Opal Care Llc

To care, supervision, and ...meet their individual needs...by staff that are sufficient in numbers, qualifications, and competency...This requirement was not met as evidence by Based on interview, the licensee did not comply with the section cited above by not having enough supervision which posed a potential health and safety risk to persons in care.

Additional Personal Right…addition to the rights..residents…shall have all of the following personal rights…to have …accommodations…personal care…family groups.This requirement was not met as evidence by: Based on observation, the licensee did not comply with the section cited above by not having adequate amount of toilet paper and paper towels available which poses a potential health and safety risk to persons in care.

To care, supervision, and ...meet their individual needs...by staff that are sufficient in numbers, qualifications, and competency...This requirement was not met as evidence by: Based on observation, the licensee did not comply with the section cited above by not having staff scheduled Monday to Sunday 2:00 Am to 7:00 AM which poses a potential health and safety risk to persons in care.

In addition to Section 87611,…licensee shall…Ensuring...are kept clean and dry …remains free of odors from incontinence.This requirement was not met as evidence by Based on record review, the licensee did not comply with the section cited above by not tracking and recording incontinent checks which poses a potential health and safety risk to persons in care.

Personal Accommodations and Services …supplies necessary…readily available to each resident…if the resident is…licensee shall assure provision of…Hygiene items…such as soap….This requirement was not met as evidence by Based on observation, the licensee did not comply with the section cited above by not having an adequate supply to cover all residents which poses a potential health and safety risk to persons in care.

87555 General Food Service Requirements(b) The following food service requirements shall apply: (8) All food shall be of good quality. Based on observation, the licensee did not comply with the section cited above by having moldy food which poses an immediate health, safety or personal rights risk to persons in care.

(a) Living accommodations and grounds shall…lapply. 3)…supplies necessary for personal care...of adequate hygiene practice shall be readily available to each resident….the licensee shall assure provision of: (D) Hygiene items of general use such as…toilet paper. Based on observation, the Licensee did not comply with the section above by not having sufficient amount of hygiene supplies for the number of residents in the facility, which poses a potential health and safety risk to persons in care.

To care, supervision, and ...meet their individual needs...by staff that are sufficient in numbers, qualifications, and competency...This requirement was not met as evidence by Based on observation, the licensee did not comply with the section cited above by not having the supervision which posed a potential health and safety risk to persons in care.

87555 General Food Service Requirements (b) The following food service requirements shall apply:(3) Between-meal nourishment or snacks shall be made available for all residents...(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.This requirement is not met as evidenced by: Based on observation and interview, the licensee did not comply with the section cited above in not having snacks, nonperishable foods for a minimum of one week and perishable foods for a minimum of two days which poses an immediate health, safety or personal rights risk to persons in care.

87307 Personal Accommodations and Service (a) Living accommodations…facility shall…provide…accommodations and privacy for… residents…shall apply: (2) Resident bedrooms shall…(B) No…used for other purposes shall be used as a sleeping room for any resident. Based on observation, the licensee did not comply with the section cited above by having a resident's sleeping quarters in commmon area which posed a potential health and safety risk to persons in care.

To care, supervision, and ...meet their individual needs...by staff that are sufficient in numbers, qualifications, and competency...This requirement was not met as evidence by: Based on interview, the licensee did not comply with the section cited above by not having staff scheduled 10:00 PM to ^:00 AM which posed a potential health and safety risk to persons in care.

87204 Limitations - Capacity and Ambulatory Status(b) Resident rooms approved for 24-hour care of ambulatory residents only shall not accommodate nonambulatory residents. . Residents whose condition becomes nonambulatory shall not remain in rooms restricted to ambulatory residentsBased on observation, the licensee did not comply with the section cited above by having a bedridden resident in a non-cleared room.

87202 Fire Clearance All facilities shall maintain a fire clearance…Prior to accepting or retaining any of the following types of persons…State Fire Marshal.(2) Bedridden persons Based on observation, the licensee did not comply with the section cited above by having a bedridden resident in a non-cleared room.

