
- CCR
What the official deficiency says
(1) Staff providing care shall receive appropriate training in first aid from persons qualified by such agencies as the American Red Cross. This requirement is not met as evidenced by: Deficient Practice Statement Based on records review, the licensee did not comply with the section cited above in 1 out of 3 staff records (S2), as S2's first aid expired, which poses a potential health and safety risk to residents in care.
Official plan of correction
POC Due Date: 10/01/2021 Plan of Correction The Administrator agreed to do the following: 1. Provide S2's first aid certificate by 10/1/2021
Citation dismissed - not a correction
Deficiency Dismissed Type B Section Cited CCR 87411(c)(1)
Plan of correction recorded
Correction not verified in available records
Facility condition and maintenanceType B
- Official classification
- Type B
- Official code
- 87303(e)(2)
- Regulation authority
- CCR
What the official deficiency says
Faucets used by residents for personal care such as shaving and grooming shall deliver hot water. Hot water temperature controls shall be maintained to automatically regulate the temperature of hot water used by residents to attain a temperature of not less than 105 degree F (41 degree C) and not more than 120 degree F (49 degree C). 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 the water measured below 105 degees Fahrenheit, which poses a potential health and safety risk to residents in care.
Official plan of correction
POC Due Date: 10/01/2021 Plan of Correction The Administrator has agreed to do the following: 1. Adjust the water heater to ensure that the water is within regulation 2. Keep a five day log to ensure that the water is within regulation. Submit log on 10/1/2021
Plan of correction recorded
Correction not verified in available records
Source and limits
California Department of Social Services, Community Care Licensing Division. Public facility history is described by the source as a five-year window. Older records and previous-licensee history may require a regional-office request. Type 741 RCFE-CCRCs, nursing homes, and other care settings are excluded from this page.
Read the data methodology