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13 | On 8/31/2022, Licensing Program Analyst (LPA) M. Medina conducted a subsequent complaint visit. LPA introduced self, stated purpose of visit, and allowed entrance into facility. LPA met with Licensee, Herman Fickerwirth and Administrator, Michael Hagerty.
LPA Medina toured entire facility with Licensee and Administrator. LPA observed that there are currently 9 residents residing in facility of which 3 are identified as independent living. LPA observed 2 bedrooms (R1 & R2) to have exit doors being blocked.
Based on LPA observation and interviews, the preponderance of evidence standard has been met therefore the allegation is found to be substantiated. Per California Code of Regulations, Title 22, Division 6, Chapter 8, a deficiency is being cited on the attached 9099-D.
An immediate civil penalty of $500 is assessed.
An exit interview was conducted with Michael Hagerty, Administrator. A copy of this report and appeal rights were discussed and provided.
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Substantiated | Estimated Days of Completion: |
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Deficiency Type
POC Due Date /
Section Number | DEFICIENCIES | PLAN OF CORRECTIONS(POCs) |
Type A
09/01/2022
Section Cited
CCR
87204(a) | 1
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7 | Limitations - Capacity and Ambulatory Status (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 | 1
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7 | Licensee to submit written plan by POC due date to bring facility into compliance. Licensee/Administrator to continue to work with APS to find suitable housing to meet resident needs. Licensee/Administrator to |
 | 8
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14 | 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 was not met as evidenced by LPA observed 9 residents currently in facility of which 3 are identified as Independent Living.
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14 | contact Department no later than 9/30/22 with updates and relocation information for residents. |
Type A
09/01/2022
Section Cited
CCR
87468.1 | 1
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7 | 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 | 1
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7 | Licensee to move items blocking doors in R1 & R2 bedrooms and ensure they remain clear |
 | 8
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14 | personal relationships with staff, residents, and other persons.
**This was not met as evidenced by LPA observed 2 bedrooms (R1 & R2) to have exit doors being blocked. | 8
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14 |  |