The Commons at Dallas Ranch

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. This requirement was not met as evidenced by staff failing to timely follow up with residents’ primary care physician to timely discontinue and/or administer refilled medications which posed a potential health & safety risk to resident in care.

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 was not met as evidenced by staff failing to timely administer residents’ medications which posed a potential health & safety risk to resident in care.

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 was not met as evidenced by staff failing to timely assist resident with blood pressure checks which posed a potential health & safety risk to resident in care.

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 was not met as evidenced by staff failing to respond to resident’s call button in a timely manner which posed a potential health & safety risk to residents in care.

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 was not met as evidenced by staff failing to timely process residents' insurance invoices for reimbursements which posed a potential health & safety risk to client in care.

To have a reasonable level of personal privacy in accommodations, medical treatment, personal care and assistance, visits, communications, telephone conversations, use of the Internet, and meetings of resident and family groups. This requirement was not met as evidenced by staff failing to ensure resident’s medical information is confidential which posed a potential health & safety risk to client in care.

Once ordered by the physician the medication is given according to the physician's directions. This requirement was not met as evidenced by staff administering unauthorized medication to a resident which posed a potential health & safety risk to resident in care.

To have their records and personal information remain confidential and to approve their release, except as authorized by law This requirement was not met as evidenced by staff publicly disclosing resident's personal information which posed a potential health & safety risk to residents in care.

Delayed egress devices shall not substitute for trained staff in sufficient numbers to meet the care and supervision needs of all residents, including staff needed to escort residents who need supervision to leave the facility. This requirement was not met as evidenced by staff do not ensure adequate supervision is provided resulting in residents eloping from the facility which posed a potential health & safety risk to residents in care

There is written direction from a physician, on a prescription blank, specifying the name of the resident, the name of the medication, all of the information in Section 87465(e), instructions regarding a time or circumstance (if any) when it should be discontinued, and an indication when the physician should be contacted for a medication reevaluation. This requirement was not met as evidenced by staff mismanaged resident’s medication which posed a potential health & safety risk to residents in care.

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 was not met as evidenced by staff failing to lock memory care medication room which posed a potential health & safety risk to residents in care

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. This requirement was not met as evidenced by staff left resident on floor for an extended period of time which posed a potential health & safety risk to residents in care.

Complaint investigation finding was amended to unsubstantiated.Deficiency removed 09/05/24.

Complaint investigation finding was amended to unsubstantiated.Deficiency removed on 09/05/24.

Complaint investigation finding was amended to unsubstantiatedDeficiency removed on 09/05/24

A record of each dose is maintained in the resident's record. The record shall include the date and time the PRN medication was taken, the dosage taken, and the resident's response This requirement was not met as evidenced by staff did not ensure medication records were properly maintained which posed a potential health & safety risk to residents in care.

) Facility staff shall contact the resident's physician prior to each dose, describe the resident's symptoms, and receive direction to assist the resident in self-administration of that dose of medication This requirement was not met as evidenced by staff did not ensure medication was dispensed as prescribed which posed a potential health & safety risk to residents in care

All persons shall be protected against hazards within the facility.This requirement was not met as evidenced by presence of pest in the memory care areas which posed a potential health & safety risk to residents in care

The facility shall be clean, safe, sanitary and in good repair at all times. Maintenance shall include provision of maintenance services and procedures for the safety and well-being of residents, employees and visitors. This requirement was not met as evidenced by bed bug infestation in memory care which posed a potential health and safety risk to residents in care.

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 and record review, the licensee did not comply with the section cited above by staff not responding timely before R1 eloped outside the building and across the streets which posed a potential health and safety risk to persons in care.

Each container shall carry all of the information specified in (6)(A) through (E) below plus expiration date and number of refills. This requirement was not met as evidenced by staff not timely ordering medication refills which posed a potential health & safety risk to residents in care.

A record of each dose is maintained in the resident's record. The record shall include the date and time the PRN medication was taken, the dosage taken, and the resident's response.. This requirement was not met as evidenced by staff mismanaging resident’s medication which posed a potential health & safety risk to residents in care

Facility staff shall contact the resident's physician prior to each dose, describe the resident's symptoms, and receive direction to assist the resident in self-administration of that dose of medication. This requirement was not met as evidenced by staff not timely ordering medication refills which posed a potential health & safety risk to residents in care

Once ordered by the physician the medication is given according to the physician's directions... This requirement was not met as evidenced by staff mismanaging resident’s medication which posed a potential health & safety risk to residents in care.

