Ymz Assisted Living

Request a transfer of criminal record clearance

Criminal Record Clearance: 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: 3) Request a transfer of a criminal record clearance as specified in Section 87355(c) or This requiement was not met as evidenced by: Svetlana Petrosian, an employee of the licensee at North Care Residential, Inc was observed at the home as staff from the licensees other facilities are used as backup staff and was not associated to the home

Criminal Record Clearance: 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: 2) Obtain a California clearance or a criminal record exemption as required by the Department or...This requirement was not met as evidenced by: Shazada A. Zholdoshova, Staff does not have an employee file and no evidence of a criminal record clearance. Per staff, it is her first day covering for Staff #2. Civil penalties were assessed.

Call 9-1-1 for imminent health threats

Incidental Medical and Dental Care :The licensee shall immediately telephone 9-1-1 if an injury or other circumstance has resulted in an imminent threat to a resident’s health including, but not limited to, an apparent life-threatening medical crisis except as specified in Sections 87469(c)(2), (c)(3), or (c)(4). This requirement was not met as evidenced by: Resident #1 slipped and fell from their bed and sustained a humeral fracture to the left arm, bruising and swelling to the forearm and elbow on 2/16/25 and 911 was not called to assess the resident and transported to the hospital until 2/21/25, 5 days after the fall.

Notification to department after hospice care starts

Hospice Care Waiver: If the Department grants a hospice care waiver it shall stipulate terms and conditions of the waiver as necessary to ensure the well-being of terminally ill residents and of all other facility residents, which shall include, but not be limited to, the following requirements. The licensee shall notify the Department in writing within five working days of the initiation of hospice care services for any terminally ill resident in the facility or within five working days of admitting a resident already receiving hospice care services...... R1 through R4 are on hospice and was not reported

Give PRN medication by physician order

Incidental Medical and Dental care: .......(2) Once ordered by the physician the medication is given according to the physician's directions. Staff failed to dispense R1's Oxycodone at 12am and 4am as prescribed. This requirement was not met as evidenced by Staff dispensed R1's Oxycodone at 8am, 12pm,4pm, 8pm and failed to dispense R1's Oxycodone at 12am and 4am as prescribed

Document each PRN medication dose taken

Incidental Medical and Dental care: If the resident's physician has stated in writing that the resident is unable to determine his/her own need...A record of each dose is maintained in the resident's record. The record shall include the date and time the PRN medication was taken, the dosage taken, and the resident's response.This requirement was not met as evidenced by: Resident #1 was prescribed PRN Oxycodone while under the care of Elara Hospice and was dispensed by staff. However, the facility did not document the date, time, dose given and the response.

Ensure hazardous items are locked and not unattended

(a) Except as specified in subsection (b), the licensee shall ensure that ... knives, ... sharp objects, and other similar items which could pose a danger to residents are in locked storage and are not left unattended if outside the locked storage.This requirement is not met as evidenced by: Based on observation, the licensee did not comply with the section cited above in the drawer containing knives were accessible which poses an immediate 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. The facility did not have emergency water 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. The facility's Staff crushes 1 resident's medications without a physician's order which poses an immediate health, safety or personal rights risk to persons in care.

Ensure hazardous items are locked and not unattended

Based on observation and interview, the licensee did not comply with the section cited above in 1 restroom cabinet containing cleaning supplies was unlocked which poses an immediate 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 2 out of 2 pool gates were unsecured which poses an immediate health, safety or personal rights risk to persons in care.

Passageways and stairways kept clear

Based on observation and interview, the licensee did not comply with the section cited above in 1 bed frame was obstructing the passageway of the emergency side exit which poses an immediate health, safety or personal rights risk to persons in care.

Require physician order and label for PRN medication

Based on interview and record review, the licensee did not comply with the section cited above in 2 out of 2 residents receiving PRN Medications do not have a PRN Authorization Letter or PRN administration log which poses/posed a potential health, safety or personal rights risk to persons in care.

Facility maintenance and healthful environment

Based on observation, the licensee did not comply with the section cited above. The facility's side yard has exposed electrical wiring and a hole in the wooden ramp utilized by residents which poses an immediate health, safety or personal rights risk to persons in care.

Provide resident hot water for personal care

Based on observation, the licensee did not comply with the section cited above in the resident's restroom sink delivered water at 149 degrees F which poses an immediate health, safety or personal rights risk to persons in care.

