Sierra Palace for Elderly #2

Based on records reviewed. The licensee did not comply with the section cited above in that the facility staff is assisting 4 of 4 residents with glucose testing and or administration of medication. This poses an immediate health safety and of personal rights risk to residents in care.

Based on record review, the licensee did not comply with the section cited above in that the emergency and disaster plan was lacking details or missing information. This poses a potential health, safety or personal rights risk to persons in care.

Maintain facility in clean, safe, sanitary condition

This requirement was not met as evidence by LPA observation. The licensee did not comply with the section cited above in that the driveway concrete was observed to be broken up and the back yard flooded due to a broken pipe. Dryer vent in need of cleaning. Back doors (2) in need of weather stripping. Bathroom shower observed dirty in need of cleaning. Bedroom #2 door plate damaged and in need of repair. Kitchen drawer and bedroom #3 dressor broken and in need of repair or replacement. Dining room blinds broken and in need of replacement. This poses a potential health safety and or personal rights risk to residents in care.

Facility must clear fire safety for bedridden persons

Based on records reviewed and LPA observation, the licensee did not comply with the section cited above in that 1 of 6 resident medical assessments identify R1 as bedridden. LPA observation of R1's room showed R1 utilizes a Hoyer lift. This poses an immediate health, safety or personal rights risk to persons in care.

Based on records reviewed, the licensee did not comply with the section cited above in that care plans were not completed for residents with allowable health conditions. This poses a potential health safety and or personal rights risk to residents in care.

Resident record must include minimum required items

Based on records reviewed, the licensee did not comply with the section cited above in 3 of 3 resident records reviewed do not have the required documentation. This poses a potential health, safety or personal rights risk to persons in care.

Cool occupied rooms to regulated temperature range

87303 Maintenance and Operation (b) A comfortable temperature for residents shall be maintained at all times. (2) The facility shall cool rooms to a comfortable range, between 78 degrees F (26 degrees C) and 85 degrees F (30 degrees C), or in areas of extreme heat to 30 degrees F less than the outside temperature. This requirement was not met as evidence by records reviewed and interviews completed. The licensee did not comply with the section cited above in that the facility had a broken AC unit from 8/8/25 through 8/11/25. Inside temperature did not measure less than 30 degrees from the outside temperature in extreme heat. This poses a potential health safety and or personal rights risk to residents in care.

Maintain facility in clean, safe, sanitary condition

Based on observation, the licensee did not comply with the section cited above. LPA’s observed 1 of 5 residents rooms observed with odor of urine. No seating under covered patio area. Right side gate does not self-latch. Light with missing bulbs exposing electrical. Pest control issue. Laundry piled in receptacle without lid. Laundry room door in need of repair or replacement. Laundry vent on roof in need of cleaning. Metal rebar sticking out of ground in need of removal. Food source does not meet regulation requirements. Door plate in R1's room missing screws. R3's bedroom door (master) missing trim. R3's light cover exposing electric. R3's bathroom door observed with a small hole in need of repair. Bedroom #3 observed with torn screen in need of replacement. This poses a potential health, safety or personal rights risk to persons in care.

Ensure hazardous items are locked and not unattended

Based on observation, the licensee did not comply with the section cited above. LPA's observed chemicals in 6 of 6 bedrooms, 3 of 3 restrooms and in shed unlocked and accesible to clients in care. This poses a potential health, safety or personal rights risk to persons in care.

Diet quality and preparation in safe healthful manner

87555(a) General Food Service Requirements The total daily diet shall be of the quality and in the quantity necessary to meet the needs of the residents and shall meet the Recommended Dietary Allowances of the Food and Nutrition Board of the National Research Council. This requirement was not met as evidenced by: Based on observation made during the tour of the facility and records reviewed, the facility did not have an adequate supply of food, which poses a potential health and safety risk.

Arrange appropriate medical and dental care

87465(a)(1) Incidental Medical and Dental Care - 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: Based on records reviewed and interviews conducted, the facility failed to seek medical assistance with resident had a change of condition, which poses a potential health and safety risk.

Resident care and supervision skills

87411(d)(3) Personnel Requirements – General - Skill and knowledge required to provide necessary resident care and supervision, including the ability to communicate with residents. This requirement was not met as evidenced by: Based on record reviewed and interviews conducted, the facility failed to follow client’s behavior plan with Regional Center, which poses a potential health and safety risk.

Maintain facility in clean, safe, sanitary condition

87303(a) Maintenance and Operation - 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: Based on LPA observation, the resident’s bedroom smelled like urine during the complaint visit, which poses a potential health and safety risk.

(c) All RCFE staff who assist residents with personal activities of daily living shall receive initial and annual training as specified in Health and Safety Code sections 1569.625 and 1569.69(3) The training shall include, but not be limited to, the following:(A) The aging process and physical limitations and special needs of the elderly. This requirement was not met as evidenced by LPAs records review of staff training records. Records provided were medication management training only, and records were outdated. If not corrected, this poses an immediate risk to the health and safety of residents in care.

(b) The following food service requirements shall apply: …Facilities licensed for less than sixteen (16) residents shall maintain a sample menu in their file. Menus shall be made available for review by the residents or their designated representatives and the licensing agency upon request. Based on observations and interviews, the Licensee did not ensure a menu was available to review upon request, which poses a potential health and safety risk to residents/clients in care.

Assist residents with self-administered medication

(a) A plan for incidental medical and dental care shall be developed by each facility... by compliance with the following: (4) The licensee shall assist residents with self-administered medications as needed. This requirement was not met as evidenced by: Based on observation and interview, Licensee did not ensure all residents were assisted with self-administered medications as needed when R1 was not administered medications and R2 was missing medications, which poses an immediate health and safety risk to residents in care.

Maintain facility in clean, safe, sanitary condition

(a) The facility shall be clean, safe, sanitary and in good repair at all times. This requirement was not met as evidenced by: Based on observation, Licensee did not ensure the facility was in good repair when the oven, built-microwave, and shower in R1’s bathroom was in disrepair, which poses a potential health and safety risk to residents/clients in care.