Deficiency Type
POC Due Date /
Section Number | DEFICIENCIES | PLAN OF CORRECTIONS(POCs) |
Type A
06/23/2022
Section Cited
CCR
87465(c)(2)
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7 | 87465(c)(2) Incidental Medical and Dental Care: (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 | 1
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7 | Licensee agrees to submit a plan to train staff on adminstering medications and PRNs according to doctor's orders and to notify the physician if resident is unable to take medications. This plan is to be submitted to CCL by POC date. Once trainings are completed, the Licensee shall |
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14 | 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 was not being met as evidenced by: Based on record review, facility stopped giving R1’s medication without a doctor’s order to stop when R1 was not eating for 48 hours. This poses an immediate risk to the health and safety of resident in care. | 8
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14 | submit copies of trainings to CCLD. |
Type B
06/29/2022
Section Cited
CCR87224(d)(1)
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7 | 87224(d)(1) Eviction Procedures: (d) The licensee shall set forth in the notice to quit the reasons relied upon for the eviction with specific facts to permit determination of the date, place, witnesses, and circumstances concerning those reasons.
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7 | Licensee agrees to train relevent staff on proper eviction procedures, especially as specified in Title 22 Regulation 87224. Once trainings are completed, the licensee shall submit copies of training records to CCLD. |
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14 | (1) The notice to quit shall include the following information: (B) to (D)
This requirement is not being met as evidenced by: Based on record review, the eviction notice dated 2/10/22 did not have information on resources, the right to file a complaint, and unlawful detainer language.
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Deficiency Type
POC Due Date /
Section Number | DEFICIENCIES | PLAN OF CORRECTIONS(POCs) |
Type B
06/29/2022
Section Cited
CCR
87507(a)
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7 | 87507(a) Admission Agreements: (a) The licensee shall complete an individual written admission agreement, as defined in Section 87101(a), with each resident or the resident's representative, if any.
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7 | Licensee agrees to train relevant staff on ensuring residents have completed individual admission agreements and ensuring the admission agreements are kept in the resident record. Once training is completed, the licensee shall submit training records to CCLD. |
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14 | This requirement is not being met as evidenced by:
Based on interview and record review, the licensee did not complete a written admission agreement with R1’s representative which poses a potential risk to the health of the resident in care.
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Type B
06/29/2022
Section Cited
CCR87224(f)
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7 | 87224(f) Eviction Procedures: (f) A written report of any eviction shall be sent to the licensing agency within five (5) days. This requirement was not met as evidenced by: Based on record review, CCL did not receive a copy of R1’s eviction notice in February. | 1
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7 | Licensee agrees to train relevent staff on properly documenting eviction notices to CCLD. Once training is completed, the licensee shall submit training records to CCLD. |
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