Precious Life Residences, Llc

Certified administrator requirements and substitute coverage

no deficiency

Maintain facility in clean, safe, sanitary condition

Based on observation, LPA and L1 toured the facility and observed side backyard fence boards broken, spider webs were observed around the outside of the facility patio and walls, live cockroach was observed in kitchen drawer, which poses/posed a potential health and safety and personal rights risk to the resident in care.

Maintain fire clearance before retaining specified persons

Based on observation, the licensee did not comply with the section cited above when LPA and L1 observed wood stick on the bottom of the exit sliding door blocking and preventing sliding door to open. LPA was informed by L1 and S2 that the wood stick is to prevent anyone from coming inside at night, which an immediate health and safety risk which poses an immediate health, safety or personal rights risk to persons in care.

Ensure hazardous items are locked and not unattended

Based on observation, the licensee did not comply with the section cited above when LPA and L1 observed knives stored in kitchen drawer, chemicals and cleaning solution unlock throughout the facility and tools were unlock in the garage cabinet, accessible to residents which poses an immediate health, safety or personal rights risk to persons in care.

Obtain required California clearance or exemption

Based on records reviewed, S1 is not fingerprinted cleared and not associated to facility was providing resident care and supervision, which poses an immediate risk to the health and safety of the residents.

Conformance with applicable laws and regulations

Based on observation, Fire Extinguisher has a service date of 08/09/24, which poses an immediate health and safety risk to the residents.

Record dose details and resident medication response

Based on observations, records reviewed, and interviews conducted, L1 administered R1’s Stimulant laxative medication on 11/18/25 in the morning, and R1’s Fentanyl patch was applied on 11/09/25 and did not record in the resident’s MARs, which poses/posed a potential health and safety risk for the person in care.

Store centrally held medications in locked secure place

Based on observation, the licensee did not comply with the section cited above when LPA and Licensee observed residents’ medications stored and unlock in the medication cabinet, medication on nightstand in room 4, and medications for former residents under dining room counter, which poses an immediate health, safety or personal rights risk to person in care.

Based on record review, all residents’ files were reviewed. A complete appraisal (Lic 603) and was not observed in R1 and R5 files. A complete Needs and Services plan (Lic 625) was not observed in R3, R4and R5’s files. Medical Consent form (Lic 627C) was not observed in R2, R3, and R5’s files. R5’s file was observed with no current physician report (Lic 602A), which poses/posed a potential health, safety or personal rights risk to persons in care.

Maintain physician order documentation in resident record

Based on interview conducted, observation and records reviewed, R4 uses a half rail bed. There is no doctor’s order for ½ rail bed for R4, which poses/posed a potential health and safety and personal rights risk to the resident in care.

Based on observation and records reviewed, R1 whose receiving hospice care and R2 whose not receiving hospice care were observed with full rail bed, which poses/posed a potential health and safety and personal rights risk to the resident in care.

Facility must keep complete hospice care plan on file

Based on record review, the licensee did not comply with the section cited above when LPA reviewed R1’s file, whose currently receiving hospice care with no hospice care plan on file, which poses a potential health or personal rights risk to persons in care.

S2 do have current First Aid/ CPR certification, this poses an immediately health and safety risk for the residents in care.

87507(g)(5)(A) Refund conditions. (A)Facility policy concerning refunds, including the conditions under which arefund for advanced monthly fees will be returned in the event of a resident’s death…This requirement is not met as evidenced by: Based on records reviewed and interview conducted, the licensee did not comply with the section cited above whenR2 made payments for September 2024 in August 2024 and deceased on 09/27/24. R1 made payments for October 2024 in September 2024 and R1 moved out of the facility on 10/27/24. L1 did not refund full refund amount after R2 deceased, which poses/posed a potential health, safety or personal rights risk to persons in care

HSC 1569.655 (a) If a licensee of a residential care facility for the elderly increases the rates of fees for residents or makes increases in any of its rate structures for services, the licensee shall provide no less than 60 days' prior written notice to the residents or the residents' representatives setting forth the amount of the increase, the reason for the increase, and a general description of the additional costs, except for an increase in the rate due to a change in the level of care of the resident…This requirement is not met as evidenced by: Based on records reviewed and interview conducted, the licensee did not comply with the section cited above. Licensee informed R1 rent adjust applied starting the same month, which poses/posed a potential health, safety or personal rights risk to persons in care.

Ensure hazardous items are locked and not unattended

Based on observation, the licensee did not comply with the section cited above when LPA observed cleaning supplies unlock under the kitchen sink and under bathroom sink. At approximately 12:42PM, LPA and L1 observed chemicals stored in garage cabinet unlock. Alcohol bottle was observed on resident television stand unlock in the R3 and R5’s shared room. Cleaning chemicals stored under bathroom sink unlock. A bleach bottle was observed outside next the BBQ grill unlock accessible to residents in care this poses an immediate health, safety or personal rights risk to persons in care.

Give PRN medication by physician order

Based on records review and observation, staff did not administer R1’s medication Cardizem 120 mg as directed by physician, which poses an immediate health and safety risk for the person in care.

Store centrally held medications in locked secure place

Based on observation, the licensee did not comply with the section cited above when LPA and Licensee observed residents’ medications stored and unlock in the medication cabinet. Over the counter medications were observed stored in First Aid box unlock on the wall. LPA observed R1 and R2 refrigeration medication was observed stored in the refrigerator unlock which poses an immediate health, safety or personal rights risk to person in care.

Notify agency before locking doors or gates

Based on observation, the licensee did not comply with the section cited above when LPA observed knives stored unlock under medication shelf and in in garage cabinet accessible to residents which poses an immediate health, safety or personal rights risk to persons in care.

Maintain required personnel records for staff

Based on records review, S1 and S2 do not have all the required personnel records maintained on file.

Keep prescriptions in original containers

Based on observation, the licensee did not comply with the section cited above when LPA checked R1’s medication and observed a different color tablet stored with R1’s Losartan 50mg medication in the medication bottle which poses an immediate health, safety or personal rights risk to persons in care.

Document each PRN medication dose taken

Based on observation and records reviewed, LPA and Administrator reviewed residents’ MARs and observed five out of six residents’ medications that were dispense were not documented for three occasions. Resident 4 (R4)’s PRN medication Miralax documented administered by staff for three days after medications had ran out and last dispensed on 01/14/24. MAR not documented correctly by staff possess a potential health and safety risk for the person in care.

Store centrally held medications in locked secure place

Based on observation, the licensee did not comply with the section cited above when LPA and Administrator observed at approximately 11:18 AM in bedroom 1, Resident 1 (R1)’s whose able to store own medication, all R1's medications stored on top and in a rolling night stand unlock. At approximately 11:22 AM, LPA and Administrator observed in bedroom 4 bathroom, Risamine ointment, Dayquil 12 oz, and Hydrocortisone cream 1% stored under bathroom sink unlock. LPA and Administrator was informed by staff that Resident 3 (R3)’s Triamclinolone 1% cream was stored under bathroom sink unlock. Medications were observed unlock and accessible to residents poses an immediate health, safety or personal rights risk to person in care.