The Elderly Inn I

Type of visit: Annual/Random

Licensing Program Analyst (LPA) Talwinder Bains arrived on 9/1/26 to conduct the annual inspection. LPA reviewed two residents (2) and two staff files (2). All resident files contained the required paperwork. All staff files contained the required paperwork. All staff have current first aid and CPR training. Facility was clean and well organized. Facility is current on fire drills. Staff training contained the required initial training. LPA and Administrator Robert Tif toured the facility together to ensure the health and safety of residents in care. The areas toured included resident rooms, bathrooms, kitchen, and common areas and outside area. The food supply is within compliance, 2 days of perishable and 7 days worth of non-perishable food items. Grab bars were present at the toilet and in the shower. All exits were unobstructed. The disaster drill is current. The administrator's certificate is current. There is a side gate for emergency access. LPA checked the kitchen area for the ability to prepare and store food. Knives and Sharp objects found to be locked . LPA observed the area used for medication to be locked and inaccessible to residents. LPA observed smoke detectors and carbon monoxide detector at the care home are operational. Water temperature is within compliance. LPA requested a copy of the LIC 500, LIC610E and current liability insurance to be sent to the Department by 9/15/26. Deficiency was observed and cited per Title 22, CCR Regulations as listed on LIC809-D. Civil penalties will be assessed if facility will not comply with all POC requirements as issued today. Exit interview conducted. Copy of this report and appeal rights were provided.the state’s words, verbatim · CDSS document, Sep 1, 2026

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87555(b)(8) · Plan of correction due date: Sep 15, 2026

General Food Service Requirements- (b) The following food service requirements shall apply: (8) All food shall be of good quality. Commercial foods shall be approved by appropriate federal, state and local authorities. Food in damaged containers shall not be accepted, used or retained..This requirement is not met as evidenced by: Based on observation, the licensee did not comply with the section cited above as multiple food items were found to have expired dates, which poses an potential health, safety or personal rights risk to persons in care.the state’s words, verbatim · CDSS document, Sep 1, 2026

Plan of correction: Licensee/Administrator shall send a letter of understanding of this regulation, and will make sure all food items are in good qualily and not expired, and shall conduct staff training. All POC documents are due by 09/15/26.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Lavinia Muscan arrived on 09/15/25 to conduct the annual inspection. During today's annual inspection, the Compliance and Regulatory Enforcement Tool was used. LPA reviewed resident (3) and staff files (2). All resident files contained the required paperwork. All staff files contained the required paperwork. All staff have current first aid and CPR training. Facility was clean and well organized. Facility is current on fire drills. Staff training contained the required initial training. LPA and Administrator Robert Tif toured the facility together to ensure the health and safety of residents in care. The areas toured included resident rooms, bathrooms, kitchen, and common areas and outside area.The food supply is within compliance, 2 days of perishable and 7 days worth of non-perishable food items. Grab bars were present at the toilet and in the shower. All exits were unobstructed. The disaster drill is current. The administrator's certificate is current. There is a side gate for emergency access. LPA checked the kitchen area for the ability to prepare and store food. Knives and Sharp objects found to be locked . LPA observed cleaning products and other toxins to be locked away. LPA observed the area used for medication to be locked and inaccessible to residents. LPA observed smoke detectors and carbon monoxide detector at the care home are operational. Fire extinguisher is ready for emergency use. Water temperature is within compliance. In the areas toured, there were no health or safety violations observed. LPA requested a copy of the LIC 500, LIC610E and current liability insurance to be sent to the Department by end of the month. Exit interview conducted. A copy of this report was printed and given to Administrator.the state’s words, verbatim · CDSS document, Sep 15, 2025

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Angela Hood arrived at the facility unannounced on 9/18/24 and met with the Administrator, Robert Tif, to conduct a Required-1 Year Inspection. LPA conducted an inspection of the care home to ensure compliance with Title 22 regulations. There are five (5) bedrooms and three (3) bathrooms for resident use. LPA observed bedrooms to be properly furnished, with appropriate bedding and lighting. The bathrooms were in sanitary condition, properly maintained, and the hot water temperature was observed to be 110.7 degrees F. LPA checked the kitchen area for the ability to prepare and store food. Care home has required (2) two-day perishable and (7) seven-day non-perishable food supply on hand. LPA observed knives to be locked away and inaccessible to residents. LPA observed the outdoor area and perimeter of the care home to be free of clutter and debris and there appeared to be no potential safety hazards to the residents in care. Smoke and carbon monoxide detectors are operational. Fire extinguisher and first aid kit are maintained and ready for emergency use. LPA checked medication storage and found medications to be locked away and inaccessible to the residents. LPA reviewed four (4) resident files and also reviewed two (2) staff file. Per California Code of Regulations Title 22, Division 6, Chapter 8 the following (1) deficiency was observed during today's visit. A citation was issued on the LIC809-D page. Exit interview conducted. A copy of report and appeal rights provided.the state’s words, verbatim · CDSS document, Sep 18, 2024

