Redwood Senior Living Bakersfield

Notify agency before locking doors or gates

87705 Care of Persons with Dementia(f) Licensees that lock exterior doors or perimeter fence gates shall meet the following initial and continuing requirements:(1) Licensees shall notify the licensing agency of their intention to lock exterior doors and/or perimeter fence gates. Based on observation, interviews, and record review, the licensee failed to report update to fire clearance indicating there was a knockbox added, this poses a potential Health, Safety, or Personal Rights risk to residents in care.

Fire approval and staff access to unlock systems

87705 Care of Persons with Dementia(f) Licensees that lock exterior doors or perimeter fence gates shall meet the following initial and continuing requirements:(2) The licensee shall ensure that the fire clearance includes approval of locked exterior doors or perimeter fence gates and that facility staff on all shifts have access to, and know how to use, equipment needed to unlock exterior doors or perimeter fence gates.This requirement is not met as evidenced by: Based on observation, interviews, and record review, the licensee failed to report changes to the fire clearance, which poses an immediate Health, Safety, or Personal Rights risk to residents in care.

Based on LPA observation of three residents in hospital beds with full rail and the subsequent review of those resident files, only 1 had a hospice approval for the use of a full rail. Licensee did not comply with the section cited above for 2 of 3 residents which poses an immediate 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 4 staff files reviewed by this LPA which poses a potential health, safety or personal rights risk to persons in care.

(c) All information and records obtained from or regarding residents shall be confidential.This requirement was not met evident by: Based on LPA observation of text messages on staff phones and staff interviews. Administrator and staff were using personal communication devices to communicate resident medical information using pictures and text, which is a potential personal rights risk to persons in care.

Maintain facility in clean, safe, sanitary condition

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 was not met as evidence by: Based on observation and interviews, the Licensee did not comply with section 87303 (a). LPA observed thick layer of unknown white powder along the walls in 4 resident rooms. This poses an immediate health, safety or personal rights risk to persons in care.

Give PRN medication by physician order

Based on observation, the licensee did not comply with the section cited above in 1 out of 1 when LPA reviewed the residents’ medication with MARS and centrally stored list and observed medication was not disturbed to the resident for 16 consecutive days which poses/posed a potential health, safety or personal rights risk to persons in care.

Facility personnel sufficiency and competence

87411(a) Personnel Requirements - General: Facility personnel shall at all times be sufficient in numbers, and competent to provide the services necessary to meet resident needs. In facilities licensed for sixteen or more, sufficient support staff shall be employed to ensure provision of personal assistance and care... The licensing agency may require any facility to provide additional staff whenever it determines through documentation that the needs of the particular residents, the extent of services provided, or the physical arrangements of the facility require such additional staff for the provision of adequate services.This requirement was not met as evidenced by: Based on interviews conducted and records reviewed, the facility failed to prevent R1 from engaging in non-consensual sexual relations with other residents.

80078 Responsibility for Providing Care and Supervision (a) The licensee shall provide care and supervision as necessary to meet the client's needs. This requirement was not met as evidenced by: Based on records review and interview, the licensee did not not ensure that Client 1(C1) was provided proper care and supervision, which poses a potential health, safety or personal rights risk to persons in care.

87459 Functional Capabilities(a) The facility shall assess the person's need for personal assistance and care by determining his/her ability to perform specified activities of daily living.This requirement is not met as evidenced by: During the course of the investigation, LPA reviewed records for R1. The Needs and Services Plan for R1 was incomplete.

Maintain facility in clean, safe, sanitary condition

87303 Maintenance and Operation, (a) The facility shall be clean, safe, sanitary and in good repair at all times...This requirement was not met evident by: Based on observation, the Licensee did not ensure the facility was free of urine odor which poses a potential health and safety risks to persons in care.

Licensee reports required by licensing agency

87211 Reporting Requirements (a) Each licensee shall furnish to the licensing agency such reports as the Department may require, including, but not limited to, the following:(1) A written report shall be submitted to the licensing agency and to the person responsible for the resident within seven days of the occurrence of any of the events specified in (A) through (D) below. This report shall include the resident's name, age, sex and date of admission; date and nature of event; attending physician's name, findings, and treatment, if any; and disposition of the case.This requirement was not met evident by: Based on observation of documentation licensee did not submit report within 7 days which poses a potential health and safety risks to persons in care.

Maintain facility in clean, safe, sanitary condition

87303 Maintenance and Operation, (a) The facility shall be clean, safe, sanitary and in good repair at all times...This requirement was not met evident by: Based on observation, the Licensee did not ensure the kitchen backsplash was clean and sanitary, which poses a potential health and safety risks to persons in care.

No admission for total dependence in daily living tasks

87615 Prohibited Health Conditions. (a) Persons who require health services...those specified below shall not be admitted or retained..., (5) Residents who depend on others to perform all activities of daily living...This requirement was not met evident by: Based on record reviews, the Licensee did not ensure an exception was obtained prior to accepting Resident 1 who had a prohibited health condition, which poses a potential health and safety risk to persons in care.

Protection from punishment and intimidation

87468.1 Personal Rights of Residents in All Facilities; (a) Residents...shall have all of the following personal rights:; (3) To be free from punishment, humiliation, intimidation, abuse, or other actions...This requirement was not met evident by: Based on interviews and record reviews, the Licensee did not ensure Resident 1 was free from being sexually assualted by another resident, which poses an immediate health and safety risk to person's in care.

Admission agreement signing and dating deadline

87507 Admission Agreements; (c) Admission agreements shall be signed and dated, ...by the resident or the resident’s representative,...no later than seven days following admission.This requirement was not met evident by: Based on interview and record reviews, the Licensee did not ensure an admission agreement was signed by Resident 1 or authorized representative, which poses a potential personal rights risk to persons in care.

87224 Eviction Procedures (a) The licensee may evict a resident for one or more of the reasons listed in Section 87224(a)(1) through (5). Thirty (30) days written notice to the resident is required except as otherwise specified in paragraph 5.This requirement was not evidenced by: Licensee issued a 30 Day Notice of Eviction to R1 on 8/31/21 that did not include the reason for eviction, Nonpayment of the rate for basic services within ten days of the due date.This poses a potential health and safety risk to persons in care.