Sequoia Springs Senior Living Community

Based on record review, the licensee did not comply with the section cited above in 8 of 10 staff files reviewed. Records did not containt the required number of annual training hours, 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. Staff provided the wrong medication to a resident on 3 separate occasions, which poses an immediate health, safety or personal rights risk to persons in care.

Based on observation, the licensee did not comply with the section cited above. Facility is preparing medication in separate cups before assisting residents with medication, resulting in a medication error. This poses/posed a potential health, safety or personal rights risk to persons in care.

87705 Care of Persons with Dementia:(d) The licensee shall ensure that the facility has an auditory device or other staff alert feature to monitor exits on exterior doors and perimeter fence gates accessible to those residents who may be at risk for elopement, as defined in Section 87101, Definitions. This requirement is not met as evidenced by: Based on records reviewed, Licensee did not ensure the front exit door was monitored to ensure the safety of residents. This poses an Immediate Health, Safety or Personal Rights risk to residents in care.

(22) To be protected from involuntary transfers, discharges, and evictions in violation of state laws and regulations... This requirement is not met as evidenced by: Based on records reviewed and interviews conducted, Licensee did not accept resident back to the facility when they were discharged This poses an Immediate Health, Safety or Personal Rights risk to persons in care.

87465 Incidental Medical and Dental Care:(4) The licensee shall assist residents with self-administered medications as needed. This requirement is not met as evidenced by: Based on records reviewed, Licensee did not ensure resident received assistance with medication as ordered. This poses an Immediate Health, Safety or Personal Rights risk to residents in care.

1569.157 Resident-oriented facility council:(c) If a resident council submits written concerns or recommendations, the facility shall respond in writing regarding any action or inaction taken in response to those concerns or recommendations within 14 calendar days. This requirement is not met as evidenced by: Based on records reviewed, Licensee has not responded in writing to the resident council concerns. This poses a potential Health, Safety or Personal Rights risk to persons in care.

1569.269 Enumerated rights; severability:(24) To consent to have relatives and other individuals of the resident’s choosing visit during reasonable hours, privately and without prior notice. This requirement is not met as evidenced by: Based on interviews conducted and records reviewed, Licensee issued a visitor policy that prevented residents visiting with individuals of their choosing without prior notice. This poses an immediate Health, Safety or Personal Rights risk to persons in care.

87303 Maintenance and Operation:(a) 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 is not met as evidenced by: Licensee did not ensure resident pendant alert system was fully operational. This poses a potential Health, Safety or Personal Rights risk to persons in care.

87411 Personnel Requirements - General:(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 records reviewed, Licensee did not ensure residents received timely assistance as noted in the Resident Hand Book. This poses a potential Health, Safety or Personal Rights risk to persons in care.

1569.652(c) A refund of any fees paid in advance covering the time after the resident’s personal property has been removed from the facility shall be issued to the individual..., to the resident’s estate, within 15 days after the personal property is removed. This requirement is not met as evidenced by: Based on records reviewed, Licensee did not provide a refund within the 15 day timeframe in regulation. This poses a potential Personal Rights risk to residents in care.

Based on record review, the licensee did not comply with the section cited above in 7 out of 10 staff files reviewed. Files did not have evidence of completed staff training, 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 facility did not assist with medications as ordered. This poses an immediate health, safety or personal rights risk to persons in care.

87203 Fire Safety:All facilities shall be maintained in conformity with the regulations adopted by the State Fire Marshal for the protection of life and property against fire and panic. This requirement is not met as evidenced by: Based on interviews conducted, Licensee did not ensure staff or Fire Department was informed of a new code for an emergency exit. This poses an immediate Safety risk to persons in care.

87705 Care of Persons with Dementia:(6) Without violating Section 87468, Personal Rights, facility staff shall ensure the continued safety of residents if they wander away from the facility.This requirement is not met as evidenced by:Based on records reviewed, 2 residents left the facility without staff knoweldge. This poses an immediate Safety risk to residents in care.

87465 Incidental Medical and Dental Care:(4)The licensee shall assist residents with self administered medications as needed. This requirement is not met as evidenced by: Based on records reviewed Facility did not assist with medications as prescribed. This poses an Immediate Health risk to residents. ***An immediate civil penalty is being issued in the amount of $1000 for this repeated violation.

87465 Incidental Medical and Dental Care:(4) The licensee shall assist residents with self-administered medications as needed. This requirement is not met as evidenced by: Based on records reviewed Facility did not ensure medication was re-ordered in a timely manner. This poses an immediate Health or Safety risk to residents in care.

87307 Personal Accommodations and Services:(F) Basic laundry service (washing, drying, and ironing of personal clothing). This requirement is not met as evidenced by: Based on interviews and records reviewed, Licensee did not ensure resident laundry was completed, leaving soiled items in resident rooms for long periods of time. This poses a potential Health risk to residents in care.