87303 Maintenance and Operation(a) The facility shall be clean...sanitary...at all times. Maintenance shall include provision of maintenance services...residents, employees and visitors. Based on observation, the licensee did not comply with the section cited above by not removing soiled linens in bedroom.

87463 Reappraisals (b) The reappraisal shall document significant changes in the resident's ...mental, cognitive...condition, including those required to be documented as specified in Section 87466, Observation of the Resident. Based on record review, the licensee did not comply with the section cited above by not performing a reappraisal since March 2023.

To care, supervision, and ...meet their individual needs...by staff that are sufficient in numbers, qualifications, and competency...This requirement was not met as evidence by: Based on interview, the licensee did not comply with the section cited above by not having the supervision which posed a potential health and safety risk to persons in care.

87202 Fire Clearance All facilities shall maintain a fire clearance…Prior to accepting or retaining any of the following types of persons…State Fire Marshal.(2) Bedridden persons Based on observation, the licensee did not comply with the section cited above by having a bedridden resident in a non-cleared room.

(2) Occurrences...which threaten the welfare, safety or health of residents,...shall be reported within 24 hours... Based on interview and record review the licensee did not comply with the section cited above by not reporting to CCL within 24hrs R1's elopement which posed a potential health, safety or personal rights risk to persons in care.

To care, supervision, and ...meet their individual needs...by staff that are sufficient in numbers, qualifications, and competency...This requirement was not met as evidence by: Based on interview, the licensee did not comply with the section cited above by not having the supervision which posed a potential health and safety risk to persons in care.

Administrator - Qualifications and Duties.The administrator shall have the qualifications..all requirements for an administrator shall apply. (1) Knowledge of the requirements for providing care and supervision appropriate to the residents. Based on Interviews and document review, Administrator did not update the Appraisal Needs and Services Plan for R1 nor train staff on new conditions from 602.

To care, supervision, and ...meet their individual needs...by staff that are sufficient in numbers, qualifications, and competency...This requirement was not met as evidence by: Based on interview, the licensee did not comply with the section cited above by not having the supervision which posed a potential health and safety risk to persons in care.

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 is not met as evidenced by: Based on observation the licensee did not comply with the section cited above in not having backyards clean, refrigerators/freezers clean which poses an potential health, safety or personal rights risk to persons in care.

§1569.605 Liability insurance; coverage requirementsOn and after July 1, 2015, all residential care facilities for the elderly, except those facilities that are an integral part of a continuing care retirement community, shall maintain liability insurance covering injury to residents and guests in the amount of at least one million dollars ($1,000,000) per occurrence and three million dollars ($3,000,000) in the total annual aggregate, caused by the negligent acts or omissions to act of, or neglect by, the licensee or its employees.This requirement is not met as evidenced by: Based on record review and interview the licensee did not comply with the section cited above in not having liability insurance which poses an potential health, safety or personal rights risk to persons in care.

80086 Alterations to Existing Building or New Facilities(a) Prior to construction or alterations, all licensees shall notify the licensing agency of the proposed change.(c) Prior to construction or alterations, state or local law requires that all facilities secure a building permit. Based on observation, the licensee did not comply with the section cited above in by not notifying Licensing of the renovations, providing a copy of building permit and ensuring that residents will be safe during renovation which poses an health and safety risk to persons in care.

80075 Health Related Services(k) The following requirements shall apply to medications which are centrally stored:(1) Medication shall be kept in a safe and locked place that is not accessible to persons other than employees responsible for the supervision of the centrally stored medication. This requirement is not met as evidenced by: Based on observation there was unlocked insulin located in the refrigerator which poses an immediate health and safety risk to persons in care.

87307 Personal Accommodations and Services(a) Living accommodations and grounds shall be related to the facility's function. The facility shall be large enough to provide comfortable living accommodations and privacy for the residents, staff, and others who may reside in the facility. The following provisions shall apply:(3) Equipment and supplies necessary for personal care and maintenance of adequate hygiene practice shall be readily available to each resident. The resident may provide the following items; however, if the resident is unable or chooses not to provide them, the licensee shall assure provision of: (D) Hygiene items of general use such as soap and toilet paper.This requirement is not met as evidenced by: Based on observation and interview the licensee did not comply with the section cited above in not having toilet paper in shared bathrooms for residents which poses an potential health, safety or personal rights risk to persons in care.

