Helping Hands Senior Care

87633 Hospice Care of Terminally Ill Residents(b) A current and complete hospice care plan shall be maintained in the facility for each hospice resident and include the following:(4) A description of the area of licensee’s responsibility for implementing the plan including, but not limited to, facility staff duties; record keeping; and communication with the hospice agency, resident’s physician, and the resident’s responsible person(s), if any. This description shall include the type and frequency of the tasks to be performed by the facility. **This requirement was not met as evidenced by LPAs records review and interviews conducted, there is was no hospice care plan or descrption of resposibilty for R4's care.

On-the-job training requirements

Personnel Requirements - General:All personnel shall be given on the job training or have related experience in the job assigned to them. This training and/or related experience shall provide knowledge of and skill in the following, as appropriate for the job assigned and as evidenced by safe and effective job performance:**This was not met as evidenced by, based on record rerview and interview with Administrator Assistant, direct care staff have no documented training on file.

87463 Reappraisals(e) The licensee shall immediately, or as soon as reasonably possible, bring any significant change in condition, as defined in Section 87101, Definitions, to the attention of the appropriate licensed medical professional and if applicable, other specialized care provider. Documentation of such communication shall be added to the resident's record and shall include: **This requirement was not met as evidenced by LPA review of R2's records. There was no reappraisal observed in R2s file.

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. When changes such as unusual weight gains or losses or deterioration of mental ability or 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 is not met as evidenced by LPAs review of R2 hospital records stating R2 was sent to the ER via ambulance by the wound specialist clinic due to worsening of the right leg wound. R2 was hospitalized for 3 days to receive antibiotics for a serious infection on their leg. An immediate civil penalty in the amount of $500 is hereby assessed. If not corrected, the violation will have a direct and immediate risk to the health, safety, or personal rights of clients in care.

Personal Rights of Residents in All Facilities: (a)Residents in all residential care facilities for the elderly shall have all of the following personal rights: (15) To send and receive unopened correspondence in a prompt manner.**This was not met as evidenced by, interviews conducted with R2 & R3 who stated that they are not receiving mail. During records review of resident files LPAs observed unopened mail for R5 in their file.

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, residents in privately operated residential care facilities for the elderly shall have all of the following personal rights: (9) To present grievances and recommend changes in policies, procedures, and services to the facility staff, management, and governing authority, and to any other person without restraint, coercion, discrimination, reprisal, or other retaliatory actions..**Thiis requirement was not as evidenced by LPAs interviews, licensee stated R4 brought problems to the facility and needs to find another place to live.

87609 Allowable Health Conditions and the Use of Home Health Agencies(b) Incidental medical care may be provided to residents through a licensed home health agency provided the following conditions are met: (4) The licensee and home health agency agree in writing on the responsibilities of the home health agency, and those of the licensee in caring for the resident’s medical condition(s). (A) The written agreement shall reflect the services, frequency and duration of care. **This requirement was not met as evidenced by LPAs interviews with R7 and S3, stating Home Health changed R7’s catheter wrong. Facility was unable to provide proof of home health care plan.

87613 General Requirements for Restricted Health Conditions(a) Prior to admission of a resident with a restricted health condition, the licensee shall: (2) Ensure that facility staff who will participate in meeting the resident’s specialized care needs complete training provided by a licensed professional sufficient to meet those needs. **This requirement was not met as evidenced by LPAs request of training records for 5 out of 10 restricted health conditions observed involving R2 for oxygen and wound care, R4 for managed incontinence and R7 for catheter and diabetic care.

87623 Indwelling Urinary Catheter(b) In addition to Section 87611, General Requirements for Allowable Health Conditions, the licensee shall be responsible for the following:(2) Ensuring that the bag and tubing are changed by an appropriately skilled professional should the resident require assistance. (A) The bag may be emptied by facility staff who receive instruction from an appropriately skilled professional. **This requirement was not met as evidenced by LPAs interview with R7 and records review of R7s file.