To have a reasonable level of personal privacy in accommodations, medical treatment, personal care and assistance…” This requirement was not met as evidenced by staff did not ensure resident had clean clothing which posed a potential health & safety risk to resident in care

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 was not met as evidenced by resident left in soiled clothing for an extended period of time which posed a potential health & safety risk to resident in care

(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.” This requirement was not met as evidenced by staff failing to assist residents hygiene needs which posed a potential health & safety risk to residents in care.

Maintenance and Operation.The facility shall be clean, safe, sanitary and in good repair at all times....This requirement is not met as evidence by: Based on investigation, licensee did not comply with the section cited above by not cleaning R3's room which poses a potential health and safety risk to the persons in care.

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...(4) To care, supervision, and services that meet their individual needs and are delivered by staff that are sufficient…This requirement is not met as evidenced by: Based on records reviewed, facility staff failed to respond to R1 & R2’s pendant call for assistance in a timely manner which poses a potential risk to the health and safety of resident under care.

Facility personnel shall at all times be sufficient in numbers, and competent to provide the services necessary to meet resident needs... This requirement was not met as evidenced by short staffing which posed a potential health & safety risk to residents in care

For every prescription and nonprescription PRN medication for which the licensee provides assistance there shall be a signed, dated written order from a physician, on a prescription blank, maintained in the residents file, and a label on the medication… This requirement was not met as evidenced by staff mishandling resident's medication which posed an immediate health & safety risk to resident in care.

There is written direction from a physician, on a prescription blank, specifying the name of the resident, the name of the medication, all of the information in Section 87465(e), instructions regarding a time or circumstance (if any) when it should be discontinued, and an indication when the physician should be contacted for a medication reevaluation... This requirement was not met as evidenced by staff failing to timely seek medical attention to resident which posed an immediate health & safety risk to resident in care.

87633 Hospice Care of Terminally Ill Residents(d) The licensee shall ensure that the hospice care plan is current, accurately matches the services actually being provided, and that the client’s care needs are being met at all times.This requirement is not met as evidenced by: Based on record review, the licensee did not comply with the section cited above. LPA observed facility staff assisted resident for self-administering medicine Morphine without instructed by hospice agency which poses a potential health and safety concern to persons in care.

Facility personnel shall at all times be sufficient in numbers, and competent to provide the services necessary to meet resident needs This requirement was not met as evidenced by insufficient staff which posed a potential health & safety risk to residents in care

If the resident's physician has stated in writing that the resident is able to determine and communicate his/her need for a prescription or nonprescription PRN medication, facility staff shall be permitted to assist the resident with self-administration of his/her PRN medication This requirement was not met as evidenced by staff failing to administer residents' medications as prescribed which posed a potential health & safety risk to residents in care.

When regular staff members are absent, there shall be coverage by personnel with qualifications adequate to perform the assigned tasks This requirement was not met as evidenced by insufficient staff which posed a potential health & safety risk to residents in care.

(c) “Care and supervision” means the facility assumes responsibility for, or provides or promises to provide in the future, ongoing assistance with activities of daily living without which the resident’s physical health, mental health, safety, or welfare would be endangered. Assistance includes assistance with taking medications, money management, or personal care. This requirement was not met as evidenced by staff failing to provide basic services which posed a potential health & safety risk to residents in care

Ensuring that incontinent residents are kept clean and dry and that the facility remains free of odors from incontinence. This requirement was not met as evidenced by staff failing to assist residents with incontinence care which posed a potential health & safety risk to residents in care.

Personnel Requirements(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. This requirement was not met as evidenced by staff failing to meet residents needs which posed a potential health & safety risk to residents in care

Personnel RequirementsFacility personnel shall be competent to provide the services necessary to meet individual client needs and shall, at all times, be employed in numbers necessary to meet such needs. This requirement was not met as evidenced by resident sustaining a fractured back while in care which posed an immediate health & safety risk to resident in care

Personal RightsTo 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 was not met as evidenced by staff not assisting residents with their ADLs in a timely manner which posed a potential health & safety risk to residents in care

Medical & Dental CareThe licensee shall immediately telephone 9-1-1 if an injury or other circumstance has resulted in an imminent threat to a resident’s health including, but not limited to, an apparent life-threatening medical crisis… This requirement was not met as evidenced by staff not seeking timely medical attention for the resident which posed a potential health & safety risk to resident in care

Criminal Record Clearance. Request a transfer of a criminal record clearance as specified in Section 87355(c) or...This requirement is not met as evidence by: Based on record review, licensee did not comply with the section cited above by not associating staff who works at the facility which poses an immediate health and safety risk to the persons in care.