Quality Care Assisted Living

87217 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 the following:(1) Records of residents' cash resources maintained as a drawing account shall include a ledger accounting (columns for income, disbursements and balance) for each resident, and supporting receipts filed in chronological order. Each accounting shall be kept current. The following requirement has not been met as evidenced by: Based on observation the facility staff was not keeping accurate record on a ledger documenting resident 1's purchases, which poses a potential, health, safety, or personalm rights risk to residents in care

Health screening and fitness requirements

(f) All personnel, including the licensee and administrator, shall be in good health, and physically and mentally capable of performing assigned tasks. Good physical health shall be verified by a health screening, including a chest x-ray or an intradermal test, performed by a physician not more than six (6) months prior to or seven (7) days after employment or licensure. A report shall be made of each screening, signed by the examining physician. The report shall indicate whether the person is physically qualified to perform the duties to be assigned, and whether he/she has any health condition that would create a hazard to him/herself, other staff members or residents. A signed statement shall be obtained from each volunteer affirming that he/she is in good health. Personnel with evidence of physical illness or emotional instability that poses a significant threat to the well-being of residents shall be relieved of their duties. This requirement was not met as evidenced by Licensee did not obtain a TB test for S1 and LPA observed S1 alter the health screening, writing in a date of 8/17/25 and marking the positive box which poses a potential 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 orThis requirement is not met as evidenced by: Licensee had S1 at the facility who was not fingerprint cleared according to LIS and Guardian which poses an immediate 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. When the administrator is not in the facility, there shall be coverage by a designated substitute who shall have qualifications adequate to be responsible and accountable for management and administration of the facility as specified in this section. 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 was not met as evidenced by Licensee did not have a current Administrator due to Administrator resigning 11/12/25 which 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 evidenced by: Licensee did not obtain a payee for R1's SSI money for rent and P&I money for R1 which poses an immediate health, safety and or personal rights risk to resident care.

Keep window screens clean and in repair

Based on [(observation), the licensee did not comply with the section cited above in several window screens in the facility courtyard were screwed into the wall, which poses/posed a potential health, safety or personal rights risk to persons in care.

Maintain records of centrally stored medication dosages

Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above in 2 of R3's medication were not properly documented. R3 had two different start dates of 5/1/25 and 5/16/25 for one medication and another medication did not indicate if it started AM or PM, which poses/posed a potential health, safety or personal rights risk to persons in care.

Facility must keep complete hospice care plan on file

Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above in not having a hospice care plan for R3, 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) (record review)], the licensee did not comply with the section cited above in administering two of R3's pills correctly. R3's medication 1 started on 5/1/25. Pill bottle originally contained 30 pills. R3 has 8 pills left and R3's medication 2 started on 5/1/25. Pill bottle originally contained 30 pills. R3 has 7 pills left, which poses an immediate health, safety or personal rights risk to persons in care.

Update reappraisal at required intervals

Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above in R3 did not have a current LIC 602 for change in condition or a diagnosis listed on LIC 602, which poses/posed a potential health, safety or personal rights risk to persons in care.

Obtain baseline medical assessment before resident admission

Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above in R1 did not have a completed LIC 602 missing several required boxes, which poses/posed a potential health, safety or personal rights risk to persons in care.

87211 Reporting Requirements (d) The licensee shall notify the Department, the State Long-Term Care Ombudsman, all residents, and, if applicable, their representatives, in writing within two business days of any of the following specified events, or knowledge thereof: (5) A utility company has sent a notice of intent to terminate electricity, gas, or water service on the property within not more than 15 days of the notice. This requirement was not met as evidenced by: Licensee did not report to Licensing Final Notice from PG & E that the electric was going to be shut off which poses an immediate health safety and or personal rights risk.

Assist residents with self-administered medication

87465 Incidental Medical and Dental Care (a) A plan for incidental medical and dental care shall be developed by each facility. The plan shall encourage routine medical and dental care and provide for assistance in obtaining such care, by compliance with the following: (4) The licensee shall assist residents with self-administered medications as needed. This requirement was not met as evidenced by Licensee had two loggings of the same medication by different doctors which was not logged as to why it was not administered and PRN's were not properly documented for the month of June.2024 which poses an immediate health safety and or personal rights risk to residents in care

Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above in Licensee did not have a physician note for R6 to have full bed rails which poses an immediate health, safety or personal rights risk to persons in care.

Based on observation, interview, & record review, the licensee did not comply with the section cited above which poses/posed a potential health, safety or personal rights risk to persons in care. Licensee did not have documentation to verify training was completed.

Based on observation, interview, record review, the licensee did not comply with the section cited above which poses/posed a potential health, safety or personal rights risk to persons in care. Licensee failed to document training completed by staff.

