The Gardens at Park Balboa

Personal Rights of Residents in All Facilities: Residents in all residential care facilities for the elderly shall have all of the following personal rights: To be free from punishment, humiliation, intimidation, abuse, or other actions of a punitive nature, such as withholding residents’ money or interfering with daily living functions such as eating, sleeping, or elimination. This requirement was not met as evidenced by- Resident #1 was shoved by their caregiver which caused the resident to sustain a cut over the left eye. Immediate civil penalties were assessed

Based on medication review and LPA observation, the licensee did not comply with the section cited above as three (3) out of four (4) PRN medication for R1 are being administered but is not being documented which poses/posed a potential health, safety or personal rights risk to persons in care.

Based on record review and LPA observation, the licensee did not comply with the section cited above as facility has an approved hospice waiver for four (4) residents but facility has five (5) residents on hospice which poses/posed a potential health, safety or personal rights risk to persons in care.

Based on medication review and LPA observation, the licensee did not comply with the section cited above as medication for Resident #2 (R2) medication ROSUVASTATIN 20 mg, was counted and was observed to have 4 more pills than needed. However there is no record of refusal documented which poses an immediate health, safety or personal rights risk to persons in care.

Additional Personal Rights of Residents in Privately Operated Facilities: In addition to the rights listed in Section 87468.1, Personal Rights of Residents in All Facilities, residents in privately operated residential care facilities for the elderly shall have all of the following personal rights: (19)To have prompt access to review all of their records and to purchase photocopies of their records. Photocopied records shall be provided within two (2) business days and at a cost that does not exceed the community standard for photocopies. Facility failed to provide timely access to Resident #1's files

Based on record review and observation, the licensee did not comply with the section cited above per request to verify the the names of the residents and the names of their physicians and dentist, address and contact information and the facility was not able to easily provvide the requested information which poses a potential health, safety or personal rights risk to persons in care.

Based on record review, the licensee did not comply with the section cited above per review of 10 staff files, there was no evidence of current first aid training maintained in staff files except for Grace Bulaclac. LPA was not able to establish if staff have taken current first aid training, which poses/posed a potential health, safety or personal rights risk to persons in care.

1569.269 Enumerated rights; severability (a)(10) Residents of residential care facilities for the elderly shall have all of the following rights: To be free from ... verbal, mental, physical, or sexual abuse.This requirement is not met as evidenced by: Based on interviews, the licensee did not comply with the section cited above as the resident was handled roughly by staff resulting in an injury which poses an immediate health, safety and personal rights risk to persons in care.

87303(a) Maintenance and Operation. The facility shall be clean, safe, sanitary and in good repair at all times.This requirement is not met as evidenced by: Based on interview and observation, the licensee did not comply with the section cited above, as R1's call button was inoperable on 11/3/2022 and 3 out of 14 rooms did not have a call button in the resident unit, which poses an immediate health and safety risk to residents in care.

87303(e)(2) Maintenance and Operation. Hot water temperature controls shall be maintained to automatically regulate the temperature of hot water used by residents to attain a temperature of not less than 105 degree F and not more than 120 degree F.This requirement is not met as evidenced by: Based on observation, the licensee did not comply with the section cited above, as water temperature measured above 120 degree F in four (4) out of fourteen (14) rooms, which poses an immediate health and safety risk to residents in care.

87211 Reporting Requirements: (a) Each licensee shall furnish to the licensing Agency.. the following: (1)A written report.. within seven days of the occurrence of..(A) Death of any resident.. regardless of where the death occurred..This requirement is not met as evidenced by: Based on record review and interview with the administrator, the licensee failed to comply with the section cited above as the facility failed to submit R1's Death Report as required, which poses a potential health and safety risk to residents in care.

87468.2(a)(4) Additional Personal Rights of Residents in Privately Operated Facilities (a)In addition.. residents in privately operated residential care facilities for the elderly shall have all of the following personal rights: (4)To care, supervision, and services..This requirement is not met as evidenced by: Based on record review, and interviews conducted, the licensee did not comply with the section cited above as the facility did not respond to R1’s calls for assistance in a timely manner, which poses an immediate health, safety, personal rights risk to persons 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 accommodations, furnishings and equipment.This requirement is not met as evidenced by: Based on record review, and interviews conducted, the licensee did not comply with the section cited above as the facility did not respond to two (2) of R1’s calls for assistance, which poses an immediate health, safety, personal rights risk to persons in care.

87411(a)Personnel Requirements: Facility personnel shall at all times be sufficient in numbers..to provide the services necessary to meet resident needs..facilities licensed for sixteen or more, sufficient support staff.. to ensure..personal assistance and care..This requirement is not met as evidenced by: Based on record review, and interviews conducted, the licensee did not comply with the section cited above as the facility did not respond to R1’s calls for assistance in a timely manner to meet R1’s needs, which poses an immediate health, safety, personal rights risk to persons in care.

Based on observation, the licensee did not comply with the section cited above, as the laundry room was observed not properly secured containing cleaning supplies and disinfectants accessible to residents, which poses an immediate health and safety risk to persons in care.

Based on observations, the licensee failed to ensure hot water temperature measured within 105 to 120 degrees F in resident rooms which poses an immediate health, and safety risk to residents in care.

Employees assisting residents with self-administration of medication; training requirements: Each residential care facility for the elderly licensed under this chapter shall ensure that each employee..assists residents with the self-administration of medications meets all of the following training requirements:This requirement was not met as evidenced by: Based on interviews and record review 1 out of four facility staff failed meet the requirements of set by the health and safety code for medication training which poses a potential risk to residents in care.