Tlc Home Care 1

Maintain fire clearance before retaining specified persons

Based on observation and interview, the licensee did not comply with the section cited above in that the door from the dining room into the laundry room was locked and the laundry room, leads to the staff office, which is a fire exit (Exit #3 on the sketch), which poses an immediate health, safety or personal rights risk to persons in care.

Maintain facilities for fire and panic safety

Based on observation, the licensee did not comply with the section cited above in that the fire extinguiser was last serviced on 09/17/2024,which poses an immediate 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 that the hospice care plan for R1 indicates to record blood pressure readings and provide guidance for elavated readings on when to seek medical attention;however, Facility staff are not recording blood pressure readings for R1 and were not trained on when the reading would require medical attention, which poses/posed a potential health, safety or personal rights risk to persons in care.

Assist residents with self-administered medication

Based on observation, interview, and record review, the licensee did not comply with the section cited above in that the start date for R1's Losartan medication was on 12/18/25. Started with 30 pills, has eight pills left. Medication Hydrochlorothiazide has the same start date of 12/18/25 and started with 30 pills; however, has nine pills left. Both medications are administered in the morning according the MARs log. Hydrochlorothiazide medication was not administered, which poses an immediate health, safety or personal rights risk to persons in care.

Maintain records of centrally stored medication dosages

Based on observation, interview, and record revidew, the licensee did not comply with the section cited above in that facility staff did not log on the centrally stored log, R1's medication of Doxazosinmesylate,which poses/posed a potential health, safety or personal rights risk to persons in care.

Store centrally held medications in locked secure place

Based on observation, interview, and record review, the licensee did not comply with the section cited above in that Insulin medication was stored in a a lock box with no lock in a fridge in the garage. The garage is also kept unlocked, which poses an immediate 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 that the licensee used a second bed to block R3's closet, to keeep R3 from accessing the closet space, which poses an immediate 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 that the facility staff do not have training by skilled professional for R2's restricted health condition, which poses/posed a potential health, safety or personal rights risk to persons in care.

Each terminal resident needs a written hospice care plan

Based on observation, interview, and record review, the licensee did not comply with the section cited above in that R3 and R4 do not have a hospice care plan on file, which poses/posed a potential health, safety or personal rights risk to persons in care.

Protection from punishment and intimidation

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:(3) To be free from punishment, humiliation, intimidation, abuse, or other actions of a punitive nature, such as withholding residents’ money or interfering with daily living functions such as eating, sleeping, or elimination. This requirement was not met as evidenced by: Based on interviews, observation, and review of documentation: R1 was locked in bedroom due to wandering. In addition, R1 had a mattress on the floor without linen because R1 removes all linen and bedding, and goes under the bed, so the mattress was placed on the floor to avoid potential injury.

Maintain fire clearance before retaining specified persons

(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 count fire department, or district providing the fire protection services, or the State Fire Marshal. ***This was not met as evidenced by 3 of the 4 designated exits from resident rooms were locked requiring key to exit.

Ensure hazardous items are locked and not unattended

(a) Except as specified in subsection (b), the licensee shall ensure that disinfectants, cleaning solutions, poisonous substances, knives, matches, tools, sharp objects, and other similar items which could pose a danger to residents are in locked storage and are not left unattended if outside the locked storage. ***This was not met as evidenced by LPAs observed a clear bin with S2's medication in the kitchen unsecured. Medication for R1 in the refrigerator unsecured and cabinet under kitchen sink with cleaning supplies unlocked. All accessible to residents.

Auditory exit monitoring for elopement risk

(d) The licensee shall ensure that the facility has an auditory device or other staff alert feature to monitor exits on exterior doors and perimeter fence gates accessible to those residents who may be at risk for elopement, as defined in Section 87101, Definitions. ***This was not met as evidenced by: LPA's observed that the front door auditory alarm was in place but not in the "on" position upon arrival. Four of four exit doors from resident bedrooms did not have auditory alarms, and the sliding door to back yard had an auditory alarm that was not "on" during inspection.

Request a transfer of criminal record clearance

(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(3) Request a transfer of a criminal record clearance as specified in Section 87355(c) or: **This was not met as evidenced by Staff 1 (S1) is fingerprint cleared and not associated to facility. S1 has worked daily since 10/10/25 for a total of 5 days.

Store centrally held medications in locked secure place

87465 Incidental Medical and Dental Care (h) The following requirements shall apply to medications which are centrally stored: (2) Centrally stored medicines 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. Licensee did not ensure resident medications were stored as required. Medication box was observed on a kitchen table and Insulin was found to be refrigerated when orders state at room temp after opening.This poses a potential health and safety risk to 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..... 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: Licensee did not ensure: Patio area was unsafe and cluttered, side yard storage which stores tools was unlocked, multiple piles of trash and construction materials in the yard, shower mat was not clean, sharps storage was unsafe for staff. This poses a potential health & safety risk to residents in care.

Based on observation and intervie, the licensee did not comply with the section cited above, which poses an immediate health, safety or personal rights risk to persons in care. Licensee has altered the facility building by adding exit doors to each resident room without proper fire clearance or pcity permits. Two of the newly added doors are completely blocked by resident beds and a third is obstructed by forniture and resident bed. The fire marshall or licensing were not informed.

Limit staff assistance with self-administered drugs

Based on observation and interview, the licensee did not comply with the section cited above, which poses an immediate health, safety or personal rights risk to persons in care. LPA observed S1 administer an Insulin Injection for R3.

Health screening and fitness requirements

Based on observations, interview, records review, the licensee did not comply with the section cited above in two out of two staff not having current health assessments, which poses a potential health, safety or personal rights risk to persons in care.

Based on observation, interview, and records review, the licensee did not comply with the section cited above. R1 has full length bed rails, but R1 is not on hospice and facility does not have an approved exception on file for R1, which poses a potential health, safety or personal rights risk to persons in care.

Based on interview and records review, the licensee did not comply with the section cited above in two out of two staff. S1 and S2 started working on 1/1/22 and have only received 10.5 training hours, which poses a potential health, safety or personal rights risk to persons in care.

Maintain facility in clean, safe, sanitary condition

Based on observations and interview, the licensee did not comply with the section cited above. LPA observed the complete grass area in backyard to be covered in dog feces and observed there were 3 dogs present on the facility premises, which poses a potential health, safety or personal rights risk to persons in care.

Provide resident hot water for personal care

Based on observations, the licensee did not comply with the section cited above. LPA measured the hall bathroom hot water at 130.1 degrees F, which poses an immediate safety risk to persons in care.