Based on observation, interview, & record review, the licensee did not comply with the section cited above which poses/posed a potential health, safety or personal rights risk to persons in care. Licensee failed to document the number of hours completed for training.

Based on observation, interview, & record review, the licensee did not comply with the section cited above which poses/posed a potential health, safety or personal rights risk to persons in care. Licensee failed to document the number of hours completed for training.

Maintain facility in clean, safe, sanitary condition

Based on observation, the licensee did not comply with the section cited above which poses/posed a potential health, safety or personal rights risk to persons in care. Broken window, screens torn, mold in ice maker, trash and misc. items along the side of the facility (pictures). Room 38's shower had mildew buildup (picture). Sliding door to courtyard does not open and close properly.

Provide resident hot water for personal care

Based on observation, the licensee did not comply with the section cited above which poses an immediate health, safety or personal rights risk to persons in care. R3 & R5 water temperatures were above the allowed limit. R3 was 128.1 and R5 was 139.9

Ensure hazardous items are locked and not unattended

Based on [(observation), the licensee did not comply with the section cited above in Licensee had cleaning supplies in unlocked closets and outdoors on the outside yard of the facility accessible to residents, which poses an immediate health, safety or personal rights risk to persons in care.

Request a transfer of criminal record clearance

Based on observation, interview, record review, the licensee did not comply with the section cited above which poses an immediate health, safety or personal rights risk to persons in care. Staff listed in the facility as the Administrator was not associated to the facility. Administrator was working in the facility for 2 months before being properly associated to the facility.

Facility personnel sufficiency and competence

Based on observation, interview, & record review, the licensee did not comply with the section cited above which poses/posed a potential health, safety or personal rights risk to persons in care. After conducting interviews with staff it was stated Administrator assists with MedTech and Caregiver duties when there is not enough staff.

Based on observation, interview, & record review, the licensee did not comply with the section cited above which poses/posed a potential health, safety or personal rights risk to persons in care. Licensee failed to maintain R3's physician report which did not have diagnosis listed.

Assist residents with self-administered medication

Based on observation, interview, record review, the licensee did not comply with the section cited above which poses an immediate health, safety or personal rights risk to persons in care. R1 had not received insulin medication from November 2023 to April 2024.

Limit staff assistance with self-administered drugs

Based on interview & record review, the licensee did not comply with the section cited above which poses an immediate health, safety or personal rights risk to persons in care. Interviewees (staff and residents) stated glucose testing is conducted by staff. R2 & R3's physician reports state the residents cannot administer self injection or conduct own glucose testing.

Require physician-written PRN medication directions

Based on observation, interview, & record review, the licensee did not comply with the section cited above which poses/posed a potential health, safety or personal rights risk to persons in care. Facility did not to have proper doctor's orders for resident's PRNs

Require physician order and label for PRN medication

Based on observation, interview, & record review, the licensee did not comply with the section cited above which poses/posed a potential health, safety or personal rights risk to persons in care. LPA observed resident files which did not have doctor's orders for PRN medication.

Keep prescriptions in original containers

Based on observation, interview, & record review, the licensee did not comply with the section cited above which poses/posed a potential health, safety or personal rights risk to persons in care. LPA observed medication not being stored in original containers, and being placed in envelopes to be passed out in the evenings.

Based on observation, interview, & record review, the licensee did not comply with the section cited above which poses/posed a potential health, safety or personal rights risk to persons in care. Licensee did not to have required documentation for R1, R2, R3, R4, & R5

Based on observation, interview, & record review, the licensee did not comply with the section cited above which poses/posed a potential health, safety or personal rights risk to persons in care. Licensee did not keep record of R1's medical needs when R1 refuses treatment.

Based on observation, interview, record review, the licensee did not comply with the section cited above which poses/posed a potential health, safety or personal rights risk to persons in care. Licensee failed to have consultation services provided in the facility for food services and document consultation services.

Maintain required personnel records for staff

87412 Personnel Records (a) The licensee shall ensure that personnel records are maintained on the licensee, administrator and each employee. Each personnel record shall contain the following information: This requirement was not met as evidenced by Licensee did not have a complete personnel file for S1 which poses a potential health safety and or personal rights risk to residents in care.

87219 Planned Activities (f) In facilities licensed for fifty (50) persons or more, one staff member shall have full-time responsibility to organize, conduct and evaluate planned activities, and shall be given such staff assistance as necessary in order for all residents to participate in accordance with their interests and abilities. The program of activities shall be written, planned in advance, kept up-to-date, and made available to all residents. The responsible employee shall have had at least one year of experience in conducting group activities and be knowledgeable in evaluating resident needs, supervising other employees, and in training volunteers. This requirement was not met as evidenced by Licensee does not have a full time staff for activities or planned activities for residents in care which poses an immediate health safety and/or personal rights risk to residents in care.

