Real Care Llc

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. This requirement was not met as evidenced by: Based on observation and interview, the gate on Real Rd was observed secured closed with a chain and a lock. Another exit gate from the walkway on Chester Lane was observed with a lock; however, the gate was unlocked, this gate leads to another gate that exits to parking lot, the area between both gates was observed being utilized to store lawn and gardening supplies and tools.

87307 Personal Accommodations and Services(e) The licensee shall supervise residents as needed and as determined by the resident's appraisal pursuant to Section 87457, Pre-Admission Appraisal or Section 87463, Reappraisals, when residents are in proximity to or when there is use of the following items:(2) Fishponds, wading pools, hot tubs, swimming pools, or similar larger bodies of water. (A) The licensee shall ensure that the bodies of water specified above are inaccessible through fencing, covering, or other means when not in active use by residents. This requirement was not met as evidenced by: Based on observation and interview, the four gates to the pool were observed unlocked and one gate was observed with the key inside the lock, making the pool accessible to residents.

Ensure hazardous items are locked and not unattended

87309 Storage Space and Access(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 requirement was not met as evidenced by: Based on observation and interview, exit gate from the walkway on Chester Lane was observed with a lock; however, the gate was unlocked, this gate leads to another gate that exits to parking lot, the area between both gates was observed being utilized to store plastic gasoline cans, lawn and gardening supplies and tools.

87618 Oxygen Administration - Gas and Liquid(b) In addition to Section 87611(b), the licensee shall be responsible for the following:(3) Ensuring that the use of oxygen equipment meets the following requirements:(F)Plastic tubing from the nasal canula or mask to the oxygen source shall be long enough to allow the resident movement within his/her room but does not constitute a hazard to the resident or others. R1 was observed in a wheelchair. The wheelchair wheels were observed to be rolling over the canula tube while moving around the room. The canula tube was observed to measure approximately 20 ft in length causing possible obstruction to oxygen flow.

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...(D)Any incident which threatens the welfare, safety or health of any resident...This requirement was not met as evidenced by LPAs interview with R1, who stated went to the hospital on two occassions. A review of facility files, shows no incident was submitted for R1's hospital visit.

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 LPA observed room 174 to be floaded and with an industrial fan to air out the room. LPAs also observed multiple resident rooms and hallways throughout the facility with dirty and/or stained carpet, toilets, and showers. In addition the kitchen tiles have dirt built up in the groute.

87355 Criminal Record Clearance(b) Prior to the Department issuing a license, the applicant, administrator and any adults other than a client, residing in the facility shall have a criminal record clearance or exemption.This requirement was not met as evidenced by LPAs observation of two individuals not on the facility schedule as employees, had personal belongings in rooms 166 and 269 and staff reported that they reside there. A Civil Penalty in the ammount of $500 per individual for Criminal Record Clearance is here by assessed. If not corrected, the violation will have a direct and immediate risk to the health, safety, or personal righs of persons in care.

87303 Maintenance and Operation(i) Facilities shall have signal systems which shall meet the following criteria:(1) All facilities licensed for 16 or more and all residential facilities having separate floors or buildings shall have a signal system which shall: (A) Operate from each resident's living unit. This requirement was not met as evidenced by LPAs observation of Resident R1 and R2 did not have a signal system. If not corrected, the violation will have a direct and immediate risk to the health, safety, or personal righs of persons in care.

87355 Criminal Record Clearance(a) The Department shall conduct a criminal record review of all individuals specified in Health and Safety Code section 1569.17 and shall have the authority to approve or deny a facility license, or employment, residence, or presence in the facility, based upon the results of such review. This requirement was not met as evidenced by LPAs observed S1 to not be on the personnel roster and not finger print cleared. A Civil Penalty in the amount of $500 for Criminal Record Clearance is here by assessed. If not corrected, the violation will have a direct and immediate risk to the health, safety, or personal rights of persons in care.

87618 Oxygen Administration - Gas and Liquid(b) In addition to Section 87611(b), the licensee shall be responsible for the following:(3) Ensuring that the use of oxygen equipment meets the following requirements: (E) Oxygen tanks that are not portable shall be secured in a stand or to the wall. This requirement was not met as evidenced by LPAs observation of 5 unsecured Oxygen tanks in Resident R2s room. If not corrected, the violation will have a direct and immediate risk to the health, safety, or personal rights of persons in care.

Maintain fire clearance before retaining specified persons

87202(a) - (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 evidenced by: Licensee did not ensure approved fire cleareance was maintained by attaching latch locks on the outside of the main builiding, on top of the door, locking residents in facility which poses an immediate health, safety, and/or personal rights risk to resident in care.

Assist residents with self-administered medication

(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 did not ensure R1's medication were issued as prescribed. LPAs observed the Centrally stored medication log for R1 has a start date of 09/01/2025; however, medication bubble pack has a label indicating Date Opened is 09/05/25. Medication bubble pack shows eight pills out of 28 were administered for the evening and the bubble pack for the morning shows seven out of 28 were administered for the morning,which poses an immediate health, safety, and/or personal rights risk to resident in care.

Maintain records of centrally stored medication dosages

(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: (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 ensure R1 and R2 had a centrally stored log for August of 2025, which poses a potential health, safety, and/or personal rights risk to residents in care.

Label and preserve medicine compliance standards

87465(h)- The following requirements shall apply to medications which are centrally stored:(4) -All centrally stored medications shall be labeled and maintained in compliance with state and federal laws. No persons other than the dispensing pharmacist shall alter a prescription label. This requirement was not met as evidenced by: Licensee did not ensure prescription labels remained unaltered. LPAs observed the time for R1 to take a prescribed medication at noon was altered to indicate to take at 2 PM, which poses an immediate health, safety, and/or personal rights risk to resident in care.

Each terminal resident needs a written hospice care plan

(a)The licensee shall be permitted to accept or retain residents who have been diagnosed as terminally ill by his or her physician and surgeon and who may or may not have restrictive and/or prohibited health conditions, to reside in the facility and receive hospice services from a hospice agency in the facility when all of the following conditions are met:(4) A written hospice care plan which specifies the care, services, and necessary medical intervention related to the terminal illness as necessary to supplement the care and supervision provided by the facility is developed for each terminally ill resident or prospective resident by that resident’s hospice agency and agreed to by the licensee and the resident, or prospective resident, or the resident’s or prospective resident’s Health Care Surrogate Decision Maker, if any, prior to the initiation of hospice services in the facility for that resident, and all hospice care plans are fully implemented by the licensee and by the hospice(s). This requirement was not met as evidenced by: Licensee did not ensure R2 had a Hospice Care Plan, which poses a potential health, safety, and/or personal rights risk to residents in care.