Country Inn of Downey

Maintenance and OperationThe facility shall be clean, safe, sanitary and in good repair at all times.This requirement is not met as evidenced by: As evidenced by observation and record reivew Resident 1's room contained a broken window of which Administrator was aware of since early November 2025 and has not been repaired, which poses a potential health and safety and personal rights risk to persons in care.

87465 Incidental Medical and Dental Care(c) If the resident's physician has stated in writing that the resident is unable to determine his/her own need for nonprescription PRN medication but can communicate his/her symptoms clearly, facility staff designated by the licensee shall be permitted to assist the resident with self-administration, provided all of the following requirements are met:(2) Once ordered by the physician the medication is given according to the physician's directions.This requirement was not met as evidence by: While LPA was reviewing medication 1 out of the 10 residents medications reviewed appeard to have missed their am medications as the bubble pack for R9's AM medications (for 1/9/25) were still in bubble pack, S1 investigated this error and it was discovered that the medication was missed as the medtech from the evening shift (on 1/8/25) experienced an emergency in the middle of prepping meds for the following morning (1/9/25) and did not pop the medications, causing the medication to be missed in the moring of 1/9/25. This error was discovered at approx. 12:40pm on 1/9/25.

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 standard is not met as evidence by: During visit LPA inspected the elevators emergency alarm button and when button was pushed, there was no sound, no lights, no idication that the emergency button was pressed, which poses a potential health, safety or personal rights risk to residents in care.

Based on observation, interview, record review, the Administrator did not comply with the section cited above in which there are currently (2) residents (R1/R2) under hospice care and CCL/Licensing was not notified in writing of the initiation of hospice care services which poses/posed a potential health, safety or personal rights risk to residents in care.

Safeguards for Resident Cash, Personal Property, and Valuables (i) Upon discharge of a resident, all cash resources, personal property and valuables of that resident which have been entrusted to the licensee shall be surrendered to the resident, or his responsible person. A signed receipt shall be obtained. This standard is not met as evidence by: Per interview with Administrator Ana Giron facility continued to receive payments after R1's departure, payments were received for months July-Sept 2023. Administrator did not notify SSI of departure until August. The delay of monies returned to R1 or SSI and of urgency to contact SSI upon R1's departure from facility corroborates this allegation.

87303 Maintenance and Operation ..(e) Water supplies and plumbing fixtures shall be maintained...(2) Faucets used by residents for personal care such as shaving and grooming shall deliver hot water. Hot water temperature controls shall be maintained to ..... temperature of not less than 105 degree F (41 degree C) and not more than 120 degree F (49 degree CThis requirement is not met as evidenced by: Based on observation, the hot water temperature readings today measured between 118.8 deg F - 124.4 deg F which poses an immediate health and safety risk to residents in care.

Maintenance and Operation. Water supplies and plumbing fixtures shall be maintained as follows: Faucets used by residents for personal care such as shaving and grooming shall deliver hot water. Hot water temperature controls shall be maintained to automatically regulate the temperature of hot water used by residents to attain a temperature of not less than 105 degree F (41 degree C) and not more than 120 degree F (49 degree C).Based on observation, the hot water temperature readings today measured between 113.5 DF - 126.9 DF; which poses an immediate health and safety risk to persons in care.

HSC 1569.683 (a)(2)... a licensee of a residential care facility for the elderly who sends notice of eviction to a resident ... notice to quit shall include all of the following: (2) Resources available to assist in identifying alternative housing and care options including public and private referral services and case management organization. This requirement was not met as evidenced by: LPA reviewed the eviction notices and observed missing information required by health and saftey code 1569.683, which poses an immediate health and safety, or personal rights risk to persons in care.

87208(a). Plan of Operation. Each facility shall have and maintain a current, written definitive plan of operation...... Any significant changes in the plan of operation which would affect the services to residents shall be submitted to the licensing agency for approval. The plan and related materials shall contain the following:This requirement is not met as evidenced by: Based on physical plant inspection LPA observed nonsmoking sign on the front porch and cigarette buds on the front porch. Based on interviews 5/7 residents confirmed staff allowed them to smoke on front porch which is a nonsmoking area. 2/2 staff stated residents are only allowed to smoke on the front porch on rainy days. Per plan of operation: House rules residents are not allowed to smoke in nonsmoking areas.