Chateau Jesadean

Facility personnel sufficiency and competence

87411(a)Facility personnel shall at all times be sufficient in numbers, and competent to provide the services necessary to meet resident needs….This requirement is not met as evidenced by: Based on interviews and records review, staff did not provide care and supervision when R1 went AWOL on 09/29/25, and facility was not aware until a short period after. R1 went AWOL, which poses/posed an immediate health and safety risks to persons in care.

Food quality controls and rejected damaged goods

Based on observation, expired perishable foods were observed, poses/posed an immediate health, safety or personal rights risk to persons in care.

Maintain physician order documentation in resident record

Based on interview conducted, observation, and records reviewed, R1 was observed laying in hospital bed with ½ rails on each side. There is no doctor’s order for ½ rail bed for R1, which poses/posed a potential health and safety and personal rights risk to the resident in care.

Agree in writing on agency and facility responsibilities

Based on record review and interview conducted, the licensee did not comply with the section cited above when LPA review R2’s and R3’s file, whose currently receiving home health with no home health care plan on file, which poses a potential health or personal rights risk to persons in care.

Based on interview conducted, observation, and records reviewed, R1 has a restricted health conditions with no restricted health condition care plan on file or in placed, poses/posed a potential health and safety and personal rights risk to the resident in care.

Document required significant condition changes

Based on interview conducted, observation, and records reviewed, R1 was admitted to the facility as nonambulatory status and have become bedridden, and no reappraisal was completed for change of condition, poses/posed a potential health and safety and personal rights risk to the resident in care.

Store centrally held medications in locked secure place

Based on observation, the licensee did not comply with the section cited above when LPA and S1 observed medication Vitamin C bottle stored in the kitchen drawer next to the stove unlock, which poses an immediate health, safety or personal rights risk to person in care.

Record centrally stored prescriptions and refill data

Based on interview conducted, observation, and records reviewed, R2’s current medication Lactulose 10gm/15 ml, PRN medication Acetaminophen 325mg, PRN medication Hydroxyzine HCL 50 mg, medication Rifampin were not record in Centrally Stored Medication (Lic 622) record, poses/posed a potential health and safety and personal rights risk to the resident in care.

Based on observation, the licensee did not comply with the section cited above when carbon monoxide was not operating during visit, which poses an immediate health, safety or personal rights risk to persons in care.

All staff files were reviewed, A1, S2, and S3 did not have current First Aid/ CPR certification on file, this poses an immediately health and safety risk for the residents in care.

Based on interviews conducted with Licensee, last emergency disaster drill was completed on 02/2025 and not recorded, which poses/posed a potential health and safety and personal rights risk to the resident in care.

Maintain fire clearance before retaining specified persons

Based on observation, the licensee did not comply with the section cited above when LPA and A1 observed facility exit 5 in room 5 blocked with a metal leaver rod preventing sliding exit door to open, which an immediate health and safety risk which poses an immediate health, safety or personal rights risk to persons in care.

Report specified resident events within seven days

Based on record review and interview conducted, Licensee did not submit a written report to the department within 7 days of incident when R1 had went to the hospital on 07/08/25, 09/19/25, 09/20/25 and when R2 went to the hospital on 09/12/25, this poses a potential health and safety risk to residents in care.

Maintain facility in clean, safe, sanitary condition

Based on observation, a hole was observed in the parlor room on the wall, wall was observed in disrepair in room 2, wall electric outlet was in disrepair in room 5 and in room 6. Electric wall outlet in dining room rock wall not working, poses/posed a potential health and safety and personal rights risk to the resident in care.

Keep bath, laundry and kitchen floors clean

Based on observation, mold was observed under bathroom sink in room 1 bathroom, which poses a potential Health, Safety, and Personal Rights risk to the resident.

Ensure hazardous items are locked and not unattended

Based on observation, the licensee did not comply with the section cited above when LPA observed 08:58AM, S1 removing knives from the dishwasher and locking it in shelf over the stove. LPA and A1 observed cleaning chemicals unlock on bathroom 1 tub and in the garage. A gardening tool was observed in the shelf in the garage unlock. accessible to residents in care this poses an immediate health, safety or personal rights risk to persons in care.

Based on records review, S2 did not have a TB result and good health screening on file. S3 did not have good health screening on file, which poses a potential risk to the health and safety of the residents.

Maintain required personnel records for staff

Based on record review and interview, the licensee did not comply with the section cited above when A1’s personnel file was not observed maintained at the facility, which poses/posed a potential health, safety or personal rights risk to persons in care.

Based on record review and interview, the licensee did not comply with the section cited above when all staff files did not have the proper documentation of staff trainings, which poses/posed a potential health, safety or personal rights risk to persons in care.

Document each PRN medication dose taken

Based on interviews and records reviewed, R2’s medication Lactulose 10gm/15 ml, PRN medication Acetaminophen 325mg, and PRN medication Hydroxyzine HCL 50 mg were not record in the resident’s MAR , which poses a potential health and safety risk for the person in care.

Require fire clearance before non-temporary bedridden admission

Based on observation and interviews conducted, the licensee did not comply with the section cited above, the facility has no fire clearance for bedridden and has R1 a bedridden resident whose not receiving hospice care reside in room 1, which an immediate health and safety risk which poses an immediate health, safety or personal rights risk to persons in care.

Safe, healthful, comfortable accommodations

(a) Residents in all residential care facilities for the elderly shall have all of the following personal rights: (2) To be accorded safe, healthful and comfortable accommodations, furnishings and equipment. **This was not met as evidenced by LPAs observed R1s bed to be situated in the corner of the room against the wall, with full bed rails. LPAs observed a twin mattress on its side pushed up against bed with a chair and wheelchair keeping mattress in place

Obtain required California clearance or exemption

(e) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1569.17(b) shall prior to working, residing or volunteering in a licensed facility: (2) Obtain a California clearance or a criminal record exemption as required by the Department or ***This was not met as evidenced by staff 1 (S1) on shift is not fingerprint cleared.Immediate civil penalty assessed

Maintain required personnel records for staff

Based on record review, the licensee did not comply with the section cited above in when S1 did not have a file on site and S2 did not have documentation on file, which poses/posed a potential health, safety or personal rights risk to persons in care.

Facility must keep complete hospice care plan on file

Based on record review, the licensee did not comply with the section cited above when the facility did not have a hospice care plan for 2 out of 2 residents receiving hospice services, which poses/posed a potential health, safety or personal rights risk to persons in care.

Provide resident hot water for personal care

Based on observation, the licensee did not comply with the section cited above when hot water measured at 122.7 degrees F, which poses an immediate health, safety or personal rights risk to persons in care.

Conformance with applicable laws and regulations

Based on observation, the licensee did not comply with the section cited above when the fire extinguisher was last serviced on 04/10/2023, which poses an immediate health, safety or personal rights risk to persons in care.