Skyhill Quality Living

Based on observation, the licensee did not comply with the section cited above in ensuring to lock a small scissor and a large sharp kinfe in a kitchen cabinet, 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 ensuring the walls/doors in the hallways were clean, which poses/posed a potential health, safety or personal rights risk to persons in care.

Based on observation, the licensee did not comply with the section cited above. LPA identified resident room #4 is missing a window screen. This violation 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. LPA identified (1) out of (6) residents is diagnosed with dementia and (4) residents are on hospice care. This violation which poses/posed a potential health, safety or personal rights risk to persons in care.

Based on observatin, the licensee did not comply with the section cited above. LPA identified (2) range burners and oven non operarable. LPA identified grease stains on kitchen wall and ceiling and over range exhaust fan. This violation which poses/posed a potential health, safety or personal rights risk to persons in care.

Based on observation, the licensee did not comply with the section cited above. LPA observed loose faucet in rear bathroom and a loose toilet flusher in front bathroom. This which poses/posed a potential health, safety or personal rights risk to persons in care.

87705(j) Care of Persons with Dementia. The licensee shall have an auditory device or other staff alert feature to monitor exits, if exiting presents a hazard to any resident.This requirement was not met as evident of: Facility retains dementia resident and alarms on exit doors were not working properly.

(e) Water supplies and plumbing fixtures shall be maintained as follows: (2) Faucets used by residents for personal care such as shaving and grooming shall deliver hot water. 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 (41 degrees C) and not more than 120 degree F (49 degrees C).This requirement is not met as evidenced by: Based on observation, the licensee did not comply with the section cited above by Bathroom 1 water temperature tested at 139.7 Degrees F at 10:38am. Shower by room #3 tested 146.7 at 10:55 am, kitchen sink tested at 145.3 at 10:21am Bathroom #2 tested at 144.9 at 10:30am which poses an immediate health, safety or personal rights risk to persons in care.

87217 Safeguards for Resident Cash, Personal Property, and Values: (b)... facility shall take appropriate measures to safeguard residents' cash resources,...which have been entrusted to the licensee.... The licensee shall give the residents receipts for all such articles or cash resources.This requirement is not met as evidence by: Based on documents reviewed licensee did not ensure to maintain record receipts for items purchase with P&I funds for R1,R2,R4 which poses a potential health, safety, personal rights risk to the persons in care.

87217 Safeguards for Residents, Personal Property,and Valuables: (e)Cash resources... which are handled by the licensee... shall not be commingled... used as the facility funds or petty cash, and shall be separate,...from any liability ... in the use of his own or the facility's funds and valuables...This requirement is not met as evidence by: Based on documents reviewed licensee did not ensure to maintain a separate account for residents' cash resources wihch poses a potential risk to the health, safety, or personal rights of the persons in care.

87506 Personal Records: (a) The licensee shall ensure that a separate, complete, and current record is maintained for each resident in the facility or in a central administrative location readily available to facility staff and to licensing agency staff.This requireement is not met as evidence by: Based on record review observations during the visit dated 9/1/21 in reference to complaint # 28-AS-20210824090807, residents' files were incomplete and/or missing required forms i.e. P & I ledgers, hospice care plans, original receipts of P & I expenditures, and authorized representative contact information. This poses a potential health, safety or personal rights risk to persons in care.

87207 False Claims: No licensee, officer or employee of a licensee shall make or disseminate any false or misleading statement regarding the facility or any of the services provided by the facility.This requirement is not met as evidence by: Based on documents reviewed licensee did not ensure to provide accurate information and records to teh LPAs and other agency representatives which poses a health, safety, or personal rights risk for the persons in care.

87215 Commingling of Money: Money and valuables of residents entrusted to the licensee of one community care facility licensed under a particular license number shall not be commingled with those of another residential care facility...This requirement is not met as evidence by: Based on documentation reviewed licensee did not maintain a separate checking account for facility from personal account which poses a potential health, safety, or personal rights risk to the persons in care.

87216 Bonding: (a) Each licensee,... entrusted to safeguard...cash resources, shall file or have on file with the licensing agency a copy of a bond issued by a surety company to the State of California as principal.This requirement is not met as evidence by: Based on document review the licensee did not ensure to obtain a proper surety bond prior to handling the resident's cash resources which poses a potential health, safety, or personal rights risk to the persons in care.

87217 Safeguard for Resident Cash, Personal Property, and Values (b) Every facility shall take...measures to safeguard residents' cash resources, ... have been entrusted to the licensee...The licensee shall give the residents receipts for all such articles or cash resources.This requirement is not met as evidence by: Based on documents reviewed licensee did not ensure to maintain record receipts for items purchase with P&I funds for R1,R2,R4 which poses a potential health, safety, personal rights risk to the persons in care.