Type of visit: Case Management - Health Checks

Licensing Program Analyst (LPA) Angela Hood arrived unannounced today, 9/18/24, and met with the Administrator, Robert Tif, to conduct a health and safety inspection. LPA observed two (2) residents watching television in the common area and one (1) independent resident sitting outside. There are currently four (4) residents in care with 1 of the 4 residents receiving hospice care services. LPA was advised that one of the residents are on an outing today. LPA discussed that the reason for today's inspection is to request additional documentation and facility plans regarding recent inspections conducted. LPA discussed the details of each item requested. The requested items are listed below: Behavioral triggers and de-escalations training Environmental modifications Regular care team meetings Enhanced family involvement Proactive medication review Technology integration Personalized activity plan Staffing plan The facility agrees to provide the Department with the requested information by Friday, 9/20/24. There are no deficiencies issued today. Exit interview. Copy of report provided to Administrator.the state’s words, verbatim · CDSS document, Sep 18, 2024

Type of visit: Case Management - Health Checks

LPA Sabrina Calzada arrived unannounced to conduct a health and safety inspection. LPA met with caregiver, Icolyn "Sonia" Powell who called Administrator, Robert Tif, who arrived at 12:20 pm.. LPA observed (2) residents watching television in the common area and observed (1) resident, who is independent, enter the common area. LPA was advised that a second independent resident was currently out of the facility. There are (4) residents currently and (1) resident under hospice care. LPA discussed that the reason for today's inspection is to provide additional information related to the recent inspections conducted and request a documented staffing plan. LPA and Administrator discussed the details of the letter being requested and that it is due, along with a completed LIC500 (Personnel Report), by tomorrow morning, 9/13/24. LPA and Administrator toured the interior and observed it to be clean, in good repair and odor free. There is 2+day perishable and 7+day non-perishable supply of food on hand. LPA discussed resident who is on hospice and updated medication list. Administrator and caregiver advised to document any PRN medication when it is given and to keep daily notes. Also discussed is that documentation of staff training, per Plan of Correction issued on 7/24/24, is due by 9/14/24 (extended deadline). Administrator, Robert Tif, agreed to also provide (re-send) the Department the required documents, including a letter from the Licensee, to change the Administrator to his name. Administrator agreed to provide an updated LIC500 and the requested letter by tomorrow morning, 9/13/24, to be emailed to this LPA. There are no deficiencies issued today. Exit interview. Copy of report provided to Administrator.the state’s words, verbatim · CDSS document, Sep 12, 2024

Type of visit: Case Management - Health Checks

LPA Sabrina Calzada arrived unannounced to conduct a health and safety inspection. LPA met with Administrator, Robert Tif, who was present. Also present were care staff, Icolyn "Sonia" Powell and Jodie Ann Thomas. LPA observed Bianca Tif, staff, to be assisting Administrator with paperwork. LPA observed (2) residents (R1 and R2) watching television or napping in the common area and resident (R3) in their room. Resident (R4) who is independent was currently out of the facility. There are (4) residents currently. LPA and Administrator toured the facility and observed the facility to be clean in all areas and cooled to the temperature of 73*F. LPA and Administrator discussed how residents are doing today and the supervision levels needed. There were no deficiencies observed during today's inspection. Exit interview. Copy of report provided to the Administrator.the state’s words, verbatim · CDSS document, Sep 10, 2024

