Cobble Stone Residential Home Care Llc

Based on records reviewed, the licensee did not comply with the section cited above in that 1 location shelter is not outside the immediate area. Facility sketch does not have an assembly point identified. Facility is not completing quarterly drills. Last fire disaster drill was last completed on 08/27/24. This poses a potential health, safety or personal rights risk to persons in care.

Resident record must include minimum required items

Based on records reviewed, the licensee did not comply with the section cited above in that 2 of 2 resident records did not have the required documentation. 2 of 2 medical assessments reviewed were over 1 year old. 2 of 2 files reviewed did not have a pre-admission appraisal. 2 of 2 files reviewed did not have a reappraisal completed within the last year. 2 of 2 files reviewed did not have a functional capabilties. 2 of 2 files reviewed did not have safeguarding for property/valuables.This poses a potential health, safety or personal rights risk to persons in care.

Maintain required personnel records for staff

Based on records reviewed, the licensee did not comply with the section cited above in that 2 of 2 personnel records reviewed did not have the required documents. S1 was missing health screening, job application, employee rights. S2 was missing documentation of fingerprint clearance, health screening, TB testing and employee rights.This poses a potential health, safety or personal rights risk to persons in care.

Store disinfectants separately from food supplies

Based on observation, the licensee did not comply with the section cited above in that LPA observed chemicals in bathroom #2 under sink unlocked and accessible. Chemical in laundry room cabinet observed unlocked and accessible. Chemicals in garage cupboard observed unlocked and accessible. This poses a potential health, safety or personal rights risk to persons in care.

Use slip-resistant surfaces in bathing areas

Based on observation, the licensee did not comply with the section cited above no non-skid mat was observed in master bathroom, which poses/posed a potential health, safety or personal rights risk to 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 knives, chemicals, cleaning solutions were unlock accessible to residents in care this poses an immediate health, safety or personal rights risk to persons in care.

Give PRN medication by physician order

Based on records review and observation, staff did not administer R1’s medication Memantine Hcl 10mg, Quetiapine 25 mg, Donepezil Hcl 10mg, and Midodrine 5mg as directed by physician, which poses an immediate health and safety risk for the person in care.

Record dose details and resident medication response

Based on observations, records reviewed, and interviews conducted, S1 administered all the residents’ medication in the morning of 04/03/25 and did not sign in the residents’ MARs, which poses/ posed a potential health and safety risk for the person in care.

Food quality controls and rejected damaged goods

Based on observation, expired food was observed in the refrigerator which poses/posed an immediate health, safety or personal rights risk to persons in care.

Label and preserve medicine compliance standards

Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above Licensee crossed out the instructions from the pharmacist on the prescription 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 [(observation) (interview) (record review)], the licensee did not comply with the section cited above Licensee did not have a Hospice Care Plan for R1 which poses/posed a potential health, safety or personal rights risk to persons in care.

Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above Licensee did not have staff training for R1's Hospice Care with morphine and oygen which poses/posed a potential health, safety or personal rights risk to persons in care.

Maintain fire clearance before retaining specified persons

Based on [(observation) (interview), the licensee did not comply with the section cited above in Licensee turned a computer room into a caregiver bedroom which does not show on the facility sketch which poses an immediate health, safety or personal rights risk to persons in care.

Based on interview and record review, the licensee did not comply with the section cited above in not having listed training needed or trainings provided to staff for R1 and R2 or how the hospice plan will be implemented, which poses/posed a potential health, safety or personal rights risk to persons in care.

Complete admission suitability appraisal

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

Perform a pre-admission resident appraisal

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

Assist residents with self-administered medication

Based on interview and record review, the licensee did not comply with the section cited above in 1 out of 1 residents R1 did not receiveprescribed medication on 5/8/23, 05/09/23, 5/10/23 and 05/11/23 which poses an immediate health, safety or personal rights risk to persons in care.

Based on interview and record review, the licensee did not comply with the section cited above in staff not having triaining in postural supports, restricted conditions or health services, and hospice care, which poses/posed a potential health, safety or personal rights risk to persons in care.

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

Each terminal resident needs a written hospice care plan

Based on interview and record review, the licensee did not comply with the section cited above in 1 out of 2 Residents did not have a hospice care plan at the facility, which poses an immediate health, safety or personal rights risk to persons in care.