87355 Criminal Record Clearance(e) All individuals subject to a criminal record review (b) shall prior to working...in a licensed facility: (3) Request a transfe...of a criminal record clearance as specified in Section 87355(c) orThis requirement is not met as evidenced by: Based on observation and record review, the licensee did not comply with the section cited above in not having S3 associated with Guardian systems which poses an immediate health, safety or personal rights risk to persons in care.

87628 Diabetes(a) The licensee shall be permitted to accept or retain a resident who has diabetes if the resident is able to perform his/her own glucose testing with blood or urine specimens, and is able to administer his/her own medication including medication administered orally or through injection, or has it administered by an appropriately skilled professional.This requirement is not met as evidenced by: Based on record review and interview conducted, R7 is diabetic and per dr's medication orders requires insulin injections daily at night. However, R5 and R6 is unable to check own blood sugar and administer own injections per current physician's report, which poses an immediate health and safety risk to persons in care.

87621 Colostomy/IleostomyIn addition to Section 87611(b), the licensees shall be responsible for the following: (1) Ensuring that ostomy care is provided by an appropriately skilled professional.This requirement is not met as evidenced by: Based on observation, record review and interview, the licensee did not comply with the section cited above in not having exception request for R5's ostomy bag with documents that an appropriately skilled professional is caring for ostomy bag which poses an immediate health and safety risk to persons in care.

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.This requirement is not met as evidenced by: Based on observation, record review and interview the licensee did not comply with the section cited above in not having doctor's orders for hospital bed and bed rails for R4 and R5 respectively which poses an potential health, safety or personal rights risk to persons in care.

87555 General Food Service Requirements (b) The following food service requirements shall apply:(3) Between-meal nourishment or snacks shall be made available for all residents...(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.This requirement is not met as evidenced by: Based on observation and interview, the licensee did not comply with the section cited above in not having snacks, nonperishable foods for a minimum of one week and perishable foods for a minimum of two days which poses an immediate health, safety or personal rights risk to persons in care.

To care, supervision, and ...meet their individual needs...by staff that are sufficient in numbers, qualifications, and competency...This requirement was not met as evidence by: Based on interview, the licensee did not comply with the section cited above by not having the supervision which posed a potential health and safety risk to persons in care.

87621 Colostomy/Ileostomy(a) Except as specified in Section 87611(a), the licensee shall be permitted to accept or retain a resident who has a colostomy or ileostomy under the following circumstances Based on interview, and record review the licensee did not comply with the section cited above by not having appropriate documentation and care plan on file for R5's ostomy bag which poses a potential health and safety risk to persons in care.

87455 Acceptance and Retention Limitations(c) No resident shall be accepted or retained if any of the following apply:(1) The resident has active communicable tuberculosis. Based on interview, record review the licensee did not comply with the section cited above by not having written doctor's order indicating if R1 has active TB which poses a potential health and safety risk to persons in care.

(2) Occurrences...which threaten the welfare, safety or health of residents,...shall be reported within 24 hours...This requirement was not met as evidence by: Based on interview and record review the licensee did not comply with the section cited above by not reporting to CCL within 24hrs R4's elopement which posed a potential health, safety or personal rights risk to persons in care.

87465 Incidental Medical and Dental Care(6) When requested by... the Department, a record of dosages of medications which are centrally stored shall be maintained by the facility. Based on interview and record review the licensee did not comply with the section cited above by not having a record (MAR) for R1-R5 on file which poses a potential health and safety risk to persons in care.

To care, supervision, and ...meet their individual needs...by staff that are sufficient in numbers, qualifications, and competency...This requirement was not met as evidence by: Based on interview, the licensee did not comply with the section cited above by not having the supervision which posed a potential health and safety risk to persons in care.

