Sierra Palace for the Elderly

80075 Health Related Services(5) If the client's physician has stated in writing that the client 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 client with self-administration, providing all of the following requirements are met: (B) Once ordered by the physician the medication is given according to the physician's directions. This requirement was not met by: LPA records review, the licensee did not comply with the section cited above in that R1 was not provided medication as per physicians orders. This posed a potential health, safety and or personal rights risk to persons in care.

Based on LPA observation, the licensee did not comply with the section cited above in that 1 of 4 resident rooms was observed with a 1/2 bed rail. File review showed a prescription was not found for repositioning. This poses a potential health, safety or personal rights risk to persons in care.

Based on LPA file reviews, the licensee did not comply with the section cited above in that 2 of 2 files reviewed did not have a pre-appraisal/functional capabilities. This poses a potential health, safety or personal rights risk to persons in care.

Based on LPA observation, the licensee did not comply with the section cited above in that Holes observed in bedroom #5 door in need of repair or replacements. Plug cover in bedroom #6 missing and in need of replacement. Holes in stucco on back left side of house in need of repair. Fence on left side yard leaning in need of repair. Carpet in living room observed dirty and in need of cleaning. Bedroom #4 observed with bed railing without prescription for repositioning. Vents throughout the house observed rusted in need of paint or replacement. Carpet outside bedrooms 2 & 3 observed torn in need of repair/replacement. Bedroom #1 in need of touch up paint in bedroom/bathroom. This poses a potential health, safety or personal rights risk to persons in care.

Based on record review, the licensee did not comply with the section cited above in that the facility has a plan but does not have the required information listed. This poses a potential health, safety or personal rights risk to persons in care.

80061 Reporting Requirements(b) Upon the occurrence, during the operation of the facility, of any of the events specified in (1) below, a report shall be made to the licensing agency within the agency's next working day during its normal business hours. In addition, a written report containing the information specified in (2) below shall be submitted to the licensing agency within seven days following the occurrence of such event. This requirement was not met by: LPA records review, the licensee did not comply with the section cited above in that incident involving R1 occurred on 2/26/25 & 2/27/25 and was not reported until 3/14/25. This posed a potential health, safety and or personal rights risk to persons in care.

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 ensure resident was transported to the hospital, which poses a potential health and safety risk.

Maintain facility in clean, safe, sanitary condition

This requirement was not met as evidence by: LPA observations of screens missing on windows and in need of replacements, carpet in living room torn and in need of repair/replacement, tile in bathroom #1 and entry way broken and in need of repair/replacement, cabinets in bathroom #1 in need of paint/repair, 3 of 5 bedrooms missing night stands, bedroom #3 in need of new mattress, sharps observed in bedroom #4, crack where ceiling meets wall in bedroom #5 in need of repair, light cover missing in laundry room, light plate cover in hallway broken and in need of replacement. These pose a potential health, safety and or personal rights risk to residents in care.

Report specified resident events within seven days

87211(a)(1) 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 of any of the events specified in (A) through (D) below. This requirement was not met as evidence by: Based on records reviewed, the facility failed to submit an incident report of the altercation between R1 and R2 or of R1’s injuries until after the Department was notified by Regional Center, which poses a potential health and safety risk to the residents in care.

Facility personnel sufficiency and competence

87411(a) Personnel Requirements - GeneralFacility 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: Based on interviews conducted and records reviewed, the facility failed to intervened in a physical altercation between R1 and R2 that resulted in R1 getting a black eye, four missing teeth, and injury to his right arm. This poses an immediate health and safety risk to the clients in care.

Regular observation and documentation of resident changes

87466 Observation of the ResidentThe 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: Based on records reviewed and interviews conducted, facility failed to seek medical attention for R1 after a physical altercation with another resident, which poses a potential health and safety risk to the residents in care.

Facility maintenance and healthful environment

87307 Personal Accommodations and Services (d)(2) The premises shall be maintained in a state of good repair and shall provide a safe and healthful environment. This requirement was not met as evidenced by: Based on interviews, the licensee did not comply with the section cited above for five out of five residents, which posed a potential health, safety or personal rights risk to persons in care.

Safe, healthful, comfortable accommodations

87468.1 Personal Rights of Residents in All Facilities: (a)(2)To be accorded safe, healthful and comfortable accommodations, furnishings and equipment. This requirement was not met as evidenced by: Based on interviews, the licensee did not comply with the section cited above for five out of five residents, which posed a potential health, safety or personal rights risk to persons in care.

Facility maintenance and healthful environment

Based on obervation and photographs taken, the licensee did not comply with the section cited above in one out of six bedrooms, which poses a potential health, safety or personal rights risk to persons in care.

Required bedroom furniture and lighting items

Based on observation and photographs, the licensee did not comply with the section cited above in one out of six bedrooms which poses/posed a potential health, safety or personal rights risk to persons in care.