Deficiency Type
POC Due Date /
Section Number | DEFICIENCIES | PLAN OF CORRECTIONS(POCs) |
Type B
03/08/2024
Section Cited
CCR
87705(c)(5)
| 1
2
3
4
5
6
7 | Per CCR Section 87506(a) on Resident Records: "(a) The licensee shall ensure that a separate, complete, and current record is maintained for each resident in the facility (...) readily available to (...) licensing agency staff." This requirement is not met as evidenced by: | 1
2
3
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5
6
7 | Licensee will be ensuring that complete records for all six residents currently in care are present before the plan of corrections due date. |
 | 8
9
10
11
12
13
14 | Based on records reviewed at the facility, two resident files did not include the respective medical assessment form. A third file included an admission agreement that was not dated/signed by the administrator. This constitute a potential risk to the health, safety and personal risks of residents in care. | 8
9
10
11
12
13
14 | |
| 1
2
3
4
5
6
7 | | 1
2
3
4
5
6
7 | |
| 1
2
3
4
5
6
7 | | 1
2
3
4
5
6
7 | |
Deficiency Type
POC Due Date /
Section Number | DEFICIENCIES | PLAN OF CORRECTIONS(POCs) |
Type A
02/10/2024
Section Cited
CCR
87705(f)(2)
| 1
2
3
4
5
6
7 | Per CCR Section 87705(f)(2) on Care of Persons with Dementia: "The following shall be stored inaccessible to residents with dementia: (...)Over-the-counter medication, nutritional supplements or vitamins, (...) cleaning supplies and disinfectants." This requirement is not met as evidenced by: | 1
2
3
4
5
6
7 | Licensee removed and made all dangerous items encountered inaccessible during the present visit. |
| 8
9
10
11
12
13
14 | Based on a tour of the physical plant, multiple instances ohe-counter treatments and cleaning supplies left accessible to residents were observed. This constitutes an immediate risk to the health, safety and personal rights of individuals in care | 8
9
10
11
12
13
14 | |
Type A
02/10/2024
Section Cited
CCR87615(a)(2)
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2
3
4
5
6
7 | Per CCR 87615(a)(2) on Prohibited Health Conditions: "Persons who (...) have a health condition including (...) those specified below shall not be admitted or retained in a residential care facility for the elderly:
(2) Gastrostomy tubes." This requirement is not met as evidenced by: | 1
2
3
4
5
6
7 | Licensee will submit a written statement that R3's family will be notified that either an hospice admission or discharge to a higher level of care is required at this time, before the plan of corrections due date. |
| 8
9
10
11
12
13
14 | Based on a tour of the facility and records reviewed, resident R3 is noted to be fed through a gastrostomy tube but has not been admitted to hospice or been issued an exception by licensing staff. This constitutes an immediate risk to the health, safety and personal rights of residents in care. | 8
9
10
11
12
13
14 | |
Deficiency Type
POC Due Date /
Section Number | DEFICIENCIES | PLAN OF CORRECTIONS(POCs) |
Type B
03/08/2024
Section Cited
CCR
87608(a)(5)(B)
| 1
2
3
4
5
6
7 | Per CCR Section 87608(a)(5)(B) on Postural Supports: "Bed rails that extend the entire length of the bed are prohibited except for residents who are currently receiving hospice care(...)." This requirement is not met as evidenced by:
| 1
2
3
4
5
6
7 | Licensee replaced the full rails with half rails during the visit and will obtain relevant physician orders for half rails for both residents before the plan of corrections due date. |
| 8
9
10
11
12
13
14 | The beds for two of the residents not currently receiving hospice care are seen to be equipped with full bed rails. This constitutes a potential risk to the health, safety and personal rights of residents in care. | 8
9
10
11
12
13
14 | |
| 1
2
3
4
5
6
7 | | 1
2
3
4
5
6
7 | |
| 1
2
3
4
5
6
7 | | 1
2
3
4
5
6
7 | |