(a) The licensee shall be permitted to accept or retain a resident who requires intramuscular, subcutaneous, or intradermal injections if the injections are administered by the resident or by an appropriately skilled professional. Based on interview, and record review the licensee did not comply with the section cited above by not having on file for R5 if the injections are administered by an appropriately skilled professional which poses a potential health and safety risk to persons in care.

87468.2(a)(4) Additional Personal Rights of Residents in Privately Operated Facilities..(a) In addition to the rights listed in Section 87468.1, Personal Rights of Residents in All Facilities, residents in privately operated residential care facilities for the elderly shall have all of the following personal rights: (4) To care, supervision, and services that meet their individual needs and are delivered by staff that are sufficient in numbers, qualifications, and competency to meet their needs.This requirement is not met as evidenced by: Based on observation, record review and interview the licensee did not comply with the section cited above in by not submitting a comprehensive plan for adequate staffing and to identify, document and mitigate elopements which posed a potential health and safety risk to persons in care.

(a) All facilities shall have a qualified...The Department may require that the administrator devote additional hours in the facility to fulfill his/her responsibilities when the need for such additional hours is substantiated by written documentation.This requirement is not met as evidenced by: Based on observation, record review and interview the licensee did not comply with the section cited above in by hiring a qualified administrator that will be present at the facility for 40 hours a week which poses a potential health, safety or personal rights risk to persons in care.

87458(c) Medical Assessments(c) The licensee shall obtain an updated medical assessment when required by the DepartmentThis requirement is not met as evidenced by: Based on observation, record review and interview the licensee did not comply with the section cited above in by not submitting updated physician's reports for all eleven (11) residents which poses a potential health, safety or personal rights risk to persons in care.

87788(h)(1)(A) Continuing Education Training Program Vendor RequirementsThis requirement is not met as evidenced by: Based on observation, record review and interview the licensee did not comply with the section cited above in by completing staff training with a approved CCLD approved vendor which poses a potential health, safety or personal rights risk to persons in care.

87628 Diabetes(a) The licensee shall be permitted to accept or retain a resident who has diabetes if the resident is able to perform his/her own glucose testing with blood or urine specimens, and is able to administer his/her own medication including medication administered orally or through injection, or has it administered by an appropriately skilled professional.This requirement is not met as evidenced by: This requirement is not met as evidenced by: Based on record review and interview conducted, R4 is diabetic and per dr's medication orders requires insulin injections daily at night. However, R2 and R3 is unable to check own blood sugar and administer own injections per current physician's report, which poses an immediate health and safety risk to persons in care.

(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 clientsThis requirement is not met as evidenced by: Based on observation, the licensee did not comply with the section cited above in by having bleach and Clorox spray unlocked under kitchen cabinet which poses an immediate health and safety risks to persons in care.

87303 Maintenance and Operations(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. Based on observation, the licensee did not comply with the section cited above in by not having the back yards cleaned up with ladders, mattresses, paint cans, doors removed and inaccessible to residents which poses an health and safety risk to persons in care.

80086 Alterations to Existing Building or New Facilities(a) Prior to construction or alterations, all licensees shall notify the licensing agency of the proposed change.(c) Prior to construction or alterations, state or local law requires that all facilities secure a building permit. Based on observation, the licensee did not comply with the section cited above in by not notifying Licensing of the renovations, providing a copy of building permit and ensuring that residents will be safe during renovation which poses an health and safety risk to persons in care.

80075 Health Related Services(k) The following requirements shall apply to medications which are centrally stored:(1) Medication shall be kept in a safe and locked place that is not accessible to persons other than employees responsible for the supervision of the centrally stored medication. This requirement is not met as evidenced by: Based on observation there was unlocked insulin located in the refrigerator which poses an immediate health and safety risk to persons in care.

87202 Fire Clearance(a) All facilities shall maintain a fire clearance approved by the city, county, or city and county fire department, or district providing fire protection services, or the State Fire Marshal. Prior to accepting or retaining any of the following types of persons, the applicant or licensee shall notify the licensing agency and obtain an appropriate fire clearance approved by the city, county, or city and county fire department, or district providing fire protection services, or the State Fire Marshal. Based on observation, the licensee did not comply with the section cited above in by having R1 located in a staff room without a fire clearance which poses an immediate health and safety risk to persons in care.

