Trudez Home Care

Termination of admission agreement upon death of resident; removal of resident’s... A refund of any fees paid in advance covering the time after the resident’s personal property has been removed... within 15 days after the personal property is removed.This requirement is not met as evidenced by: Based on record review & interview, licensee did not issue a refund within 15 days of R1's personal property being removed which posed a potential personal rights risk to residents in care.

Based on record review the licensee did not comply with the section cited above by not maintaining complete facility files for residents which poses a potential health, safety or personal rights risk to persons in care.

Based on observations mad, the licensee did not comply with the section cited above by utilizing full bedrails for R1 who is on hospice. However, licensee does not have hospice care plan which indicates the need for the rails which poses an immediate health, safety and personal rights risk to persons in care.

Based on observation and interview the licensee did not comply with the section cited above by not ensuring medications for S2 are kept inaccessible to resident which poses an immediate health, safety or personal rights risk to persons in care.

Reporting Requirements. (b) during the operation of the facility...(1) below, a report shall be made to the licensing agency within...seven days following the occurrence of such event... (D) Any injury to any client..This requirement was not met evidenced by: Based on the interviews and record review, the Administrator did not comply with the section cited above by not reporting an incident/death of two residents to Licensing agency, which poses a potential health and safety risk to clients in care.

87468.1 Personal Rights of Residents in all Facilities. (a) Residents in all residential care facilities for the elderly shall have all of the following personal rights: 2) To be accorded safe, healthful and comfortable...This requirement is not met as evidenced by: Based on observation, the licensee did not comply with the section cited above. The licensee failed to follow the infection control protocol on screening procedures. Staff was not familiar with screening procedures, which poses an immediate health, safety or personal rights risk to persons in care.

87632 Hospice Care Waiver(a) In order accept or retain terminally ill residents and permit them to receive care from a hospice agency... (1) Specification of the maximum number of terminally ill residents which the facility wants to have at any one time.This requirement is not met as evidenced by: Based on record review, the licensee did not comply with the section cited above. R1 was admitted on hospice as of 12/29/21. However, the facility did not have an approval for hospice, which poses an immediate health, safety risk to persons in care.

Licensee is required to have PRN authorization letter on file signed by a physician to determine whether or not the residents can communicate the need and/or symptoms clearly for the as needed (PRN) medication.This requirement is not met as evidenced by: Based on record review, the licensee did not comply with the section cited above by not obtaining PRN authorization letters for 5 out of 5 residents which poses a immediate health, safety or personal rights risk to persons in care

(3) 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 is not met as evidenced by: Based on record review, the licensee did not comply with the section cited above by not keeping PRN administration records when given to 3 out of 4 residents poses a potential health, safety or personal rights risk to persons in care.

The licensee shall ensure that residents are regularly observed for changes in physical, mental, emotional and social functioning and that appropriate assistance is provided when such observation reveals unmet needs. When changes such as unusual weight gains or losses or deterioration of mental ability or a physical health condition are observed, the licensee shall ensure that such changes are documented and brought to the attention of the resident's physician & the resident's RP if any. This requirement is not met as evidenced by: Based on interview with staff the licensee did not comply with the section cited by not notifying prior residents physician of a change in condition

Postural Supports. A written order from a physician indicating the need for postural support shall be maintained in the resident’s record. The licensing agency is authorized to require additional documentation if needed. This requirement is not met as evidenced by: Based on Records review, observations the licensee did not comply with the section cited by not obtaining an order for postural support for R2 which poses a potential health, safety or personal rights risk to persons in care.

Persons who require health services for or have a health condition including, but notlimited to, those specified below shall not be admitted or retained in a residential care facility for the elderly: (1) Stage 3, 4, unstageable pressure injuries. This Requirement was not met as evidenced by: Based on information obtained during the investigation, the licensee/ administrator/staff did not comply with the cited section by retaining R1 at the facility who developed a prohibited health condition due to improper wound care which posed an immediate health and safety and personal rights risk to R1

(a) Persons who require health services for or have a health condition including, but not limited to, those specified below shall not be admitted or retained in a residential care facility for the elderly: (5)Residents who depend on others to perform all activities of daily living for them as set forth in Section This requirement is not met as evidenced by: Based on interview and observation the licensee/administrator did not comply with the cited section by admitting 1 (R2) and retaining 2 (R1 and R2) residents who depend on staff to perform all activities of Daily living for them which poses and immediate health and safety risk to residents in care.

(B) 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.This requirement is not met as evidenced by: Based on observations the licensee did not comply with the section cited by utilizing full bed rails for 2 out of 5 residents (R1 and R4). Licensee does not have the hospice care plan to indicate the need for the full rails for R4 and R1 is currently not on hospice. which poses an immediate health, safety & personal rights risk to R1 and R4.

(c) Licensees who accept & retain residents with dementia shall be responsible for ensuring the following: (5) Each resident with dementia shall have an annual medical assessment, & a reappraisal done at least annually, both of which shall include a reassessment of the resident's dementia care needs. This requirement is not met as evidenced by: Based on LPA record review, the licensee did not comply with the section cited by not obtaining an complete Annual Medical assessment and not completing annual re-appraisals for 2 out of 5 residents diagnosed with dementia. This poses a potential health and safety risk to the residents in care.

