Emerald Valley

The licensee shall ensure that residents are regularly observed for changes in physical, mental, emotional and social functioning and that appropriate assistance is provided when such observation reveals unmet needs. When changes such as unusual weight gains or losses or deterioration of mental ability or a physical health condition are observed, the licensee shall ensure that such changes are documented and brought to the attention of the resident's physician and the resident's responsible person, if any. Based on documentations provided by W1, records review and interviews, care and supervision was not in accordance with R1's assessed needs which poses a potential health and safety risk to the resident.

(b) In addition to Section 87611, General Requirements for Allowable Health Conditions, the licensee shall be responsible for the following:(2) Ensuring that the bag and tubing are changed by...(A)The bag may be emptied by facility staff who receive instruction from an appropriately skilled professional. Based on interviews, record review, and documentation provided by W1, the facility did not ensure that person trained to provide catheter care was available to monitor and manage R1's foley catheter in accordance with the resident's care plan which poses an immediate health and safety risk to the resident.

87555(b) The following food service requirements shall apply:...(9) Procedures which protect the safety, acceptability and nutritive values of food shall be observed in food storage, preparation and service....(27) All kitchen areas shall be kept clean and free of litter, rodents, vermin and insects. Based on observation and records review, the kitchen was observed to have food items stored uncovered, raw food stored in close proxitimity to read to eat foods, and cooking equipment heavily soiled with grease and food debris which pos a potential health and safety risk to residents.

Residents in all residential care facilities for the elderly shall have all of the following personal rights...(3)To be free from punishment, humiliation, intimidation, abuse, or other actions of a punitive nature, such as withholding residents’ money or interfering with daily living functions such as eating, sleeping, or elimination. Based on record review and staff interview, it was determined that staff (S4-S6) restrained a resident for an extended period of time while in the memory care unit. Review of staff records, termination letters confirmed the restraint occured, posing an immediate personal rights risk to residents in care.

(b) In addition to Section 87611, General Requirements for Allowable Health Conditions, the licensee shall be responsible for the following:(2) Ensuring that the bag and tubing are changed by...(A)The bag may be emptied by facility staff who receive instruction from an appropriately skilled professional. Based on interviews, record review, and documentation provided by W1, the facility did not ensure that person trained to provide catheter care was available to monitor and manage R1's foley catheter in accordance with the resident's care plan.

1569.269Enumerated rights; severability(a) Residents of residential care facilities for the elderly shall have all of the following rights:(6) To care, supervision, and services that meet their individual needs and are delivered by staff that are sufficient in numbers, qualifications, and competency to meet their needs.This requirement is not met as evidenced by: Based on record review and interviews by the Department, Licensee did not comply with the regulation cited above by resident sustained pressure injury while in care. And Staff did not ensure resident's wound care needs were met.

87411 Personnel Requirements – General(a) Facility personnel shall at all times be sufficient in numbers, and competent to provide the services necessary to meet resident needs. In facilities licensed for sixteen or more, sufficient support staff shall be employed to ensure provision of personal assistance and care as required in Section 87608, Postural Supports. Additional staff shall be employed as necessary to perform office work, cooking, house cleaning, laundering, and maintenance of buildings, equipment and grounds. The licensing agency may require any facility to provide additional staff whenever it determines through documentation that the needs of the particular residents, the extent of services provided, or the physical arrangements of the facility require such additional staff for the provision of adequate services.This requirement is not met as evidenced by: Based on record review and interviews by the Department, Licensee did not comply with the regulation cited above by Staff did not attend to resident's call button.

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 is not met as evidenced by: Based on record review and interviews by the Department, Licensee did not comply with the regulation cited above by Staff did not ensure proper medication assistance was provided to resident in care.

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 record review and interviews by the Department, Licensee did not comply with the regulation cited above by Staff did not meet resident's diapering needs.

87468.2 Additional Personal Rights of Residents in Privately Operated Facilities(a) In addition to the rights listed in Section 87468.1, Personal Rights of Residents in All Facilities, residents in privately operated residential care facilities for the elderly shall have all of the following personal rights:(8) To be free from neglect, financial exploitation, involuntary seclusion, punishment, humiliation, intimidation, and verbal, mental, physical, or sexual abuse. This requirement is not met as evidenced by: Based on record review and interviews by the Department, Licensee did not comply with the regulation cited above. S4 had committed sexual battery upon R1. S4 was taken into custody that day.

To care, supervision, and ...meet their individual needs...by staff that are sufficient in numbers, qualifications, and competency...This requirement was not met as evidence by: Based on interview, the licensee did not comply with the section cited above by not having the supervision which posed a potential health and safety risk to persons in care.

(2) Occurrences...which threaten the welfare, safety or health of residents,...shall be reported within 24 hours...This requirement was not met as evidence by: Based on interview and record review the licensee did not comply with the section cited above by not reporting to CCL within 24hrs which posed a potential health, safety or personal rights risk to persons in care.

Maintenance and Operation. Hot water provided for the use of residents shall be maintained between 105 and 120 degrees F. 5 residents’ room temperature were measured above 121 degree.