Limit operations to licensed capacity

Based on interview, the licensee did not comply with the section cited above in 1 Staff lives on the premises and sleeps on the living room futon which poses an immediate health, safety or personal rights risk to persons in care.

Maintain facility in clean, safe, sanitary condition

Based on observation and interview, the licensee did not comply with the section cited above in 1 kitchen drawer's face panel was falling off the screws and 1 fire door latch was jammed which poses/posed a potential health, safety or personal rights risk to persons in care.

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: A written report shall be submitted to the licensing agency and to the person responsible for the resident within 7 days of the occurrence of any of the events specified in (A) through (D) below. A) Death of any resident from any cause regardless of where the death occurred, including..... a hospital, en route to or from a hospital, or visiting away from the facility. Resident #1's death was not reported to the Department

Notification to department after hospice care starts

Hospice Care Waiver: If the Department grants a hospice care waiver it shall stipulate terms and conditions of the waiver as necessary to ensure the well-being of terminally ill residents and of all other facility residents, which shall include, but not be limited to, the following requirements. The licensee shall notify the Department in writing within five working days of the initiation of hospice care services for any terminally ill resident in the facility or within five working days of admitting a resident already receiving hospice care services...... R1, R4 & R5 are on hospice and was not reported

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: A written report shall be submitted to the licensing agency and to the person responsible for the resident within 7 days of the occurrence of any of the events specified in (A) through (D) below. Any incident which threatens the welfare, safety or health of any resident, such as psychological abuse of a resident by staff or other residents, or unexplained absence of any resident. R1's hospitalization wasn't reported

Postural Support: Based on the individual's preadmission appraisal, and subsequent changes to that appraisal.... Postural supports may be used under the following conditions.Under no circumstances shall postural supports include tying, depriving, or limiting the use. of a resident's hands or feet.Bed rails that extend the entire length of the bed are prohibited except for residents who are currently receiving hospice care and have a hospice care plan that specifies the need for full bed rails. R7's hospital bed was observed equipped with a full bed rail. (not on hospice)

Provide resident hot water for personal care

Based on observation, the licensee did not comply with the section cited above in 1 count out of 2 bathroom where the water temperature was tested, the water temperature tested in the private bathroom tested 121.4 degrees Fahrenheit which 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 as the blinds on the front window in bedroom #3 were broken which poses/posed a potential health, safety or personal rights risk to persons in care.

Ensure hazardous items are locked and not unattended

Based on observation, the licensee did not comply with the section cited above per observation of items stored in the cabinet of the private bathroom in bedroom #2 was a can of Lysol and cleaning solution and a can of lighter fluid was observed left on the barbecue grill located by the swimming pool which poses an immediate health, safety or personal rights risk to persons in care.

Maintain grab bars for toileting and bathing

Based on observation, the licensee did not comply with the section cited above as it was observed that the shower stall and toilet in the private bathroom did not have grab bars installed which poses/posed a potential health, safety or personal rights risk to persons in care.

Onsite food stock levels for nonperishables and perishables

Based on observation, the licensee did not comply with the section cited above, insufficient perishables such as vegetables and fruits were observed in the refrigerator. Per staff, Administrator is purchasing more food today - 7/21/23 which poses an immediate health, safety or personal rights risk to persons in care.

Protection from punishment and intimidation

Based on observation the licensee did not comply with the section cited above as food pantry and cabinets located in the kitchen, containing foods were observed locked with a padlock and child locks,] 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 in 1 out of 1 count which poses/posed a potential health, safety or personal rights risk to persons in care. which poses/posed a potential health, safety or personal rights risk to persons in care. The fire place located in the living room is covered by a glass screen but is not made inaccessible to the residents in care, Per Administrator, they don't use the fireplace.

Based on observation in 2 out of 3 rooms inspected, the 2 bedrooms located in the back by the common bathroom did not contain the appropriate number of dressers for the 4 residents' use, which poses/posed a potential 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 in 1 out of 13 rooms inspected, the blinds in the bedroom located to the right of the common bathroom are broken and do not provide privacy to the residents assigned to the room, which poses/posed a potential health, safety or personal rights risk to persons in care.

Provide resident hot water for personal care

Based on observation the licensee did not comply with the section cited above in 1 out 2 tests conducted for the water temperature taken in the private bathroom read 152.5 degrees Fahrenheit and the water temperature in the common bathroom read 147.6 degrees Fahrenheit which poses an immediate health, safety or personal rights risk to persons in care.