Type of visit: Case Management - Health Checks

LPA Sabrina Calzada arrived unannounced to conduct a health and safety inspection. LPA met with caregiver, Icolyn "Sonia" Powell who called Administrator, Robert Tif, who arrived at 3:50 pm. Caregiver advised there were (3) residents present at the start of the inspection. LPA observed (2) residents watching television in the common area and (1) resident later enter the common area. There are (4) residents currently. LPA observed that the (2) medications unlocked in the refrigerator, on 9/7/24, were now secured in a box with a combination lock in the refrigerator. The Plan of Correction issued yesterday was cleared during today's inspection. LPA toured the facility and observed the facility to be clean in all areas and cooled to the temperature of 73*F.Administrator to place a gate/barrier to the upstairs staff area. LPA discussed how residents are doing with caregiver and Administrator. There were no deficiencies observed during today's inspection. Exit interview. Copy of report provided to the Administrator.the state’s words, verbatim · CDSS document, Sep 8, 2024

Type of visit: Case Management - Health Checks

Licensing Program Analyst (LPA) Sabrina Calzada arrived unannounced to conduct a health and safety check. LPA met with caregiver, Icolyn "Sonia" Powell who called Administrator Designee, David Tif, who arrived at 12:00 pm. Also present was staff, Jodie Ann Thomas, who was cutting fruit in the kitchen. LPA stated reason for today's inspection. LPA observed (1) resident watching television in the common area at the start of the inspection and (3) residents enter in the common area later during the inspection. During today's inspection, LPA and caregiver toured the interior of the facility, including both individual resident and common areas. LPA observed the facility to be clean, in good repair and odor-free. There was sufficient 2+day perishable and 7+day non-perishable supply of food on hand. LPA observed (2) unlocked medications in the refrigerator. Both medications belong to resident (R1), who moved in around 8/28/24. LPA reviewed medications and documentation for (R1). LPA and David Tif contacted Robert Tif, Administrator, to discuss the reason for today's inspection. Also discussed were (3) outstanding Plan of Correction (POC) that were due in August 2024. LPA was advised that staff training has not been completed as of today. Administrator, Robert agreed to complete the required staff training within the next week, or by 9/14/24. LPA clarified the specific training that is required per the deficiencies issued. LPA and David Tiff also contacted Sam Toplean, spouse of Licensee, by phone, to interview. LPA also briefly spoke to resident (R2). As a result of today's inspection, (1) deficiency is being cited pursuant to California Code of Regulations, Title 22 Division 6, Chapter 8, on the attached 809-D page. Exit interview. Copy of report and appeal rights provided to the Administrator Designee.the state’s words, verbatim · CDSS document, Sep 7, 2024

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87465(h)(2) · Plan of correction due date: Sep 8, 2024

87465 Incidental Medical and Dental Care (h) The following requirements shall apply to medications which are centrally stored: (2) Centrally stored medicines shall be kept in a safe and locked place that is not accessible to persons other than employees responsible for the supervision of the centrally stored medication. This requirement is not met as evidenced by: Based on observation, the Licensee did not ensure that (2) medications (Valproic Acid 250mg and Deep Relief CBD 50mg/ml), belonging to resident (R1), that need refrigeration were kept in a safe and locked place in the refrigerator, and inaccessible to residents, posing an immediate health and safety risk to residents in care.the state’s words, verbatim · CDSS document, Sep 7, 2024

Plan of correction: The Administrator Designee immediately secured both medications and stated he would obtain a lock box for the refrigerator following today's inspection.

Type of visit: Case Management - Health Checks

On 09/06/24, Licensing Program Analyst (LPA) Talwinder Bains arrived to conduct a case management and perform a health and safety check on residents in care. LPA met with staff (S1), Icolyn Powell and explained the purpose of todays' visit. S1 called Robert Tif, Administrator who came to facility shortly after and assisted LPA with today's visit. S1 stated that facility current census is four and they were all male residents . LPA toured the facility with S1 to check the health and safety of residents in care. Areas toured included but not limited to residents rooms, bathrooms, common areas and outside area. LPA toured kitchen area and observed that facility has adequate food supply of 2 days perishable and 7 days non perishable per regulation. LPA observed two residents were in common area and two residents were in their rooms. LPA observed that facility was clean and odor free. S1 stated that there were 2 caregivers on duty with four residents and there was 1 awake caregiver on night duty on daily basis. LPA reviewed records for two (2) residents (R1,R2) and two (2) staff files and collected documents during today's visit. As a result of today’s visit, no deficiencies were cited. Exit interview was conducted , and a copy was left at the facility.the state’s words, verbatim · CDSS document, Sep 6, 2024

Allegation investigated: Resident was left on the floor unassisted after sustaining a fall for an extended period of time due to staff neglect. Staff do not provide resident adequate supervision resulting in resident wandering outside. Staff do not ensure that resident's incontinence needs are being met.

