Summerfield of Fresno

Personal assistance and care for required daily activities

87464 Basic Services (f) Basic services shall at a minimum include: (4) Personal assistance and care as needed by the resident and as indicated in the pre-admission appraisal, with those activities of daily living such as dressing, eating, bathing and assistance with taking prescribed medications, as specified in Section 87608, Postural Supports. This requirement was not met as evidence by: interviews conducted and LPA observations. The licensee did not comply with the section cited above in that meals were observed at bedside, in kitchenette refrigerators and in front of residents requiring assistance. Interviews disclosed residents requiring assistance should be assisted prior to meal service but is not occurring. This poses a potential health safety and or personal rights risk to residents 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: (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…(D) Any incident which threatens the welfare, safety or health of any resident, such as psychological abuse of a resident by staff or other residents, or unexplained absence of any resident. This requirement was not met as evidence by: review of records. The licensee did not comply with the section cited above in that the facility did not report R1 eloping from the facility on 7/25/25 and 8/2/25. This poses a potential health safety and or personal rights risk to residents in care.

87705 Care of Persons with Dementia (f) Licensees that lock exterior doors or perimeter fence gates shall meet the following initial and continuing requirements: (5) Interior and exterior space shall be available on the facility premises to permit residents with dementia to wander freely and safely. This requirement was not met as evidence by: LPA observation. The licensee did not comply in the section cited above in that Delayed egress door in Garden kitchenette took 38 seconds to open from inside the kitchenette to the outside courtyard area and would not open from the outside to the inside of the facility. This door did not open in the required time posing a harm for residents in care.

Maintain fire clearance before retaining specified persons

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. This requirement was not met as evidence by: LPA observations. The licensee did not comply with the section cited above in that all facility gates were observed with pads locks on them preventing exiting. Review of records indicated the facility did not provide the Department with the proper paperwork to get an appropriate fire clearance approval. This poses an immediate health safety and or personal rights risk to residents in care. *****Immediate civil penalty in the amount of $500 assessed.*****

Facility personnel sufficiency and competence

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. In facilities licensed for sixteen or more, sufficient support staff shall be employed to ensure provision of personal assistance and care as required… This requirement was not met as evidence by: review of records and interviews completed. The licensee did not comply with the section cited above in that R1 eloped from the facility on 7/25/25 and 8/2/25 without staff supervision. This poses an immediate health safety and or personal rights risk to residents in care.

Obtain required California clearance or exemption

(e) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1569.17(b) shall prior to working, residing or volunteering in a licensed facility: (2) Obtain a California clearance or a criminal record exemption as required by the Department… This requirement was not met as evidence by: S1 observed at the facility working around residents and not being supervised without being fingerprint cleared/associated to the facility. This poses an immediate health safety and or personal rights risk to residents in care.***An immediate civil penalty in the amount of $500 was assessed.***

Request transfer of criminal record clearance

87411 Personnel Requirements - General(g) Prior to employment or initial presence in the facility, all employees and volunteers subject to a criminal record review shall: (2) Request a transfer of a criminal record clearance as specified in Section 87355(c) or ... This requirement was not met as eivdence by: LPA observation, the licensee did not comply with the section cited above in that Guardian Roster observved at 4:29 pm on 11/24/25 did not show S2 associated to the facility. If not corrected this poses an immediate risk to the health safety and or personal rights of residents in care.***An immediate civil penalty of $100 was assessed***

Maintain facility in clean, safe, sanitary condition

87303 Maintenance and Operationa) 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 evidence by LPA observation, interviews conducted and records reviewed. The licensee did not comply with the section cited above in that the facility had on overwhelming odor of incontinence during multiple visits, observation of residents room having feces on the wall and dirty laundry pilled in bathrooms. This poses a potential health, safety and or personal rights risk to residents in care.

Regular representative updates on care

87468.1 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: (8) To have their representatives regularly informed by the licensee of activities related to care or services, including ongoing evaluations, as appropriate to their needs. This requirement was not met as evidence by: LPA observations, interviews conducted and records reviewed. The licensee did not comply with the section cited above in that there is verified outbreak and family was not notified. This poses a potential health, safety and or personal rights risk to residents in care.