1522 Fingerprints and criminal records; exemptions; criminal record clearances (C) Any person who provides client assistance in dressing, grooming, bathing, or personal hygiene. Any nurse assistant or home health aide meeting the requirements of Section 1338.5 or 1736.6, respectively, who is not employed, retained, or contracted by the licensee, and who has been certified or recertified on or after July 1, 1998, shall be deemed to meet the criminal record clearance requirements of this section. A certified nurse assistant and certified home health aide who will be providing client assistance and who falls under this exemption shall provide one copy of their current certification, prior to providing care, to the community care facility. The facility shall maintain the copy of the certification on file as long as care is being provided by the certified nurse assistant or certified home health aide at the facility or in a certified family home or resource family home of a foster family agency. This paragraph does not restrict the right of the department to exclude a certified nurse assistant or certified home health aide from a licensed community care facility or certified family home or resource family home of a foster family agency pursuant to Section 1558.

87555 General Food Service Requirements (b) The following food service requirements shall apply: (17) In facilities licensed for fifty (50) or more, and providing three (3) meals per day, a full-time employee qualified by formal training or experience shall be responsible for the operation of the food service. If this person is not a nutritionist, a dietitian, or a home economist, provision shall be made for regular consultation from a person so qualified. The consultation services shall be provided at appropriate times, during at least one meal. A written record of the frequency, nature and duration of the consultant's visits shall be secured from the consultant and kept on file in the facility. This requirement was not met as evidenced by Licensee could not provide copies of trained staff that will meet this regulation which poses a potential health safety and or personal rights risk to residents in care.

Modified diets for medical necessity

87555 General Food Service Requirements (b) The following food service requirements shall apply:(7) Modified diets prescribed by a resident's physician as a medical necessity shall be provided. Licensee did not provide a modfied diet menu for residents R1 thru R6 that require doctor order modified diets which poses a potential health safety and or personal rights risk to residents in care.

Diet quality and preparation in safe healthful manner

87555 General Food Service Requirements (a) The total daily diet shall be of the quality and in the quantity necessary to meet the needs of the residents and shall meet the Recommended Dietary Allowances of the Food and Nutrition Board of the National Research Council. All food shall be selected, stored, prepared and served in a safe and healthful manner. This requirement was not met as evidenced by: Licensee did not have a sufficient amout of meat planned to cook for dinner. Facility had 5 to 7 pounds of meat out for dinner for 43 residents which poses an immediate health safety and or personal rights risk to residents in care.

Immediate disposal of contaminated food

87555 General Food Service Requirements (b) The following food service requirements shall apply(28) All food shall be protected against contamination. Contaminated food shall be discarded immediately upon discovery. This requirement was not met as evidenced by Licensee did not properly store uncooked hamburger meat which was left out and felt warm to touch. Facility staff placed meat back in the freezer which poses an immediate health safety and or personal rights risk to residents in care.

Onsite food stock levels for nonperishables and perishables

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. This requirement was not met as evidenced by Licensee did not have nonperishable foods for a minimum of one week and perishable foods for a minimum of two days shall be maintained on the premises, which poses a potential health safety and or personal rights risk to residents in care.

Right to personal privacy in daily care

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: (1) To have a reasonable level of personal privacy in accommodations, medical treatment, personal care and assistance, visits, communications, telephone conversations, use of the Internet, and meetings of resident and family groups.This was not met as evidenced by Licensee sends calls to staff's personal cell phones for residents which does not allow privacy which poses a potential health safety and or personal rights risk to residents in care.

87465 Incidental Medical and Dental Care(6) The licensee shall be responsible for assuring that a record of centrally stored prescription medications for each resident is maintained for at least one year and includes: Licensee did not comply with this section by not having a centrally stored log for some of R1's medications which poses a potential health safety and or personal rights risk to residents in care.

Assist residents with self-administered medication

87465 Incidental Medical and Dental Care (a) A plan for incidental medical and dental care shall be developed by each facility. The plan shall encourage routine medical and dental care and provide for assistance in obtaining such care, by compliance with the following: (4) The licensee shall assist residents with self-administered medications as needed. This requirement was not met as evicdenced by: Licensee did not ensure R1's medication was administered from 1/1/24 to 1/4/24 which poses an immediate health safety and or personal rights risk to residents in care.

87465 Incidental Medical and Dental Care (6) When requested by the prescribing physician or the Department, a record of dosages of medications which are centrally stored shall be maintained by the facility. This requirement was not met as evidenced by Licensee did not have a centrally stored log for some of C1's and C2's medications which poses a health safety and personal rights risk to clients in care.