Licensing Program Analyst (LPA) Sabrina Calzada arrived unannounced to deliver complaint findings to a complaint received on 4/9/24. LPA met with caregiver, Icolyn "Sonia" Powell who called Administrator, Robert Tif, who arrived at 2:55 pm. LPA observed (1) resident watching television in the common area. Sonia indicated there are (2) caregivers at the related home across the driveway and (1) caregiver is shared between both facilities when needed. During the course of the investigation, the Department reviewed documentation related to resident (R1) including the physician's report, care plan, facility notes, hospice care notes and photos. Interviews were conducted with multiple facility staff, hospice staff and resident's family member. The results of the investigation are as follows: Resident (R1) moved to the care home on 3/5/24. Resident's pre-appraisal notes that (R1) appears weak, is unable to walk safety, does not have a diagnosis of Dementia, but nurses stated resident is confused and disoriented, as he has attempted to leave the previous facility before. Resident's physician's report (2/15/24) states (R1) has diagnoses of Metabolic Encephalopathy and Dementia, is incontinent, confused, disoriented but able to follow simple directions, is a fall risk, has some aggressive behavior with pulling catheter out, needs extensive assistance with bathing, dressing, toileting and medications and cannot leave the care home unassisted. *cont on 9099C-1.. Substantiated 9099C-1.. Resident's care plan, dated 3/5/24, notes says resident is “weak and confused” and “planned an escape from previous facility before arriving”. Care plan says resident has a “history of confusion and wants to leave, having some outbursts”. Watch resident and work with hospice if he has any outbursts. Allegation: Resident was left on the floor unassisted after sustaining a fall for an extended period of time due to staff neglect. Allegation states resident (R1) was left on the floor after falling for more than 2 hours, on 3/19/24. Administrator, Robert Tif, stated on 4/10/24 to LPA Angela Hood that (R1) slid off the bed and refused to get up , didn't want staff to assist, and he wanted to stay on the floor, stating resident was cooperative only at times. Resident facility notes indicate that on 3/19/24, resident slid down from his bed and refused help from (3) caregivers. Caregiver (S1) stated she "checked on (R1) at 7:00 am, and he was still sleeping" but by 9:00 am, he was on the floor, asserting, "he did not fall- he slid off his bed". (S1) stated that she and another staff were trying to get (R1) up from the floor, but "we couldn't get him up- he was kicking staff". (S1) stated that even hospice nurses couldn't provide care for (R1) and one night, the nurse was at the care home until midnight observing (R1')s behaviors and was unable to provide care at some times. Hospice notes show the nurse stayed for (6) hours on 3/19/24, from 6:00 pm until 12:00 am, observing resident and administering a new medication. Another staff (S2), who worked during the day, was interviewed but stated she was not at this facility at the time of this incident, but that another care staff, went to assist (S1) from the adjacent related facility, with (R1). (S2) indicated she no longer works at the care homes. Hospice notes document on 3/19/24 (12:06 pm)- a Home Health Aide (HHA) from hospice arrived and resident was “found on the ground, bleeding on the right arm and covered in urine”. Notes stated care staff indicated (R1) had been on the floor since the morning, the HHA and the caregiver were able to put (R1) back in bed, but (R1) was observed to have redness on right hip, new skin tears, and a missing a toe nail. (R1's) condition was reported to an Registered Nurse, who would provide follow up care later that day. Hospice notes document that (R1) received a complete bed bath and ADL care. *cont on 9099C-2... 9099C2... Three (3) photos were viewed that were taken by hospice on 3/19/24 (12:06 pm) showing (R1) on the floor. One photo shows (R1)laying on the floor in his room with blood near the right arm where he was laying. Clothes appear soaked, and hospice notes say resident was "soaked in urine". The photo shows resident's catheter attached laying on the floor. The second photo shows (R1) was found wearing a soiled diaper when the nurse arrived. The third photo shows redness on (R1's) right hip, as stated in hospice notes. Hospice notes show that on 3/19/24 (2:15 pm) a nurse arrived to provide catheter care and (R1) became very agitated and would not let go of the nurse's wrist for a couple of minutes. The nurse obtained a physician's order for the medication Haldol. Notes show that another nurse arrived on 3/19/24 (3:15 pm) to administer Haldol and monitor resident who was displaying restlessness, agitation, and episodes of hallucinations. A continuous care nurse arrived around 6:00 pm to continue monitoring (R1), who continued to show agitation, disorientation and attempts to stand up. Another dose of medication was given around 7:00 pm, and again at 11:00 pm, before (R1) relaxed and went to sleep, at which time the nurse left. Both the resident's family member and hospice stated the facility did not call them, and they were not aware of (R1) being on the floor, for over 2 hours, until the hospice home health aide arrived for a scheduled appointment to provide assistance with Activities of Daily Living (ADL's). Based on information obtained, LPA finds the allegation to be SUBSTANTIATED- A finding that the complaint is Substantiated means that the allegation is valid because the preponderance of the evidence standard has been met. Allegation: Staff do not provide resident adequate supervision resulting in resident wandering outside. The allegation states resident (R1) had to be retrieved from outdoors unaccompanied at night, and was found in the garage, without any clothes on on another occasion. Staff (S1) stated she found (R1) around 9:00 am, "squatting in the garage with a diaper on only", and she has "no idea" how long (R1) was in the garage. (S1) confirmed that the large garage door was open and that she "doesn't know how it opened or how (R1) got to the garage". (S1) confirmed she brought (R1) into the house upon discovering him there and it was only one time he was found in the garage. Staff (S2) stated she remembers when (R1) was found in the garage one morning and stated "he always wanted to leave, especially when his daughter visited- he would get agitated sometimes". *cont on 9099C-3.. 