Residents in all facilities must have rights

87468.1 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:... This requirement was not met as evidence by LPA observation, interviews conducted and records reviewed. The licensee did not comply with the section cited above in facility staff did not prevent incidents between residents. This poses a potential health, safety and or personal rights risk to residents in care.

Certified administrator requirements and substitute coverage

87405 Administrator - Qualifications and Duties(a) All facilities shall have a qualified and currently certified administrator. The licensee and the administrator may be one and the same person. The administrator shall have sufficient freedom from other responsibilities and shall be on the premises a sufficient number of hours to permit adequate attention to the management and administration of the facility as specified in this section... This requirement was not met as evidence by LPA observation, interviews conducted and records reviewed. The licensee did not comply with the section cited above in that Administrator did not respond to resident representives in a timely manner and was not at the facility an appropriate amount of time. This poses a potential health, safety and or personal rights risk to residents in care.

87411 Personnel Requirements - GeneralFacility personnel shall at all times be sufficient in numbers, and competent to provide the services necessary to meet resident needs... This requirement was not met by: LPA observations and interviews conducted. The licensee did not comply with the section cited above in that facility is not meeting residents incontience needs, served frozen food, and night staff was sleeping during a working shift. This poses an immediate health, safety and or personal rights risk to residents in care.

Facility personnel sufficiency and competence

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. In facilities licensed for sixteen or more, sufficient support staff shall be employed to ensure provision of personal assistance and care as required in Section 87608, Postural Supports. Additional staff shall be employed as necessary to perform office work, cooking, house cleaning, laundering, and maintenance of buildings, equipment and grounds. The licensing agency may require any facility to provide additional staff whenever it determines through documentation that the needs of the particular residents, the extent of services provided, or the physical arrangements of the facility require such additional staff for the provision of adequate services. This requirement was not met as evidenceew of facitliy schedule show call offs we by LPA interviews and record review. The licensee did not comply with the section cited above in that R2 became verbally aggressive with residents and staff on 7/14/25. Review covered with limited staff.

Right to sufficient care and qualified staff

87468.2 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 was not met as evidence by interviews conducted. The licensee did not comply with the section cited above in that the staff on duty left R1 in their wheelchair at night. This poses a potential health safety and or personal rights risk to residents in care.

Update reappraisal at required intervals

87463 Reappraisals (a) The pre-admission appraisal, as specified in Section 87457, Pre-Admission Appraisal, shall be updated in writing as frequently as necessary or once every 12 months, whichever occurs first, to note significant changes in condition, as defined in Section 87101, Definitions, and to keep the appraisal accurate. For the purposes of this section, the updated pre-admission appraisal shall be referred to as the reappraisal. This requirement was not met as evidence by interviews conducted and record review. The licensee did not comply with the section cited above in that file review disclosed R2 has a history of anxiety/aggression. Interviews conducted disclosed R2 became verbally aggressive with residents and staff on 7/14/25. File review does not indicate R2 has had a recent needs and service plan/reappraisal completed within the last year per regulation.

Maintain fire clearance before retaining specified persons

.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. This requirement was not met as eivdence by: LPA observation. The licensee did not comply with the section cited above in that the Garden Kitchenette was observed with a broom jammed in the door handle, preventing the door from being accessed/used. Garden and Seaside kitchenette observed to take 25 (Garden) and 43 (Seaside) seconds to unlock the delayed egress door to exit. Perimeter gates observed to be locked with a chain and pad lock, preventing gates from being accessed. This poses an immediate health, safety and or personal rights risk to residents in care.

87555 General Food Service Requirements (b) The following food service requirements shall apply: (10) Where indicated, food shall be cut, chopped or ground to meet individual needs. This requirement was not met as evidence by file review and LPA observation. Records reviewed indicate R2 is on a pureed diet. Interviews conducted indicated R2 is being provided with food that is not always pureed. This poses a potential health, safety and or personal rights risk to residents in care.

Regular observation and documentation of resident changes

87466 Observation of the ResidentThe licensee shall ensure that residents are regularly observed for changes in physical, mental, emotional and social functioning and that appropriate assistance is provided when such observation reveals unmet needs... This requirement was not met as evidence by: LPA observation and record review. The Licnesee did not comply with the section cited above in that R1 had an unwitnessed fall (date and details unknown). Incident was not documented or reported and R1 did not receive timely medical care.

