Deficiency Type
POC Due Date /
Section Number | DEFICIENCIES | PLAN OF CORRECTIONS(POCs) |
Type B
12/03/2021
Section Cited
CCR
87555(b)(26)
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87555 General Food Service Requirements (b) The following food service requirements shall apply:(26) Supplies of nonperishable foods for a minimum of one week and perishable foods for a minimum of two days shall be maintained on the premises. | 1
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7 | Plan of Correction POC Licensee agrees to submit a receipt of food containing all food groups by POC due date 12/3/21. |
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This requirement was not met: Based on observation and interviews Licensee does not have a minimum of one week nonperishable foods or a minimum of two days of perishable maintained at the facilty which poses a potential Health, Safety or personal rights risk to the clients in care. | 8
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Type B
12/03/2021
Section Cited
CCR87507(c)
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87507 Admission Agreements (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. | 1
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Plan of Correction Licensee agrees to have R1's documents signed and submitted by POC due date 12/3/21. |
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Attachments to the agreement may be utilized as long as they are also signed and dated as prescribed above. This requirement was not met as evidenced by: Based on review of records Licensee did not have a signed admissions agreement for R1, which poses a potential Health, Safety or personal rights risk to the clients in care. | 8
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Deficiency Type
POC Due Date /
Section Number | DEFICIENCIES | PLAN OF CORRECTIONS(POCs) |
Type A
12/31/2021
Section Cited
CCR
87608(3)(B)
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87608 Postural Supports (3) A written order from a physician indicating the need for the postural support shall be maintained in the resident’s record. The licensing agency shall be authorized to require other additional documentation if needed to verify the order. | 1
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Plan of Correction POC Licensee agrees to obtain a doctors order for full bed rails by POC due date 12/31/21 |
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14 | (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 was not met by Based on observation and records review R1 did not have a physician order for full bed rails which poses an immediate Health, Safety or personal rights risk to the clients in care. | 8
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Type B
12/31/2021
Section Cited
CCR80065(g)(2)
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7 | 80065 Personnel Requirements(g) All personnel, including the licensee, administrator and volunteers, shall be in good health, and shall be physically, mentally, and occupationally capable of performing assigned tasks.(2) A health screening report signed by the person | 1
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7 | Plan of Correction POC Licensee agrees to submit Health Screening for all staff by POC due date 12/31/21 |
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14 | performing such screening shall be made on each person specified above, and shall indicate the following:(A) The person's physical qualifications to perform the duties to be assigned. This requierment was not met evidenced by: Based on review of records staff did not have Health Screening signed by a physician which poses a potential Health, Safety or personal rights risk to the clients in care. | 8
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