9099C-3... Resident's family member stated she was called following when (R1) was found in the garage on the morning of 3/15/24, and his "arms were torn up, he was naked and his catheter was torn out". The family member stated (S1) called hospice upon finding (R1) in the garage and hospice came out and observed wounds from his wrist to his elbow that were "bad" and had to be wrapped completely. Resident's family member stated (S1) showed her a picture she had taken of (R1) sitting on blankets by the laundry machine in the garage. Hospice notes from 3/15/24 (10:09 am) state the hospice RN received a phone call from the facility needing a nurse to come by, and upon the nurse’s arrival, the caregiver stated (R1) was found sleeping in the garage, with no clothes on, and (R1) had disconnected catheter bag again and there was blood to both arms from skin trauma (picking scabs). Notes state that (R1) allowed the nurse to perform wound care while being “confused and drowsy”. Also included in the hospice notes, is that (R1) was allowed to depart from an unlocked door in his bedroom, and the owner was contacted and advised that “dead bolt must be locked to prevent injury/escape by resident who is highly confused”. A new Seroquel prescription arrived and was administered. The facility Administrator stated on 7/24/24 that the current door alarm was on the exit door from (R1's) room but he is not sure if it was working to alert the NOC shift. LPA observed the alarm on the door today to not be activated, but the room is currently vacant. Facility notes document that on 3/9/24- (R1) “got up on his feet by himself- caregivers surprised he can walk so well”. Notes document on 3/10/24 (R1) had wandered from his room and was found in the living room by caregivers. Notes entered on 3/11/24, stated that (R1) was doing "more wandering" in his room and bed alarms were placed in his room to better monitor him. Notes entered on 3/13/24, state (R1) is more calm, seems to be getting acclimated to home and getting a little stronger. There was no time of day indicated in the notes for the above days. Facility notes document on 3/14/24, (R1) wandered into the garage at 5:00 am, was brought back to his room, and family was called. On 3/15/24, no notes were made that resident was found on the floor in the garage, with only a brief on and multiple bleeding wounds on the arms. *cont on 9099C-4... 9099C-4... Resident's family member stated that she recalls from her conversations with both facility and hospice staff, that (R1) was able to make his way to the garage on two separate occasions and stated, "It was too much for one caregiver to handle (R1) and the other residents- (R1) needed more attention and needed to be checked on more frequently". Staff (S3) who works during the night shift (7 pm- 7 am) was not available for an interview. Based on information obtained, LPA finds the allegation to be SUBSTANTIATED- A finding that the complaint is Substantiated means that the allegation is valid because the preponderance of the evidence standard has been met. Allegation: Staff do not ensure that resident's incontinence needs are being met. Allegation states resident (R1) was left in soiled briefs for prolonged periods. The Administrator confirmed "yes, we tried to change him- sometimes he would be cooperative and sometimes he would not" and (R1) had a catheter that hospice was providing care for. Hospice notes on 3/15/24 (9:42 pm) document the on-call nurse received a call from the facility that "no urine had drained into patient's collection bag since it was replaced on this morning". Both hospice staff and (R1's) family member stated that caregivers were informed to notify hospice if there is no urine output within 2-4 hours of the bag being changed. Hospice care notes entered on 3/19-(12:06 pm) by a Home Health aide, document (R1) was “found on the ground, bleeding on the right arm and covered in urine”. Care staff stated (R1) had been on the floor since the morning. The Department reviewed a photo showing the soiled diaper (R1) that was found wearing during this HHA's scheduled visit, on 3/19/24, to provide ADL care. A hospice nurse confirmed the soiled diaper shown in the photo was not blood or urine, but feces. Also provided was second photo showing (R1) laying on the floor in his room, with soiled clothing and the catheter bag and tubing on the floor. Hospice notes match the photos provided. Based on information obtained, LPA finds the allegation to be SUBSTANTIATED- A finding that the complaint is Substantiated means that the allegation is valid because the preponderance of the evidence standard has been met. Per California Code of Regulations, Title 22, Division 6, Chapter 8, the following (3) deficiencies are issued on the 9099-D pages. Exit interview. Copy of report and appeal rights provided.the state’s words, verbatim · CDSS document, Jul 24, 2024 · control 59-AS-20240409145013

