Deficiency Type
POC Due Date /
Section Number | DEFICIENCIES | PLAN OF CORRECTIONS(POCs) |
Type A
11/08/2022
Section Cited
CCR
87309(a)(1)
| 1
2
3
4
5
6
7 | 87309 Storage Space (a) Disinfectants, cleaning solutions, poisons, firearms and other items which could pose a danger if readily available to clients shall be stored where inaccessible to clients. (1) Storage areas for poisons, and firearms and other dangerous weapons shall be locked.
This requirement was not met as evidenced by: | 1
2
3
4
5
6
7 | DEFICIENCY CLEARED.
All disinfecting/cleaning products were observed to be locked and inaccessable to residents in care. Residents do not have access to razors or sharps which are locked. |
 | 8
9
10
11
12
13
14 | Licensee did not ensure that chemicals/cleaning supplies and items which could pose a danger to resident if readily available were locked and properly stored. LPA observed 3 disposable razors and unlocked cleaning supplies stored accessable being stored in resident bathroom.
This poses an immediate health, safety or personal rights risk to reisdents in care. | 8
9
10
11
12
13
14 | |
Type B
11/21/2022
Section Cited
CCR87303(a)
| 1
2
3
4
5
6
7 | 87303 Maintenance and Operation (a) The facility shall be clean, safe, sanitary and in good repair at all times. Maintenance shall include provision of maintenance services and procedures for the safety and well-being of residents, employees and visitors.
This requirement was not met as evidenced by: | 1
2
3
4
5
6
7 | AD agrees to create a deep cleaning check list and schedule that reflects that each room is deep cleaned monthly. The schedule and checklist will be provided to CCLD by the due date. |
| 8
9
10
11
12
13
14 | Licensee did not ensure the facility is clean, safe, sanitary and in good repair. LPA observed a broken window pane, dirty bedroom floors, baseboards and windowsills, walls, broken bedroom furniture with missing drawers and broken blinds in resident rooms.
This poses a potential health, safety or personal rights risk to residents in care. | 8
9
10
11
12
13
14 | |
Deficiency Type
POC Due Date /
Section Number | DEFICIENCIES | PLAN OF CORRECTIONS(POCs) |
Type B
11/21/2022
Section Cited
CCR
87307(a)(3)(C)
| 1
2
3
4
5
6
7 | 87307 Personal Accommodations and Services (a) Living accommodations and grounds shall be related to the facility's function….(3) Equipment and supplies necessary for personal care and maintenance of adequate hygiene practice shall be readily available to each resident…(C) Clean linen, including blankets, bedspreads, top bed sheets,bottom bed sheets, | 1
2
3
4
5
6
7 | AD has agreed to provide a written statement that documents that the regulation has been reviewed and the requirements are understood. AD will include the facility daily and weekly linen change protocol. This statement will be submitted to CCLD by the due date |
| 8
9
10
11
12
13
14 | pillow cases, mattress pads…. to ensure that clean linen is in use by residents at all times….
This requirement was not met as evidenced by:
LPA observed multiple residents beds with soiled or missing required linens. Multiple resident rooms smelled of urine.
This poses a health, safety or personal rights risk to residents in care. | 8
9
10
11
12
13
14 | |
Type B
11/21/2022
Section Cited
CCR87203
| 1
2
3
4
5
6
7 | 87203 Fire Safety All facilities shall be maintained in conformity with the regulations adopted by the State Fire Marshal for the protection of life and property against fire and panic.
This requirement was not met as evidenced by: | 1
2
3
4
5
6
7 | DEFICIENCY CLEARED
LPA observed that the emergency exit was free of obstruction upon entering the facility. |
| 8
9
10
11
12
13
14 | Licensee did not maintain in conformity with the regulations adopted by the State Fire Marshal. LPA observed a dresser placed blocking an Emergency Exit door which staff stated was placed to keep resident from leaving through the door.
This poses a health, safety or personal rights risk to residents in care. | 8
9
10
11
12
13
14 | |