Give PRN medication by physician order

87465 Incidental Medical and Dental Care (c) If the resident's physician has stated in writing...(2) Once ordered by the physician the medication is given according to the physician's directions. This requirement was not met as evidence by: review of records. The licensee did not comply with the section cited above in that R1's MARS was reviewed and indicated R1 did not receive 2 medications (Buspirone 5 mg and Senna/Docusate 8.5/50 mg) on 7/2/25 and 7/4/25. This poses a potential health, safety and or personal rights risk to residents in care.

87608 Postural Supports (a) Based on the individual's preadmission appraisal, and subsequent changes to that appraisal, the facility shall provide assistance and care for the resident in those activities of daily living which the resident is unable to do for himself/herself. Postural supports may be used under the following conditions... This requirement was not met as evidence by: LPAs review of resident records, observations and interviews conducted, the licensee did not comply with the section cited above in LPA observation of resident(s) observed with soft ties. Interviews disclosed soft ties are being utilized by resident(s) and review of records did not obtain a physicians prescription to be used. This poses a potential health, safety and or personal rights risk to residents in care.

Report specified resident events within seven days

87211 Reporting RequirementsEach licensee shall furnish to the licensing agency … (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 ... This requirement was not met as evidence by LPA interviews with staff, record review and observation of residents. The licensee did not comply with the section cited above in that R1, R2 and R3 incidents were not reported to CCL as required. This poses a potential health safety and or personal rights risk to residents in care.

Early illness recognition

87411 Personnel Requirements - General (d) All personnel shall be given on the job training or have related experience in the job assigned to them. This training and/or related experience shall provide knowledge of and skill in the following, as appropriate for the job assigned and as evidenced by safe and effective job performance: (5) Knowledge necessary in order to recognize early signs of illness and the need for professional help. This requirement was not met as evidence by record review. The licensee did not comply with the section cited above in that the facility did not obtain medical care for R1 in a timely manner, resulting in R1 being placed on hospice and passing. This poses an immediate health, safety and or personal rights risk to persons in care.

Right to sufficient care and qualified staff

87468.2 Additional Personal Rights of Residents in Privately Operated Facilities (a) In addition to the rights listed in Section 87468.1, ...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 was not met as evidence by: based on LPA record review and interviews conducted. The Licensee did not comply with this section cited above in that: R1 was involved with 4 altercations involving other residents in a period of 2 months. This poses a potential health, safety and or personal rights risk to residents in care.

Store toxic and hazardous substances safely

Based on LPA observation of chemicals observed in room #210 unlocked and accessible to resident in care. This poses a potential health, safety and or personal rights risk to residents in care.

Maintain facility in clean, safe, sanitary condition

Based on LPA observations of Room #407 observed with sagging mattress in need of replacement. Carpet in Apple kitchenette torn at transition observed in need of repair. Apple kitchenette cabinet handle broken and in need of repair. Room #310 toilet in need of cleaning. This poses a potential health safety and or personal rights risk to residents in care. Sidewalk in courtyard in need of debris removal. Handrailing in Garden wing in need of cleaning. Refrigerator/freezer in Garden wing in need of cleaning/repair. Spider webs observed throughout the facility in need of removal. Touch up paint needed in hallways in Garden wing. Seaside kitchenette flooring sticky and in need of cleaning. Wall in room #428 in need of patching/touch up. This poses a potential health, safety or personal rights risk to persons in care.

Ensure hazardous items are locked and not unattended

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. This requirement was not met as evidence by: LPA observation during tours completed on 9/10/24 and 9/16/24. Various areas of the facility were observed with items (sharps and chemicals) that pose a danger to residents in care unlocked and accessible.

On-the-job training requirements

87411 Personnel Requirements - General(d)All personnel shall be given on the job training or have related experience in the job assigned to them. This training and/or related experience shall provide knowledge of and skill in the following, as appropriate for the job assigned and as evidenced by safe and effective job performance: This requirement was not met as evidence by: review of records. Files review show that staff did not have the required training prior to being placed on the schedule without supervision for the NOC shift. This poses a potential health safety and or personal rights risk to residents in care.

87705 Care of Persons with Dementia(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 as identified in his/her current appraisal. This requirement was not met as evidence by: review of documentation, tours completed and interviews conducted which all indicate personal care needs (incontinence, grooming, bathing) are not being met. This poses a potential health safety and or personal rights risk to residents in care.