Each licensee shall furnish to the licensing agency such reports as the Department may require, including, but not limited to, the following:Any incident which threatens the welfare...of any resident, such as...abuse of a resident...or ...unexplained absence of any resident. the facility did not report incident to CCL

(a) 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 personal relationships with staff, residents, and other persons. This requirement was not met as evidence by:S1 had taken pictures of R1's soiled underwear and bedsheet and texted them to R1's friend with R1 included in text thread without R1's permission.

. The licensee shall ensure that a separate, complete, and current record is maintained for each resident in the facility or in a central administrative location readily available to facility staff and to licensing agency staff. Based on observation Licensee did not have any records completed for R1.

(a) Facility personnel shall at all times be sufficient in numbers, and competent to provide the services necessary to meet resident needs... Additional staff shall be employed as necessary... The licensing agency may require any facility to provide additional staff... Based on interview conducted with staff, when Licensee is on site, Licensee will monitor residents in the security cameras located in the office but will not interact with residents directly.

A plan for incidental medical and dental care shall be developed by each facility. The plan shall encourage routine medical...care and provide...obtaining such care, by compliance with the following:The licensee shall arrange...for medical...care appropriate to the conditions and needs of residents. R1 has not had any visit with a doctor because R1 does not have a primary doctor assigned yet. S1 states there is a medication that needs refill but has not been filled yet.

(a) Facility personnel shall at all times be sufficient in numbers, and competent to provide the services necessary to meet resident needs... Additional staff shall be employed as necessary... The licensing agency may require any facility to provide additional staff.. R2 eloped from the facility on January 14, 2025 and ended up at Kaiser Hospital for pneumonia and hypothermia

(a) Facility personnel shall at all times be sufficient in numbers, and competent to provide the services necessary to meet resident needs... Additional staff shall be employed as necessary... The licensing agency may require any facility to provide additional staff... This requirement was not met as evidence by:Based on interviews the Licensee did not comply with the section cited above in having sufficient supervision for residents, which posed an immediate health and safety risk to persons in care.

(a) Each licensee shall furnish to the licensing agency such reports as the Department may require... (1) A written report shall be submitted to the licensing agency and to the person responsible for the resident within seven days of the occurrence of any of the events specified in (A) through (D) below. This requirement was not met as evidence by: Based on record review the Licensee did not comply with the section cited above in report an elopement to CCLD, which poses a potential health and safety risk to persons in care.

87305 Alterations to Existing Building or New Facilities (a) Prior to construction or alterations, all facilities shall obtain a building permit.This requirement was not met as evidence by: Based on record review the Licensee did not comply with the section cited above in having a permit for alterations in facility, which poses a potential health and safety risk to persons in care.

87307 Personal Accommodations and Services (6) All outdoor and indoor passageways and stairways shall be kept free of obstruction. This requirement was not met as evidence by: Based on observation the Licensee did not comply with the section above in have solarium area blocked with 2 refrigerators, a couch, clothing and other items, which poses a potential health and safety risk to persons in care.

(21) Freezers of adequate size shall be maintained at a temperature of 0 degrees F, and refrigerators of adequate size shall maintain a maximum temperature of 40 degrees F. They shall be kept clean... This requirement was not met as evidence by: Based on observation the Licensee did not comply with the section cited above with having all four (4) refrigerator/freezers sanitary, which poses a potential health and safety risk for persons in care.

(b) The following food service requirements shall apply: (26) Supplies of nonperishable foods for a minimum of 1 week and perishable foods for a minimum of 2 days shall be maintained on the premises. This requirement was not met as evidence by: Based on observation the Licensee did not comply with the section cited above in having a minimum of 1 week perishable and 2 day non perishable foods on premises, which poses a potential health and safety risk to person in care.