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87465(a)(1) · Plan of correction due date: Jul 25, 2024

87465 Incidental Medical and Dental Care (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: (1) The licensee shall arrange, or assist in arranging, for medical and dental care appropriate to the conditions and needs of residents. This requirement is not met as evidenced by: Based on interviews conducted and documentation reviewed, the License/Administrator did not ensure that resident's (R1) hospice company was contacted promptly after resident was found on the floor, on 3/19/24 (around 9:00am), bleeding and soaked in urine, which posed an immediate health and safety risk to residents in care. Hospice was made aware when they arrived on 3/19/24 (12:00 pm) for a scheduled appointment with resident, and after (R1) had been laying on the floor for 2+ hours.the state’s words, verbatim · CDSS document, Jul 24, 2024

Plan of correction: Licensee/Administrator agree to read the regulation and stated it isunderstood and to also conduct staff training on proper incontinent care. Documentation of training due by 7/25/24 Documentation of completed training by 8/8/24 for current staff. The deadline can be extended for any new staff.

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87705(c)(4)(A) · Plan of correction due date: Jul 25, 2024

87705 Care of Persons with Dementia (c) Licensees who accept and retain residents with dementia shall be responsible for ensuring the following:(4) There is an adequate number of direct care staff to support each resident’s physical, social, emotional, safety and health care needs as identified in his/her current appraisal. (A) In addition to requirements specified in Section 87415, Night Supervision, a facility with fewer than 16 residents shall have at least one night staff person awake and on duty if any resident with dementia is determined through a pre-admission appraisal, reappraisal or observation to require awake night supervision. This requirement is not met as evidenced by: Based on documentation reviewed and interviews conducted, the Licensee/Administrator did not ensure that a staff member was alerted when resident (R1) woke up and walked to the garage on 3/14/24 and on 3/15/24, which posed an immediate health and safety risk to residents in care.the state’s words, verbatim · CDSS document, Jul 24, 2024

Plan of correction: Licensee/Administrator agree to read the regulation and stated it isunderstood and to also conduct staff training on proper incontinent care. Documentation of training due by 7/25/24. Documentation of completed training by 8/8/24 for current staff. The deadline can be extended for any new staff.

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87625(b)(3) · Plan of correction due date: Aug 25, 2024

87625 Managed Incontinence (b) In addition to Section 87611, General Requirements for Allowable Health Conditions, the licensee shall be responsible for the following: (3) Ensuring that incontinent residents are kept clean and dry and that the facility remains free of odors from incontinence. This requirement is not met as evidenced by: Based on documentation reviewed from hospice, the Licensee/Administrator did not ensure that resident's (R1's) hospice company was notifiied on 3/15/24, within 4 hours of resident not showing any urine output, and on 3/19/24, when resident was found laying in a soiled diaper and urine soaked clothing and had been on the floor for at least 2 hours, which posed an immediate health and safety risk to residents in care.bthe state’s words, verbatim · CDSS document, Jul 24, 2024

Plan of correction: Licensee/Administrator agree to read the regulation and stated it isunderstood and to also conduct staff training on proper incontinent care. Documentation of training due by 7/25/24. Documentation of completed training by 8/8/24 for current staff. The deadline can be extended for any new staff.