Allowing diabetic residents based on self-management ability

87628 Diabetes(a) The licensee shall be permitted to accept or retain a resident who has diabetes if the resident is able to perform his/her own glucose testing with blood or urine specimens, and is able to administer his/her own medication including medication administered orally or through injection, or has it administered by an appropriately skilled professional. **This requirement was not met as evidenced by LPAs observation and interviews with R7 and S3 stating S3 performs the glucose testing for R7 and prepares the dose of insulin. LPA observed S3 conducting glucose testing, insulin dial and R7 injecting themselves with insulin pen.

87631 Healing Wounds(a) Except as specified in Section 87611(a), the licensee shall be permitted to accept or retain a resident who has a healing wound under the following circumstances: (1) When care is performed by or under the supervision of an appropriately skilled professional.This requirement was not met as evidenced by LPAs request for Home Health records and interviews with staff, there is no plan of 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 was not met as evidenced by interview with residents and administrator there was an incident involving law enforcement on site searching for a suspect, the suspect had entered and was hiding in R6's home.

Personnel Requirements - General: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**This was not met as evidenced by, based on record review and interview with Administrator Assistant, direct care staff have no documented training on file.

Program Flexibility: a)The use of alternate concepts, programs, services, procedures, techniques, equipment, space, personnel qualifications or staffing ratios, or the conduct of experimental or demonstration projects shall not be prohibited by these regulations provided that: (2) A written request for a waiver or exception and substantiating evidence supporting the request shall be submitted in advance to the licensing agency by the applicant or licensee.**This was not met as evidenced by, R2 has a medical assessment signed by a nurse practioner, not a physician,

87221 Resident CouncilsThe facility shall permit the formation of a resident council by interested residents, provide space and post notice for meetings, and provide assistance in attending meetings for those residents who request it. In order to permit a free exchange of ideas, at least part of each meeting shall be allowed to be conducted without the presence of any facility personnel. Residents shall be encouraged, but shall not be compelled to attend. The purpose of such an organization shall be to work with the administration in improving the quality of life for all residents by enriching the activity program and to discuss the services offered by the facility and make recommendations regarding identified problems. This requirement was not met as evidenced by LPAs interviews with residents and records review. There has been no notice or resident council formed.

Certified administrator requirements and substitute coverage

Administrator Qualifications: a)All facilities shall have a qualified and currently certified administrator. The licensee and the administrator may be one and the same person. 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 was not met as evidenced by Adminstrator has not been available in person with LPAs for 3 visits on 10/14/25, 10/30/25 & 11/0525. Interviews with residents state they may see Administrator once per month, Administrator is not present.

Based on record reviews, the licensee did not comply with the section cited above in which poses/posed a potential health, safety or personal rights risk to persons in care.

Based on observation and interview, the licensee did not comply with the section cited above in 4 out of 4 occupied buildings on site which poses/posed 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 which poses/posed a potential health, safety or personal rights risk to persons in care.

Food quality controls and rejected damaged goods

Based on observation, interview and record review, the licensee did not comply with the section cited above which poses/posed a potential health, safety or personal rights risk to persons in care.

Report specified resident events within seven days

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

Modified diets for medical necessity

Based on record review, the licensee did not comply with the section cited above in 3 out of 3 persons which poses/posed 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 which poses an immediate health, safety or personal rights risk to persons in care. Staff 1 is not fingerprinted and cleared and has worked 5 days or more from 9/29/25 through 10/12/25.

Maintain fire clearance before retaining specified persons

Based on interview and record review, the licensee did not comply with the section cited above in 1 out of 9 out of persons which poses an immediate health, safety or personal rights risk to persons in care. Resident 1 is bedridden and facility is not cleared for bedridden.

Request transfer of criminal record exemption

Based on record review, the licensee did not comply with the section cited above which poses an immediate health, safety or personal rights risk to persons in care. Staff 2 has a fingerprint exemption that has not be transfered to facility. Staff 2 has worked 5 days or more between 9/29/25 - 10/12/25.

80075(k)(1) - Medication 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 Medication is currently stored in locked cabinet in each kitchen area however the lock is not serving its intended purpose and medication is accessible.