87217 Safeguards for Resident Cash, Personal Property, and Valuables: (c)... facility shall account for any cash resources entrusted...(1) Cash resources include but are not limited to monetary gifts,...personal and incidental need allowances from funding sources such as SSI/SSP.This requirement is not met as evidence by: Based on documents reviewed licensee did not ensure to be accountable for resident's cash resources which poses a potential health, safety, or personal rights risk to residents in care.

Administrator - Qualifications and Duties.The administrator shall... If the licensee is also the administrator, all requirements...apply. (2) Knowledge of and ability to conform to... laws, rules and regulations. (3) Ability to maintain or supervise... financial and other records. (5) Good character and a continuing reputation of personal integrity.This requirement is not met as evidence by: Based on documents review licensee did not ensure to maintain accuracy of financial records which poses a potential health, safety, or personal rights risk to the persons in care.

Based on observation, the licensee did not comply with the section cited above in Bathroom #1 was missing skid matts, which poses/posed a potential health, safety or personal rights risk to persons in care.

Based on observation, interview, and record review, LPA observed upon arrival that S2 was not associated, 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 by Bathroom 1 water temperature tested at 123 Degrees F. which poses an immediate health, safety or personal rights risk to persons in care.

87303 Maintenance and Operation: (e) Water supplies and plumbing fixtures shall be maintained as follows: (2) Faucets used by residents for personal ...shall deliver hot water... maintained to ... a temperature of not less than 105 degree F (41 degree C) and not more than 120 degree F (49 degree C). This requirement is not met as evidence by: Based on observation administrator did not ensure water temperature is maintain within the required 105 to 120 degrees F; LPAs tested water temperature in B1 at 145 and B2 at 144.5 degrees F which poses an immediate Health, Safety, and Personal Rights risk to 4 out of 4 persons in care.

87307 Personal Accomodations and Services: (a) Living accommodations... shall...(3) Equipment and supplies necessary for personal care...(C) Clean linen, including blankets, bedspreads, top bed sheets, bottom bed sheets, pillow cases, mattress pads,...This requirement is not met as evidence by: Based on LPA observation administrator did not ensure R1 and R3 did not have all required bedding which poses a potential Health, Safety, or Personal rights risk for persons in care.

87307 Personal Accomodations(a) Living accommodations and grounds shall be...(3) Equipment and supplies necessary... (B) Bedroom furniture, which shall include, for each resident, a chair, night stand, a lamp, or lights sufficient for reading, and a chest of drawers.This requirement is not met as evidence by: Based on observation administrator did not ensure each resident in R4, R2, R1 have a night stand which poses a potential Health, Safety, or Personal rights to persons in care.

(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: (1) Obtain a California clearance or a criminal record exemption as required by the Department orThis requirement is not met as evidence by: Based on LPAs observation and records administrator did not ensure S2 does not have a criminal background clearance which poses an immediate Health, Safety, and Personal Rights risk to persons in care.*Civil penalties are being assessed in the amount of $ 500.00.*

(a) 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 is not met as evidence by: Based on LPAs observation administrator did not ensure R3's dresser and closet door are in good repair, and living room smoke detector is working properly which poses a potential Health, Safety, or Personal rights risk to persons in care.

Based on observation, the licensee did not comply with the section cited due to two mattress springs and head boards obstructing the outdoor passageway and not being discarded. This poses a potential safety risk to persons in care.

Based on observation and interview, the licensee did not comply with the section cited above in 1 out of 3 bathrooms. The toilet did not flush, the sink was draining slowly, and the shower was leaking water. This poses a potential health and safety risk to persons in care.

87507(e) Admissions Agreement: The licensee shall provide a copy of the signed and dated current admissions agreement...to the resident or the resident’s representative immediately upon signing the admission agreement. This requirement was not met as evidenced by... Based on interviews, the licensee did not ensure that R1's responsible party was provided a copy of the signed admissions agreement. This poses a potential personal rights risk to persons in care.

87465(a)(7) Incidental Medical and Dental Care: When requested by the prescribing physician or the Department, a record of dosages of medications which are centrally stored shall be maintained by the facility. This requirement was not met as evidenced by... Based on observation and record review, the licensee did not ensure that medications were given according to physician's orders at the prescribed date and time and accurately documented on MAR logs. This poses an immediate health risk for persons in care.

87705(f) Care of Persons with Dementia:The following shall be stored inaccessible to residents with dementia:(1) Knives, matches, firearms, tools and other items that could constitute a danger to the resident(s).(2) Over-the-counter medication, nutritional supplements or vitamins, alcohol, cigarettes, and toxic substances such as certain plants, gardening supplies, cleaning supplies and disinfectants. This requirement was not met as evidenced by: Based on observation, the licensee did not ensure that knives, scissors, cleaning solutions, and laundry detergent was stored inaccessible for 4 out of 4 residents. This poses an immediate safety risk for persons in care.