17. Unannounced Visit: Records, Requirements, Reporting Copy

Facility Type: 730/733 (Group Home)

Investigation Findings
Licensing Program Analyst (LPA) arrived at the above facility address for the purpose of conducting an unannounced Annual/Required inspection. LPA met group home personnel.

This facility is licensed to serve ambulatory females, ages 12 through 17. The provisional license will expire on 12/30/2017. Currently in placement are six clients placed by different counties. Facility operates within license capacity and limitations.

This Group Home is a two-story facility located in a commercial/residential area. The facility consists of 6 bedrooms for clients (2 b/r downstairs and 4 b/r upstairs), 1 staff bedroom for stay-in childcare workers (downstairs), 1 shower room and 2 toilets downstairs, 2 full bathrooms upstairs, laundry area upstairs, storage/lounge room (upstairs), intake/appointment room, staff office, living/library room, dining room, and kitchen.

Physical Plant
Overall, the facility is clean, safe, sanitary, and in good repair. All passageways are unobstructed and all doors open freely. There are no bodies of water in the facility.

Disinfectants, cleaning solutions, sharps and knives are locked.

Temperatures in rooms that clients occupy are maintained between 68 and 85 degrees F. Hot water temperatures are measured at over 125 degrees F (see citation).

Care and Supervision
The staff to client ratio at the time of inspection was 3:6. Facility has non-perishable foods for at least one week and perishable foods for at least two days. Facility provides nutritious snacks between meals. Medications are locked in the staff office and accessible only to employees responsible for stored medications.

Personal Rights
Facility posts child’s personal rights. Clients are allowed to use the facility phone. This facility appears to be a safe, healthy, and comfortable home. Clients attend school (regular or home schooled).

LPA reviewed staff and client records. All employees have DOJ/FBI and CACI.

Deficiencies cited. Appeal rights explained.

An exit interview was conducted and a signed copy of this report was provided to the facility representative along with LIC 858, LIC 859, Advisory Notes and Appeal Rights.

Deficiency Type /
Section Number
DEFICIENCIESPLAN OF CORRECTIONS (POCs)
Type B
01/10/2018
Section Cited
CCR
80066(c)
80066(c) Personnel Records. Removal of records: During normal business hours, upon demand, all personnel records shall be available to the licensing agency to inspect, audit, and copy. Records may be removed if necessary for copying.
*Staff file(#1) is not available for review.
Licensee shall ensure that all personnel records are available to the licensing agency upon demand during normal business hours. Licensee will submit copies of required records (RE: staff#1) to the licensing agency no later than 1/10/18.
Type B
01/10/2018
Section Cited
CCR
84065(i)(1)(D)
84065 (i)(1)(D) Personnel Requirements. Within 7 calendar days of completion of the 8 hour training, the administrator or administrator's designee shall assess if each child care staff understands and can apply the training.
* Staff records are missing documentation of a 7-day assessment.
Licensee will submit a plan to ensure compliance with Personnel Requirements 84065 (i)(1)(D). POC will be submitted to the licensing agency no later than 1/10/18.
Type B
01/10/2018
Section Cited
CCR
84065(i)(2)(B)
84065(i)(2)(B) Personnel Requirements. Within 30 days of completion of the 16 hour training, the administrator or administrator's designee shall assess if each newly hired child care staff understands and can apply the training.
* Staff records are missing documentation of a 30-day assessment.
Licensee will submit a plan to ensure compliance with Personnel Requirements 84065(i)(2)(B). POC will be submitted to the licensing agency no later than 1/10/18.
Type B
01/10/2018
Section Cited
CCR
84068.2(d)(1)
84068.2(d)(1) Needs and services plans. Licensees shall not implement needs and services plans unless prior written approval of the plan has been obtained from the child's authorized representative(s).
* Needs & Service Plans have not been approved by the placement workers.
Licensee will obtain approval of each Needs and Service Plan from the placement worker. A copy of each approved plan will be submitted to the licensing agency no later than 1/10/18.
Type B
01/24/2018
Section Cited
CCR
80069(c)(1)
80069(c)(1) Client Medical Assessment. Client medical assessments shall include results of an examination for communicable tuberculosis and other contagious or infectious diseases.
* Client records are missing TB clearances.
Licensee will schedule a TB test for each client. TB clearances will be submitted to the licensing agency no later than 1/24/18.
Type B
01/10/2018
Section Cited
CCR
80061(b)(1)(E)
80061(b)(1)(E) Reporting Requirements. Reports are required for any unusual incident or client absence which threatens the physical or emotional health or safety of any client.
* Licensee failed to notify the Department of a TB case in the facility.
Licensee will submit an incident report RE: TB case and a written plan outlining how the facility will ensure health and safety of other clients in care. POC will be submitted to the licensing agency no later than 1/10/18.
Type B
01/10/2018
Section Cited
CCR
80088(e)(1)
80088(e) Fixtures, Furniture Equipment and Supplies. Faucets used by clients shall deliver hot water, and attain temperatures of not less than 105 degrees F and not more than 120 degrees F.
* Hot water temperatures were measured at over 125 degrees F at the time of inspection.
Licensee will adjust the hot water temperature to attain temperatures of not less than 105 degrees F and not more than 120 degrees F. POC will be submitted to the licensing agency no later than 1/10/18.

 

Source
Facility Report

secure.dss.ca.gov/ccld/TransparencyAPI/api/FacilityReports?facNum=157806794&inx=10.

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