(c) Licensees who accept and retain residents with dementia shall be responsible for ensuring the following: (4) There is an adequate number of direct care staff to support each resident’s physical, social, emotional, safety and health care needs... This requirement was not met as evidence by: Based on interviews the Licensee did not comply with the section cited above in having a sufficient number of staff which posed an immediate health and safety risk to persons in care.

(c) Licensees who accept and retain residents with dementia shall be responsible for ensuring the following: (5) Each resident with dementia shall have an annual medical assessment... and a reappraisal done at least annually... This requirement was not met as evidence by: Based on record review the Licensee did not comply with the section cited above in having R1 an annual medical assessment and reappraisal done, which poses a potential health and safety risk to persons in care.

The licensing agency shall have the authority to inspect, audit, and copy resident or facility records upon demand during normal business hours. Records may be removed if necessary for copying. Removal of records shall be subject to the requirements in Sections 87412(f), 87506(d), and 87508(b). Based on record review, the licensee did not comply with the section cited above by not having the resident's records available at the facility for LPA to inspect during regular business hours. LPA was informed that resident’s records was moved to another facility in which resident was transferred to which poses a potential health, safety or personal rights risk to persons in care.

§1569.683 Eviction notices; reasons for eviction contents; service(a) In addition to complying with other applicable regulations, a licensee of a residential care facility for the elderly who sends a notice of eviction to a resident 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. In addition, the notice to quit shall include all of the following:(1) The effective date of the eviction.(2) Resources available to assist in identifying alternative housing and care options, including public and private referral services and case management organizations.(3) Information about the resident's right to file a complaint with the department regarding the eviction, with the name, address, and telephone number of the nearest office of community care licensing and the State Ombudsman.(4) The following statement: "In order to evict a resident who remains in the facility after the effective date of the eviction, the residential care facility for the elderly must file an unlawful detainer action in superior court and receive a written judgmentsigned by a judge. If the facility pursues the unlawful detainer action, you must be served with a summons and complaint. You have the right to contest the eviction in writing and through a hearing."(b) The licensee, in addition to either serving a 30-day notice, or seeking approval from the department and serving three days notice, on the resident, shall notify, or mail a copy of the notice to quit to, the resident's responsible person.This requirement is not met as evidenced by: Based on interview and record review the licensee did not comply with the section cited above in serving R1 with an appropriate eviction notice that contained all items required under regulation, which poses a potential health and safety and personal rights risk to persons in care.

87411 Personnel Requirements – General(a) Facility personnel shall at all times be sufficient in numbers, and competent to provide the services necessary to meet resident needs.This requirement is not met as evidenced by: Based on observation, interviews and record review, the licensee did not comply with the section cited above in by not performing re-evaluations of R1 who was diagnosed with dementia on 02/03/24 and later AWOLd a total of 3 times in which this last AWOL R1 traveled over 50+ miles and found disoriented and confused by EMS which posed a potential health and safety risk to persons in care.

87211 Reporting Requirements(a) Each licensee shall furnish to the licensing agency such reports as the Department may require, including, but not limited to, the following(2)Occurrences,...shall be reported within 24 hoursThis requirement was not met as evidence by: Based on interview and record review the licensee did not comply with the section cited above by not reporting to CCL within 24hrs that resident eloped which posed a potential health, safety or personal rights risk to persons in care.

Based on observation, the licensee did not comply with the section cited above as trash bins in shared bathrooms were uncovered which poses a potential health, safety or personal rights risk to persons in care.

87204 Limitations - Capacity and Ambulatory Status(b) Resident rooms approved for 24-hour care of ambulatory residents only shall not accommodate nonambulatory residents. Residents whose condition becomes nonambulatory shall not remain in rooms restricted to ambulatory residents. This requirement is not met as evidenced by:The facility converted the formal dining room to a nonamb room with a nonamb resident occupant without an approved fire clearance.

87507 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.This requirement is not met as evidenced by: Based on record review conducted, the facility did not have an admission agreement that is compliant to the section cited. The facility is using a revised form that is not approved by the department and is missing required itemized charges which poses a potential risk to the health and safety of clients under care.

