New West Haven Ii

(c)All information and records obtained from or regarding residents shall be confidential. (1) The licensee shall be responsible for storing active and inactive records and for safeguarding the confidentiality of their contents. The licensee and all employees shall reveal or make available confidential information only upon the resident's written consent or that of his designated representative. This requirement was not met as evidenced by: Based on record reviewed it was determined that the Licensee did not produce records for R1 to R1’s representative. This poses a potential health and safety risk to residents in care.

80075 Health Related Services (b)(5)(B) - Once ordered by the physician the medication is given according to the physician's directions. This requirement was not met as evidenced by: Based on record reviewed and interviews, R1 was given the wrong medications in error. These medications were not ordered by R1s physician, which poses an immediate health and safety risk to residents in care.

Personal Rights. (a) Each client shall have personal rights which include, but are not limited to, the following: (2) To be accorded safe, healthful and comfortable accommodations, furnishings and equipment to meet his/her needs. This requirement was not met as evidenced by: Based on observation and interview, masks were not consistently being worn by staff.

87465(a)(5) Incidental Medical and Dental Care-The licensee shall assist residents with self-administered medications as needed. This requirement was not met as evidenced by: based on interview and MAR document review, residnet was not given medication as prescribed.

87465(a)(5) Incidental Medical and Dental Care-The licensee shall assist residents with self-administered medications as needed. This requirement was not met as evidenced by: Based on LPAs record review and interview, staff failed to provide medication to resident in a timely manner as prescribed. This poses a potential health and safety risk to residents in care.

87355- Criminal Record Clearance- The Department shall conduct a criminal record review of all individuals specified in Health and Safety Code section 1569.17 and shall have the authority to approve or deny a facility license, or employment, residence or presence in the facility, based upon the results of such review. This requirement is not met as evidenced by: Based on the investigation, staff members, 1) Ashley Kelly 2) Olga Estrada 3) Kitty Flannagan and 4) Joshua Sullivan were present and working in the facility without being criminally cleared. Licensee did not have the above referenced individuals criminally cleared prior to being present in the facility. This is in violation of this section. This poses an immediate health and safety risk to residents in care.

Administrator - Qualifications and Duties - The administrator shall have sufficient freedom from other responsibilities and shall be on the premises a sufficient number of hours to permit adequate attention to the management and administration of the facility as specified in this section. When the administrator is not in the facility, there shall be coverage by a designated substitute who shall have qualifications adequate to be responsible and accountable for management and administration of the facility as specified in this section. The Department may require that the administrator devote additional hours in the facility to fulfill his/her responsibilities when the need for such additional hours is substantiated by written documentation. This requirement is not met as evidenced by: Based on witness statements and investigation, administrator Joel Matkovich, is not physically present in the facility to adequately manage the facility and is in violation of this section. This poses a potential health and safety risk to residents in care.

87755-Inspection Authority of the Licensing Agency-The licensing agency shall have the authority to inspect, audit, and copy resident or facility records upon demand during normal business hours. Records may be removed if necessary for copying. This requirement is not met as evidenced by: Based on the investigation and witness statements ,facility failed to furnish requested records by a duly authorized representative of the department. Licensee did not furnish requested records and is in violation of this section. This poses a potential health and safety risk to residents in care.

87761- Penalties- This requirement is not met as evidenced by: Based on the investigation, R1s injuries and the failure to report the injuries mandates the requirement of an enhanced civil penalties. This poses an immediate health and safety risk to residents in care.

87211-Reporting Requirements-A written report shall be submitted to the licensing agency and to the person responsible for the resident within seven days of the occurrence. (B) Any serious injury as determined by the attending physician and occurring while the resident is under facility supervision. This requirement is not met as evidenced by: Based on the investigation, facility failed to report an incident where R1 sustained a fractured hip. Licensee is in violation of this section. This poses a potential health and safety risk to residents in care.

87207-False Claims-No licensee, officer or employee of a licensee shall make or disseminate any false or misleading statement regarding the facility or any of the services provided by the facility. This requirement is not met as evidenced by: Based on investigation, staff member Sunnybrook Matkovich, submitted a back dated UIR and lied to the department's investigator about the actual date of submission. This is in violation of this section. This poses an immediate health and safety risk to residents in care.

87465Incidental Medical & Dental Care(g) The licensee shall immediately telephone 9-1-1 if an injury or other circumstance has resulted in an imminent threat to a resident’s health . . . This requirement was not met as evidenced by R1 sustaining a fall and the facility failing to seek medical attention.

87468.1 Personal Rights of Residents in All Facilities(8) To have their representatives regularly informed by the licensee of activities related to care or services . . . This requirement was not met as evidenced by R1 sustaining a fall which was not reported to R1's POA until R1 was sent out via 911 days later.