87303 Maintenance and Operation:(a) The facility shall be clean, safe, sanitary and in good repair at all times. This requirement is not met as evidenced by: Based on interviews conducted, Licensee did not ensure windows in the building were in good repair. Windows in several rooms are not in good repair which causes a potential Health or Safety risk to residents in care. This is a repeat violation, civil penalty of $250.00 is being issued.

87465 Incidental Medical and Dental Care:(4)The licensee shall assist residents with self administered medications as needed. This requirement is not met as evidenced by: Based on records reviewed Facility did not assist with medications as prescribed. Facility did not have medications on hand for resident and did not re-order in a timely manner. This poses an Immediate Health risk to residents.

87466 Observation of the Resident: The licensee shall ensure that residents are regularly observed for changes in physical functioning...and that appropriate assistance is provided when such observation reveals unmet needs. This requirement is not met as evidenced by: Based on records reviewed, facility did not ensure the care needs of the resident were met. This poses a potential Health risk to residents.

87465 Incidental Medical and Dental Care:(2)The licensee shall provide assistance in meeting necessary medical and dental needs. This requirement is not met as evidenced by: Based on records reviewed, Licensee did not ensure wound care was provided to resident. This poses an immediate Health risk to residents in care.

Based on interviews conducted and a review of records, the licensee did not comply with the section cited above. Licensee did not document completed drills, 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 in 3 of 5 records reviewed, which poses/posed a potential health, safety or personal rights risk to persons in care.

The following exact statement as specified in Health and Safety Code Section 1569.683(a)(4):...This requirement is not met as evidenced by: Based on a review of the eviction notice, Licensee did not include the proper language per regulation.

(1) A written report shall be submitted to the licensing agency and to the person responsible for the resident within seven days...This requirement was not met as evidenced by: Based on records reviewed and interviews conducted, facility did not notify responsible party of several incidents regarding resident. This poses a potential Health, Safety or personal rights risk to residents.

(4) There is an adequate number of direct care staff to support each resident’s physical, social, emotional, safety and health care needs as identified in his/her current appraisal. This requirement is not met as evidenced by: Based on records reviewed, facility did not ensure staff were present to prevent resident attacking another resident. This poses an immediate Safety risk to residents in care.

(f) The following shall be stored inaccessible to residents with dementia:(1) Knives, matches, firearms, tools and other items that could constitute a danger to the resident(s). This requirement is not met as evidenced by: Based on interviews conducted, resident was in possession of several lighters. This poses an immediate safety risk to residents in care.

87411 Personnel Requirements - General:(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 records reviewed, Licensee did not ensure staff were in numbers sufficient to meet the needs of residents. This poses an immediate Health, Safety or Personal rights risk to residents in care.

87705 Care of Persons with Dementia:(f) The following shall be stored inaccessible to residents with dementia:(2)...and toxic substances such as...cleaning supplies and disinfectants. This requirement is not met as evidenced by:Based on observation, Licensing did not ensure toxic substances were secure and not accessible to residents in care. This poses an immediate Health and Safety risk to residents in care.

87465 Incidental Medical and Dental Care:(a)(4)The licensee shall assist residents with self-administered medications as needed. This requirement is not met as evidenced by: Based on records reviewed, License did not ensure resident received their physician ordered medication when needed for 3 consecutive days. This poses an immediate Health risk to residents in care.

87303 Maintenance and Operation:(a)The facility shall be clean, safe, sanitary and in good repair at all times. This requirement is not met as evidenced by: Based on observation, Licensee did not ensure the facility carpets were clean and ceiling was not in good repair. These areas are not related to earthquake damage. This poses a potential Health, Safety or Personal Rights risk to residents in care.

87463 Reappraisals:(a)The pre-admission appraisal shall be updated, in writing as frequently as necessary to note significant changes and to keep the appraisal accurate. This requirement is not met as evidenced by: Based on record review, Licensee did not update resident appraisal after several assaults on other residents. This poses an immediate Health and Safety risk to residents.

(a) Each facility shall have and maintain a current, written definitive plan of operation. This requirement is not met as evidenced by: Based on record review, Licensee did not ensure the facility phone is answered after hours as the resident handbook states. This poses a potential risk to residents in care.

87463 Reappraisals:(a)The pre-admission appraisal shall be updated, in writing as frequently as necessary to note significant changes and to keep the appraisal accurate. This requirement is not met as evidenced by: Based on record review, Licensee did not update resident appraisal after several injury falls. This poses a potential Health and Safety risk to residents.

87405 Administrator - Qualifications and Duties: All facilities shall have a qualified and currently certified administrator...and shall be on the premises a sufficient number of hours to permit adequate attention to the management and administration of the facility. This requirement is not met as evidenced by: Based on interviews conducted, the Administrator is not present at the facility a sufficent number of hours.

87465 Incidental Medical and Dental Care: (4) The licensee shall assist residents with self-administered medications as needed. This requirement is not met as evidenced by: Based on reported incident and record review, faclity staff gave resident wrong medications. This poses a potential risk to residents in care.