§1569.69 Employees assisting residents with self-administration of medication; training requirements(a) Each residential care facility for the elderly licensed under this chapter shall ensure that each employee of the facility who assists residents with the self-administration of medications meets the following training requirements: 2) In facilities licensed to provide care for 15 or fewer persons, the employee shall complete six hours of initial training. This training shall consist of two hours of hands-on shadowing training, ..Staff do not have sufficient medication training

87204 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 receive services at any one time. Based on interview conducted, the facility is approved for 3 nonamb residents. However, the actual number of nonamb residents is 6 which poses an immediate risk to the health and safety of clients under care.

87303 (a) The facility shall be clean, safe, sanitary... Maintenance shall include provision of maintenance services and procedures for the safety and well-being of residents... This requirement was not met as evidenced by: Based on staff, resident, and reporting party interviews, facility failed to prevent bed bugs which poses a potential personal rights of residents in care.

87411 Personnel Requirements - General (a) Facility personnel shall at all times be sufficient in numbers, and competent to provide the services necessary to meet resident needs...-This requirement is not met as evidenced by: Based on records review and interview, the licensee did not comply with the section above for not having sufficient staff which poses a potential safety and personal rights risks to persons in care.

87411 Personnel Requirements - General (a) Facility personnel shall at all times be sufficient in numbers, and competent to provide the services necessary to meet resident needs...-This requirement is not met as evidenced by: Based on records review and interview, the licensee did not comply with the section above for not having sufficient staff which poses a potential safety and personal rights risks to persons in care.

87411 Personnel Requirements - General (a) Facility personnel shall at all times be sufficient in numbers, and competent to provide the services necessary to meet resident needs...-This requirement is not met as evidenced by: Based on records review and interview, the licensee did not comply with the section above for not having sufficient staff which poses a potential safety and personal rights risks to persons in care.

87411 Personnel Requirements - General (a) Facility personnel shall at all times be sufficient in numbers, and competent to provide the services necessary to meet resident needs...Additional staff shall be employed as necessary to perform office work, cooking, house cleaning,..... ...laundering, and maintenance of buildings, equipment and grounds.-This requirement is not met as evidenced by:-Based on records review and interview, the licensee did not comply with the section above for not having sufficient staff which poses a potential safety and personal rights risks to persons in care.

87458 Medical Assessment; (a) Prior to a person's acceptance as a resident, the licensee shall obtain and keep on file, documentation of a medical assessment, signed by a physician, made within the last year.-This requirement is not met as evidenced by: -Based on record review and interview, the licensee did not comply with the section above for not having medical assessment or LIC602A on file which poses potential safety and personal rights risk to person in care,

87305 Alterations to Existing Building or New Facilities (a) Prior to construction or alterations, all facilities shall obtain a building permit. This requirement was not met as evidence by: Based on LPA's observation and record review the Licensee did not comply with the section cited above in obtaining a permit or notifying CCLD about the alterations, which poses a potential health and safety risk to persons in care.

87705 (c) Licensees who accept and retain residents with dementia shall be responsible for ensuring the following: (5) Each resident with dementia shall have an annual medical assessment... and a reappraisal done at least annually..., This requirement was not met as evidence by: Based on LPA's record review the Licensee did not comply with the section cited above in have a current medical assessment or appraisal, which poses a potential health and safety risk for persons in care.

87623 Indwelling Urinary Catheter (b) In addition to Section 87611, General Requirements for Allowable Health Conditions, the licensee shall be responsible for the following: This requirement was not met as evidence by: Based upon LPA's interview and record review the Licensee did not comply with the section cited above in having a skilled professional for a restricted health condition, which poses a potential health and safety risk for persons in care.

(a) ... residents in privately operated residential care facilities... shall have all of the following personal rights: (4)... supervision... that meet their individual needs... by staff that are sufficient in numbers... This requirment was not met as evidence by:

87307 (d)T he following space and safety provisions shall apply to all facilities: (6)All outdoor and indoor passageways... shall be kept free of obstruction. This requirement was not met as evidence by: Based on LPAs observation the Licensee did not comply with the section cited above in having an indoor passageway free of obstruction.