87611 (c) In addition to section 87411(d), facility staff shall have knowledge and the ability to recognize and respond to problems and shall contact the physician, appropriately skilled professional, and/or vendor as necessary. This Requirement was not met as evidenced by: Based on information obtained during the investigation, the licensee/administrator/staff did not comply with the cited section by not having the knowledge and the ability to respond properly by contacting R1’s physician when R1 developed the pressure injury which posed an immediate health and safety and personal rights risk to R1

the licensee shall be permitted to accept or retain a resident who has a healing wound under the following circumstances:(3) Residents with a stage one or two pressure injury must have the condition diagnosed by a physician or an appropriately skilled professional. A)The resident shall receive care for the pressure injury from a physician or an appropriately skilled professional. This Requirement was not met as evidenced by: Based on information obtained during the investigation the licensee/administrator/staff did not comply with the cited section by not having R1’s pressure injury diagnosed and cared for by a physician or an appropriately skilled medical professional which posed an

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: (2) Request a transfer of a criminal record clearance as specified in Section 87355(c). This requirement is not met as evidenced by Based on interviews, and record review, the licensee & administrator did not comply with the section cited above by allowing S1 to work at the facility prior to associating S1 to the facility which poses an immediate health and safety risk to residents in care.

(6) The licensee shall be responsible for assuring that a record of centrally stored prescription medications for each resident is maintained for at least one year and includes: all the required information.This requirement is not met as evidenced by: based on record review the licensee/administrator did not comply with the section cited by not completing Centrally Stored Medication and Destruction record for 5 out of 5 residents which poses a potential health, safety and personal rights risk to persons in care.

Incidental Medical and Dental Care Services. The licensee shall assist residents with self administered medications as needed/prescribedThis requirement is not met as evidenced by Based on interview, record review and medication count, the licensee did not comply with the section cited by not assisting prior resident with self administration of medications as prescribed. which poses an immediate health, safety or personal rights risk to persons in care.

(D) Assistance with self-administration does not include forcing a resident to take medications, hiding or camouflaging medications in other substances without the resident's knowledge and consent, or otherwise infringing upon a resident's right to refuse to take a medication.This requirement is not met as evidenced by: Based on interview with staff, the licensee did not comply with the section cited above by crushing and camouflaging medications with food without a doctors order for 2 out of 5 residents which poses an immediate health, safety or personal rights risk to persons in care.

Licensee is required to have PRN authorization letter on file signed by a physician to determine whether or not the residents can communicate the need and/or symptoms clearly for the as needed (PRN) medication.This requirement is not met as evidenced by: Based on record review, the licensee did not comply with the section cited above by not obtaining PRN authorization letters for 4 out of 4 residents which poses a potential health, safety or personal rights risk to persons in care.

Postural Supports. A written order from a physician indicating the need for postural support shall be maintained in the resident’s record. The licensing agency is authorized to require additional documentation if needed. This requirement is not met as evidenced by: Based on Records reviewed, observations made the licensee did not comply with the section cited above by not obtaining an order for postural support for 2 out of 4 residents which poses a potential health, safety or personal rights risk to persons in care.

(B) 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.This requirement is not met as evidenced by: Based on observations made while touring the facility the licensee did not comply with the section cited above by placing two half rails as a full rails for R1 who is on hospice however licensee does not have hospice care plan which indicates the need for the rails. which poses an immediate health, safety & personal rights risk to R1.

(c) Licensees who accept & retain residents with dementia shall be responsible for ensuring the following: (5) Each resident with dementia shall have an annual medical assessment, & a reappraisal done at least annually, both of which shall include a reassessment of the resident's dementia care needs. This requirement is not met as evidenced by: Based on LPA record review, the licensee did not comply with the section cited by not obtaining an Annual Medical assessment and not completing annual re-appraisals for 3 out of 4 residents diagnosed with dementia. This poses a potential health and safety risk to the residents in care.

87202 (a) (2) FIRE CLEARANCE. All facilities shall maintain a fire clearance. Prior to accepting persons over 60 years of age none ambulatory and/or bedridden the licensee shall notify the licensing agency and obtain an appropriate fire clearance. This requirement is not met as evidenced by: Based on observations made and interview with staff the licensee did not comply with the cited section by retaining two bedridden resident without proper fire clearance which poses an immediate health, safety or personal rights risk to persons in care.

(D) Assistance with self-administration does not include forcing a resident to take medications, hiding or camouflaging medications in other substances without the resident's knowledge and consent, or otherwise infringing upon a resident's right to refuse to take a medication.This requirement is not met as evidenced by: Based on interview with staff, the licensee did not comply with the section cited above by crushing and camouflaging medications with food without a doctors order for 2 out of 4 residents which poses an immediate health, safety or personal rights risk to persons in care.

(3) 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 is not met as evidenced by: Based on record review, the licensee did not comply with the section cited above by not keeping PRN administration records when given to 3 out of 4 residents poses a potential health, safety or personal rights risk to persons in care.