Facility personnel sufficiency and competence

87411(a) Personnel Requirements – General - Facility personnel shall at all times be sufficient in numbers, and competent to provide the services necessary to meet resident needs… This requirement was not met as evidenced by: Interviews and record review indicated R1 was left in the sun on 7/22/24 for an unknown amount of time resulting in R1 becoming unresponsive and requiring medical attention. This poses an immediate health, safety and or personal rights risk to residents in care. An immediate civil penalty in the amount of $500 was assessed per Title 22.

1569.312 Basic services requirementsEvery facility required to be licensed under this chapter shall provide at least the following basic services: (e) Monitoring the activities of the residents while they are under the supervision of the facility to ensure their general health, safety, and well-being. This requirement was not met as evidence by record review of SIR’s, staff schedules and interviews with staff. These disclosed the facility did not have coverage during the NOC shift in 1 of 4 units. This posed a potential health safety and personal rights risk to residents in care.

Facility must safeguard entrusted cash and valuables

87217 Safeguards for Resident Cash, Personal Property, and Valuables(b) Every facility shall take appropriate measures to safeguard residents' cash resources, personal property and valuables which have been entrusted to the licensee or facility staff. The licensee shall give the residents receipts for all such articles or cash resources. This requirement was not met as evidence by: Interviews conducted disclosed incontinent supplies are not properly being accounted for and going missing. LPA observation of storage room disclosed residents supplies were missing. This poses a health safety and or personal rights risk to residents in care.

87470 Infection Control Requirements(b) In addition to subsection (a), when one or more residents in the facility are diagnosed with a contagious disease, the following shall apply: (1) In addition to the requirements of subsection (a)(2) assigned staff and volunteers, regardless of having direct contact with residents, shall be required to perform enhanced environmental cleaning and disinfection to maintain a safe and sanitary environment and to prevent, contain, and mitigate the transmission of the contagious disease... This requirement was not met as evidence by: record review and interviews conducted disclosed 1 of 4 wings at the facility had an outbreak. This poses a potential health, safety and or personal right risk to residents in care.

Regular representative updates on care

87468.1 Personal Rights of Residents in All Facilities (a)(8) To have their representatives regularly informed by the licensee of activities related to care or services, including ongoing evaluations, as appropriate to their needs. This Requirement was not met as evidenced by: Based on interviews, the licensee did not comply with the section cited above for at least one Resident, which poses a potential health, safety or personal rights risk to persons in care.

Prompt responses to resident communications

87468.1 Personal Rights of Residents in All Facilities (a)(9) To have communications to the licensee from their representatives answered promptly and appropriately. This requirement was not met as evidenced by: Based on interviews, the licensee did not comply with the section cited above for at least one Resident, which poses a potential health, safety or personal rights risk to persons in care.

Give PRN medication by physician order

87465(c)(2) Incidental Medical and Dental Care: Once ordered by the physician the medication is given according to the physician's directions. This was not met as evidenced by: Based on records reviewed and observation, facility failed to provide medication for 3 residents, which poses an immediate Health & Safety risk to the residents in care.

Personal assistance and care for required daily activities

87646(f)(4) Basic services shall at a minimum include: Personal assistance and care as needed by the resident…with those activities of daily living such as dressing, eating, bathing…This requirement was not met as evidenced by: Based on records reviewed and interviews, facility failed to provide showers and grooming for at least 6 residents, which poses potential Health & Safety risk to the residents in care.

Facility personnel sufficiency and competence

87411(a) Personnel Requirements - General: Facility personnel shall at all times be sufficient in numbers, and competent to provide the services necessary to meet resident needs. This requirement was not met as evidenced by: Based on records review and interviews, Resident 1(R1) eloped from the facility unobserved on 6/24/2021. Based on records reviewed and observation, facility failed to provide supervision to 1 out of 45 residents, which poses an immediate Health & Safety risk to the residents in care.

Maintain facility in clean, safe, sanitary condition

87303 Maintenance and Operation (a):The facility shall be clean, safe, sanitary and in good repair at all times. This requirement was not met as evidenced by: Based on interviews and observation, the facility failed to keep the clean and sanitary in common areas and at least 1 bedroom, which poses potential Health & Safety risk to the residents in care.