Beck Care Home

87623 In Dwelling Catheter(B) A catheter shall only be inserted and removed by an appropriately skilled professional under physician's orders.This requirement is not met as evidenced by: Based on record review and interview, ADM changed the Resident R1s catheter without a doctors order and did not follow hospice care plan dated 04/07/25 in which hospice services would change catheter every month which poses/posed a potential health, safety or personal rights risk to persons in care.

87307 Personal Accommodations and Services (C) No bedroom of a resident shall be used as a passageway to another room, bath or toilet.This was not met as evidenced by: Based on interviews, S1 stated they sometimes use the resident's room to go to the backyard because it has an exit door. Continue to next section.

§1569.50 Denial, suspension or revocation of license;...(3) Conduct that is inimical to the health, morals, welfare, or safety of either an individual in or receiving services from the facility or the people of the State of CaliforniaThis was not met as evidenced by: On 9/25/2025 the Licensee verbally threatened to take LPAs state owned phones and break the phones, which is a conduct inimical to the health, morals, welfare, or safety of either an individual in or receiving services from the facility or the people of the State of California

87625 Managed incontinence (b)(2) Ensuring that incontinent residents are checked during those periods of time when they are known to be incontinent, including during the night.This is not met as evidenced by: Based on interview and document review, ADM stated she doesn't check the residents at night 10pm-6am. This poses an immediate health, safety, and personal rights risks to residents in care.

87507 Admission Agreements (g)(3)(B)(2) A separate charge for an item or service may be assessed only if that charge is included in and authorized by the admission agreement.This requirement was not met as evidenced by; Based on interview and records reviewed, the facility charged resident for care being provided from 10pm-6am. ADM stated the night charges are not reflected on the admission agreement. This poses an immediate health, safety, and personal rights risks to residents in care.

87405 Administrator Qualifications and Duties (d)(2) Knowledge of and ability to conform to the applicable laws, rules and regulations.This requirement was not met as evidence by: Based on the results of today's visit, the administrator did not submit the plans of correction by POC date. This poses an immediate Health, Safety, or Personal Rights risk to persons in 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: (1) To be accorded dignity in their personal relationships with staff, residents, and other persons.This is not met as evidenced by: Based on interviews and documentation reviewed, the licensee did not comply with the section cited above. ADM stated a staff used a residents shoes, and S2 was given a written warning by ADM. This poses/posed a potential health, safety or personal rights risk to persons in care.

(a) All facilities shall maintain a fire clearance approved by the city,... fire department... and obtain an appropriate fire clearance approved by the city, county, or city and county fire department ...This is not met as evidenced by: Based on investigation, LPAs observed a shed in the backyard being used as a staff sleeping area. Fire Clearance/Facility Sketch does not note the shed as a staff room/sleeping area. This poses/posed a potential health, safety or personal rights risk to persons in care.

87755 Inspection Authority of the Licensing Agency (a) Any duly authorized officer, employee ...of the licensing agency may …and inspect the entire premise ...without advance notice.This requirement was not met as evidence by: Based on interviews, ADM2 stated the LPA’s do not have the authority to inspect the shed, & stated he would have taken the phones and broken them, if he was present when the photos were taken. This poses an immediate health, safety, personal rights risks to residents in care.

Based on interview and observation, the licensee did not comply with the section cited above. ADM confirmed the cameras inside the facility do record with audio. This poses an immediate health, safety or personal rights risk to persons in care.

Based on interview and observation, the licensee did not comply with the section cited above. LPA's observed resident R2 seated in a wheel chair in front of the dinning room. LPA's then noted resident's wheel chair was tied to the dinning table. Staff S2 and S3 stated they have been tying R2 for over a month. This poses an immediate health, safety or personal rights risk to persons in care.

Based on Record review and interview , the licensee did not comply with the section cited above. Based on a review, resident R1's needs and services plan has not been updated, and does not address R1's wandering behavior. ADM stated she has not yet updated R1's care plan. This poses/posed a potential health, safety or personal rights risk to persons in care.

Based on observation and interview, the licensee did not comply with the section cited above. LPA observed the side gate had a lock, obstructing the side exit. (Photograph of the lock gate was taken.) ADM stated the gate is locked because resident R1 has wandering behaviors. This poses an immediate health, safety or personal rights risk to persons in care.

Based on interview, the licensee did not comply with the section cited above. On September 16, 2025, resident R1 eloped from the facility and staff were unaware that R1 had left the home unassisted. This poses an immediate health, safety or personal rights risk to persons in care.

Based on observation, the licensee did not comply with the section cited above. LPA's observed in the kitchen, a drawer with two knives, acessible to residents in care. ADM stored the knives in a locked cabinet during LPA's visit. LPA observed the medication cabinet and the cabinet below the sink did not have their lock engaged, LPA asked Staff S1 to lock both of them. This poses an immediate health, safety or personal rights risk to persons in care.