Riverstone Terrace Senior Living

Submit and maintain current mailing address

87355(e)(1)Criminal Record Clearance (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: (1) Obtain a California clearance or a criminal record exemption as required by the Department.This requirement is not met as evidenced by: S1 is not fingerprinted clear and not associated with the facility, which poses an immediate risk to the health and safety of the residents.

HSC 1796.45 Affiliated home care aides hired on or after January 1, 2016, shall submit to an examination 90 days prior to employment, or within seven days after employment, to determine that the individual is free of active tuberculosis disease.This requirement is not met as evidenced by: Based on records review and interview conducted with Administrator, S1 do not have a TB result on file which poses a potential risk to the health and safety of the residents.

87303(e)(5)(A) Slip-resistant mats, strips, or flooring shall be used in all bathtub and shower floors.This requirement is not met as evidenced by: Based on observation, the licensee did not comply with the section cited above when LPA and A1 observed on 07/24/25, in room 102, room 202, and room 407 with no nonskid mat or nonskid strip in bathroom showers, this poses an immediate health, safety or personal rights risk to persons in care.

Ensure hazardous items are locked and not unattended

87309(a) Disinfectants, cleaning solutions, poisons, firearms and other items which could pose a danger if readily available to clients shall be stored where inaccessible to clients.This requirement is not met as evidenced by: Based on observation, the licensee did not comply with the section cited above when LPA and A1 observed on 07/24/25, a Hydrogen Peroxide bottle in R1’s bathroom counter, unlocked accessible to residents in care this poses an immediate health, safety or personal rights risk to persons in care.

First aid training requirements

87411 (c)(1) 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 (1) Staff providing care shall receive appropriate training in first aid from persons qualified by such agencies as the American Red Cross.This requirement is not met as evidenced by: Based on records reviewed and interview conducted with Administrator, S1 and S2 do not have First Aid, this poses an immediate health and safety risk for the residents in care.

87411(F) All personnel, including the licensee and administrator, shall be in good health, and physically and mentally capable of performing assigned tasks. Good physical health shall be verified by a health screening, including a chest x-ray or an intradermal test, performed by a physician not more than six (6) months prior to or seven (7) days after employment or licensure. A report shall be made of each screening, signed by the examining physician. The report shall indicate whether the person is physically qualified to perform the duties to be assigned, and whether he/she has any health condition that would create a hazard to him/herself, other staff members or residents. A signed statement shall be obtained from each volunteer affirming that he/she is in good health. Personnel with evidence of physical illness or emotional instability that poses a significant threat to the well-being of residents shall be relieved of their duties.This requirement is not met as evidenced by: Based on record review, the licensee did not comply with the section cited above when LPA reviewed staff files and observed no health screening were on file for S1 and S2, which poses a potential health or personal rights risk to persons in care.

Document required staff training and orientation

87412(c) Licensees shall maintain in the personnel records verification of required staff training and orientation.This requirement is not met as evidenced by: Based on records reviewed and interviews, administrator informed LPA that all staff have no trainings record on file, records reviewed staff do not the required trainings on file, which poses a potential health and safety risk for the person in care.

Ensure hazardous items are locked and not unattended

Based on observation, the licensee did not comply with the section cited above when LPA and A1 observed janitor cart with cleaning chemicals unlock set aside in hall between the receptionist desks and facility bathroom. LPA and A1 observed two tool sets with box cutter stored in room 106 unlock. LPA and A1 observed a knife and sharp from blinder stored in room 107’s kitchen unlocked accessible to residents in care this poses an immediate health, safety or personal rights risk to persons 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 A1 observed a medication on top of resident’s nightstand in room 107 unlocked accessible to residents in care this poses an immediate health, safety or personal rights risk to persons in care.

Maintain facility in clean, safe, sanitary condition

Based on observation, the licensee did not comply with the section cited above when LPA observed mold inside facility’s ice machine which poses a potential health, safety or personal rights risk to person in care.

Maintain facility in clean, safe, sanitary condition

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: Based on records reviewed, interview conducted and tour, the licensee did not comply with the section cited above. LPA and Assistant Executive Director observed lives and dead ants in residents’ room and records shown ants was inspected in residents' room which poses/posed a potential health, safety or personal rights risk to persons in care.

Comply with all admission agreement terms

87507 Admission Agreements(f) The licensee shall comply with all applicable terms and conditions set forth in the admission agreement, including all modifications and attachments. This requirement was not met as evidenced by LPAs observation of records review and interviews. facility should have issued the refund within 15 days of R1's removal of personal belongings from the facility.

The conditions under which a licensee may increase or change rates shall be specified in the admission agreement, pursuant to Health and Safety Code sections 1569.655 and 1569.657.This requirement was not met when facility raised R1’s monthly rate on 2/1/18 and 2/1/19 without obtaining the signature of R1 and/or R1’s responsible party. This is a potential risk to residents in care.

A statement acknowledging any additional items and/or services that the resident refused to purchase at the time the admission agreement was signed, which shall be signed and dated by the resident or the resident’s representative, if any, and attached to the admission agreement.This requirement was not met when facility charged R1 for tray service for a period of 8 months without any written acknowledgement. This is a potential risk to residents in care.

Personal rights of residents in all facilities

87468.1 Personal Rights of Residents in All Facilities(11) To have their visitors, including ombudspersons and advocacy representatives, permitted to visit privately during reasonable hours and without prior notice, provided that the rights of other residents are not infringed upon. This requirement was not met as evidenced by interviews conducted with reporting party and executive director, stating visitation hours are being restricted to hours not available to family members.

1569.269Enumerated rights; severability (21)To have prompt access to review all of their records and to purchase photocopies. Photocopied records shall be promptly provided, not to exceed two business days, at a cost not to exceed the community standard for photocopies.This requirement was not met as evidence by interview with ED stating the requested resident records were archived and awaiting to be sent by Pacifica’s corporate office. The time required to produce records was exceeded.