Burbank Manor

87205 Accountability of Licensee Governing Body (a)The licensee, whether an individual or other entity, shall exercise general supervision over the affairs of the licensed facility and... with these regulations and the welfare of the individuals it serves. This requirement is not met as evidenced by: Based on record review, the licensee did not comply with the section cited above in the licensee was paying the majority of bills late, including facility rent which poses a potential health, safety or personal rights risk to persons in care.

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 is not met as evidenced by: Based on observation & interviews, the licensee did not comply with the section cited above in the shed at the back of the facility was being used for occupancy which poses a potential health, safety or personal rights risk to persons in care.

87213 Finances The licensee shall have a financial plan..., Application for License, and that assures sufficient resources...for care of residents;... and shall submit such financial reports as may be required upon the written request of the licensing agency. This requirement is not met as evidenced by: Based on observation & interviews, the licensee did not comply with the section cited above in that the facility's rent was not paid on time per the lease agreement for three (3) months which poses a potential health, safety or personal rights risk to persons in care.

Based on observation and record review, the licensee did not comply with the section cited above in that four (4) out of four (4) residents files (for residents R1, R2, R3 and R4) did not have an LIC 603 Preplacement Appraisal Information form which poses a potential health, safety or personal rights risk to persons in care.

Based on observation, record review, and interview the Licensee/Administrator did not comply with this section above due to Licensee's Administrators Certificate expired 10/3/2021. Although another staff has current Administrator certificate, they are not the Administraor and have not been present full time since 10/3/2021.Licensee claimed all items were submitted for renewal of administrator certificate but after calling while LPA was at facility found out from Administrator certificate unit, certificate is not pending or active. This regulation poses an immediate health, safety or personal rights risk to persons in care.

Based on interview & record review, the licensee did not comply with the section cited above in 1 out of 4 staff records reviewed did not have current required First Aid Certificate on file, which poses/posed a potential health, safety or personal rights risk to persons in care.

Based on record review, the licensee did not comply with the section cited above in 4 out of 6 resident files did not have reappraisals conducted in the last 12 months which poses/posed a potential health, safety or personal rights risk to persons in care.

Based on observatio, the licensee did not comply with the section cited above in 3 out of 3 disinfectants were available to clients in care (2 bathrooms Lysole) and cleaning supply cabinet unlocked in laundry room, which poses an immediate health, safety or personal rights risk to persons in care.