Modified diets for medical necessity

87555 General Food Service Requirements (b) The following food service requirements shall apply: (7) Modified diets prescribed by a resident's physician as a medical necessity shall be provided. This requirement was not met as evidenced by: Licensee did not provide a special diet for C2 who requires a special diet on LIC602. Based on observation and interview, C2 had cereal for breakfast and raviolis, peaches and potato chips for lunch which poses a potential health safety and or personal rights risk to clients in care.

87555 General Food Service Requirements (b) The following food service requirements shall apply: (17) In facilities licensed for fifty (50) or more, and providing three (3) meals per day, a full-time employee qualified by formal training or experience shall be responsible for the operation of the food service. If this person is not a nutritionist, a dietitian, or a home economist, provision shall be made for regular consultation from a person so qualified. The consultation services shall be provided at appropriate times, during at least one meal. A written record of the frequency, nature and duration of the consultant's visits shall be secured from the consultant and kept on file in the facility. This regulation was not met as evidenced by Licensee does not had trained kitchen staff or a consultation with a qualified person which poses a potential health safety and or personal rights risk to clients in care.

Maintain cleanliness and prevent incontinence odors

87625 Managed Incontinence (b) In addition to Section 87611, General Requirements for Allowable Health Conditions, the licensee shall be responsible for the following:(3) Ensuring that incontinent residents are kept clean and dry and that the facility remains free of odors from incontinence. This requirement was not met as evidenced by Licensee did not ensure R1 was clean and dry by R1 being observed outside soiled with flies on R1 which poses a potential health safety and or personal rights risk to residents in care.

Written exception request for prohibited conditions

87616 Exceptions for Health Conditions (a) As specified in Section 87209, Program Flexibility, the licensee may submit a written exception request if he/she agrees that the resident has a prohibited and/or restrictive health condition but believes that the intent of the law can be met through alternative means. This requirement was not met as evidenced by Licensee did not submit an exception for R2's restricted health care plan which poses and immediate health safety and/or personal rights risk to residents in care.

Keep prescriptions in original containers

87465 Incidental Medical and Dental Care (h) The following requirements shall apply to medications which are centrally stored: (5) Each resident's medication shall be stored in its originally received container. No medications shall be transferred between containers. This requirement was not met as evidenced by Licensee did not store all residents medications in original container. LPA observed all resident medcations in individual small manilla envelopes with residents names which poses an immediate health and safety and or personal rights risk to residents in care.

Based on record review, the licensee did not comply with the section cited above in by not having staff training to meet this requirement, which poses/posed a potential health, safety or personal rights risk to persons in care.

Maintain records of centrally stored medication dosages

Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above by not having a centrally stored log for 3 out of 5 residents reviewed, which poses/posed a potential health, safety or personal rights risk to persons in care.

Provide resident hot water for personal care

Based on observation, the licensee did not comply with the section cited above in 4 out of 4 rooms, where water measured at over 130 F in each room, which poses an immediate health, safety or personal rights risk to persons in care.

Based on record review, the licensee did not comply with the section cited above by not having staff training, which poses/posed a potential health, safety or personal rights risk to persons in care.

Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above in [count] out of [total count] [(objects) (persons)] [identifiers] 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 by not logging R1's medication on MARS or having a start date to show when medication was being administered which poses an immediate health, safety or personal rights risk to persons in care.

Assist PRN administration when symptoms unclear

Based on observation interview and record review, the licensee did not comply with the section cited above by having missing PRN narcotics that were not logged as being given to R2, which poses an immediate health, safety or personal rights risk to persons in care.

Document each PRN medication dose taken

Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above by not having a complete record for R2's PRN log, which poses/posed a potential health, safety or personal rights risk to persons in care.

Report specified resident events within seven days

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. This report shall include the resident's name, age, sex and date of admission; date and nature of event; attending physician's name, findings, and treatment, if any; and disposition of the case. This requirement was not met as evidenced by: Licensee did not report communicable disease or hospitalizations for R1, which poses a potential health, safety, and/or personal rights risk to residents in care.

1569.49 Civil penalties; regulations setting forth appeal procedures for deficiencies (c) The department shall assess an immediate civil penalty of five hundred dollars ($500) per violation and one hundred dollars ($100) for each day the violation continues after citation for any of the following serious violations: (1) Any violation that the department determines resulted in the injury or illness of a resident. This was not met as evidenced by: Licensee did not seek timely medical attention for R1, resulting in a hospitalization with additional medical issues due to neglect, which poses an immediate health, safety, and/or personal rights risk to residents in care.

Assist residents with self-administered medication

87465 Incidental Medical and Dental Care (a) A plan for incidental medical and dental care shall be developed by each facility. The plan shall encourage routine medical and dental care and provide for assistance in obtaining such care, by compliance with the following:(4) The licensee shall assist residents with self-administered medications as needed. This was not met as evidenced by: Licensee was not following physician orders when administering R1's medication, which poses an immediate health, safety, and/or personal rights risk to residents in care.