87211 Reporting Requirements(a)Each licensee shall furnish to the licensing agency such reports...including, but not limited to, the following: (2) Occurrences, such as...which threaten the welfare, safety or health of residents....This requirement is not met as evidenced by… Based on observation the licensee did not comply with the section cited above. Facility didn't report incident to CCL when incident occurred which poses a potential health, safety or personal rights risk to persons in care.

87405 Administrator - Qualifications and Duties. (h) The administrator shall have the responsibility to: (5) Provide or ensure the provision of services to the residents with appropriate regard for the residents' physical and mental well-being and needsThis requirement is not met as evidenced by… Based on observation the licensee did not comply with the section cited above. Facility didn't address bedbugs incident with responsible parties which poses a potential health, safety or personal rights risk to persons in care.

1569.269 Enumerated rights; severability(13)To be fully informed, as evidenced by the resident’s written acknowledgementThis requirement is not met as evidenced by… Based on observation the licensee did not comply with the section cited above. Facility didn't informed incident to resident's responsible parties which poses a potential health, safety or personal rights risk to persons in care.

87464 Basic Services(f)Basic services shall at a minimum include:(1)Care and supervision as defined in Section 87101(c)(3) and Health and Safety Code section 1569.2(c).This requirement is not met as evidenced by… Based on observation the licensee did not comply with the section cited above. Facility didn't seek medical attention for resident in a timely manner which poses a potential health, safety or personal rights risk to persons in care.

Based on observation, interview, and record review, the licensee did not comply with the section cited above, cleaning supplies in the bathroom and closet, power tools in the shed in the backyard, and laundry detergent in the laundry room were accessible to residents with dementia which poses an immediate health, safety or personal rights risk to persons in care.

Based on observation and interview, the licensee did not comply with the section cited above, water temperature was 142 degree F in bathroom which posed a potential health, safety or personal rights risk to persons in care.

Based on observation, interview and record review, the licensee did not comply with the section cited above in 2 heater vents on the 2nd floor were disrepair which posed a potential health, safety or personal rights risk to persons in care.

Based on observation and interview, the licensee did not comply with the section cited above. LPA observed that a basket of medication was left on the desk in the office where widely opened, and the centrally stored medicines was unlocked which poses an immediate health, safety or personal rights risk to persons in care.

Based on interview and record review, the licensee did not comply with the section cited above. A person who works at facility did not have background check clearance which poses an immediate health, safety or personal rights risk to persons in care.

Safeguards for Resident Cash, Personal Property, and Valuables - (g) Each licensee shall maintain adequate safeguards and accurate records of cash resources and valuables entrusted to his care, including, but not limited to… This requirement is not met as evidenced by Administrator's failure to establish policies and procedures to safeguard R1’s cash resources. Administrator possessed R1’s debit card but did not keep any accounting or records of purchases made and misappropriated R1’s funds.

Additional Personal Rights of Residents in Privately Operated Facilities - (8) To be free from neglect, financial exploitation, involuntary seclusion, punishment, humiliation, intimidation, and verbal, mental, physical, or sexual abuse. This requirement is not met as evidenced by S1’s actions of abusing R1’s cash resources. S1 used R1’s True Link debit card to make personal purchases in the amount of $3527.65.

Administrator - Qualifications and Duties – (d) The administrator shall have the qualifications specified in Sections 87405(d)(1) through (7). If the licensee is also the administrator, all requirements for an administrator shall apply.(5) Good character and a continuing reputation of personal integrity. This requirement is not met as evidenced by Administrator’s financial abuse of R1.

85068.5 Eviction Procedures(b) The licensee shall be permitted to evict a client by serving the client with a three-day written notice to quit provided ...(1) The licensing agency has granted prior written and/or documented telephone approval for the eviction.This requirement is not met as evidenced by Based on interview and records review; Administrator did not comply with the section cited above. Administrator did not follow proper eviction process, Administrator admitted not informing licensing office about the eviction of R1, which poses a potential Health, Safety, or Personal Rights risk to persons in care.