Skyhill Quality Living #2

Based on observation, the licensee did not comply with the section cited above ensuring that laundry cleaners/chemicals are kept in locked cabinets, 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 ensuring that medications and supplements are kept in locked cabinets, which poses/posed a potential health, safety or personal rights risk to persons in care.

Licensee admitted residents that became bedridden resident #1(R1) . Facility does have approved bedridden clearacne for 2 residents but must be in room#1 fire clearance.is required before bedridden residents can reside in any other room other than room #1 This requirement is not met as evidenced by:R1 is bedridden and residing in room #4 which is not cleared for bedridden which poses a helath and safety issue 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 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 degree C) and not more than 120 degree F (49 degree C).This requirement is not met as evidenced by: Based on LPA's observation, LPA observed the bathroom #1 hot water temeperature was measured at 88.5 degrees Fin the tub. Siink in room #1 was 107.6. Bathroom 2 measured at 88.5, bathroom Room #4 measured at 87.2 and kitchen ,easured at 87.2 which poses a health and safty hazard to resident's in care.

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 evidenced by:This requirement is not met as evidenced by: LPA and Administtrator observed bathroom screen in disrepiar and window sill uncleaned and toleit uncleaned.

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 evidence by:: Staff provided medications to resident without keeping log which resulted in medications being short. Medication Sertraline medication 50MG had 36 pills uncounted for based on count. Medication Monteluska 10mg had 31 pills missing and unaccounted for. Tamsulin medication .4mg had 5 pills missing. Caregiver could not account for the missing pills which poses a health and safety issue to residents in care.

87465 Incidental Medical and Dental: (e) For every prescription and nonprescription PRN medication... there shall be a signed, dated written order from a physician,... maintained in the residents file, and a label on the medication....This requirement is not met as evidence by: None of R1 medications had doctor's orders and PRN physician letter was not on file for R1 PRN medications. Cream for skin rash was missing label and doctor's order which poses a health and safety issue to residents in care.

to medications which are centrally stored: (5) Each resident's medication shall be stored in its originally received container. No medications shall be transferred between containers.This requirement is not met as evidence by: Staff stated that he transfers the new refill medications to the old bottles to consolidate the medications which poses a health and safety issue to residents in care.

87465 Incidental Medical and Dental: (e) For every prescription and nonprescription PRN medication... there shall be a signed, dated written order from a physician,... maintained in the residents file, and a label on the medication....This requirement is not met as evidence None of R1 medications had doctor's orders and PRN physician letter was not on file for R1 PRN medications. Cream for skin rash was missiing label and doctor's order.

Resident Records. 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 requirement was not met evidenced 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, and R6's file was not observed. This poses a potential health, safety or personal rights risk to persons in care.

Administrator - Qualifications and Duties.The administrator shall have the qualifications specified in Sections 87405(d)(1) through (7). If the licensee is also the administrator, all requirements for an administrator shall apply. (2) Knowledge of and ability to conform to the applicable laws, rules and regulations. (3) Ability to maintain or supervise the maintenance of financial and other records. (5) Good character and a continuing reputation of personal integrity. This requirement was not evidenced by:Based on the Trust Audit report and record review the findings indicate Licensee failed to maintain financial records; and provided DHS and CCL inaccurate documentation and information.

Safeguards for Resident Cash, Personal Property, and Valuables. Cash resources and valuables of residents which are handled by the licensee for safekeeping shall not be commingled with or used as the facility funds or petty cash, and shall be separate, intact and free from any liability the licensee incurs in the use of his own or the facility's funds and valuables... This requirement was not met evidenced by: Based on Trust Audit report and record review Licensee is commingling facility funds with personal and incidental funds. Facility bank statements were obtained. This poses a potential health, safety or personal rights risk to persons in care.

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 evidenced by: Based on record review and interview conducted during the audit investigation the licensee did not comply with the cited section by providing inaccurate information and documentation to Department of Health Services and Community Care Licensing. This poses an immediate health, safety or personal rights risk to persons in care.

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 for the elderly of a different license number, regardless of joint ownership. This requirement was not evidenced by:Based record review and interview condcuted during the audit investigation the Licensee failed to maintain accurate financial records; and provided DHS and CCL inaccurate documentation and information.

Bonding. Each licensee, other than a county, who is entrusted to safeguard resident 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. The amount of the bond shall be in accordance with the following schedule: Total Safeguarded Per Month- Bond Required $750 or less= $1,000, $751 to $1,500= $2,000$1,501 to $2,500 =$3,000. This requirement was not evidenced by:Based on record review and interviews conducted Licensee acknowledged that a Surety Bond was not in place on 9/1/2022. The bond provided covers the corporation and does not cover each license. This poses a potential health, safety or personal rights risk to persons in care.

Safeguards for Resident Cash, Personal Property, and Valuables. Every facility shall account for any cash resources entrusted to the care or control of the licensee or facility staff. Cash resources include but are not limited to... personal and incidental need allowances from funding sources such as SSI/SSP. This requirement was not met evidenced by: Based on the Trust Audit report, record review, and interviews conducted the findings indicate Licensee did not distribute P & I funds to residents (R1 & R2), and did not keep proper records of funds entrusted to her. This poses a potential health, safety or personal rights risk to persons in care.

Safeguards for Resident Cash, Personal Property, and Valuables. (b) Every facility shall take appropriate measures to safeguard residents' cash resources, personal property and valuables which have been entrusted to the licensee or facility staff. The licensee shall give the residents receipts for all such articles or cash resources. This requirement was not met evidenced by:The Trust Audit findings revealed that Licensee failed to document expenditures of items purchased with P & I monies. Hand written amounts were submitted without original receipts. Receipts were prepared after the fact dated 8/11/21. This 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 above as disinfectants, cleaning solutions and laundry detergent were not locked, 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 as R1 medications has not been administered for aprox. 1 week, 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 as bathroom #1 and #2 toilet and tub was observed with not clean and in good repair. LPA also observed Mattress, box spring and trash located at the side of the house, which poses an potential health, safety or personal rights risk to persons in care.

Based on observation the licensee did not comply with the section cited above as bathroom and showers were not observed 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 as medications was observed unlocked, refill medication was in an unlocked drawer in the kitchen and PRN medication was observed in resident #1 bedside table, 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 as knives and chemical solutions were not in a locked storage, 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 3 out of 3 bathrooms which poses an immediate health, safety or personal rights risk to persons in care.

87307 (a)(3)(C) Personal Accommodations and Services. Equipment and supplies necessary for personal care and maintenance of adequate hygiene practice shall be readily available to each resident. Clean linen, including blankets, bedspreads, top bed sheets, bottom bed sheets, pillow cases, mattress pads, bath towels, hand towels and wash cloths. This requirement was not met by evidence of: Based on observation during the physical plant inspection none of the resident beds had mattress pads in the beds. Staff confirmed mattress pads are not placed on the bed mattresses. This poses a potential health and safety risk to residents in care.

87303(a) Maintenance and Operation. 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 by evidence of: Based on observation at 10:37 am and 11:59 AM cockroaches were observed in the kitchen area. Staff confirmed there are cockroaches in the home. This poses a potential health and safety issue to residents in care. In addition, discarded stove was observed in the front yard, the exterior sides of the home had discarded mattresses, bed rails, mattress springs, and trash was observed in the backyard.

87355(e)(1) Criminal Record Clearance. Prior to working, residing or volunteering in a licensed facility, all individuals subject to a criminal record review shall obtain a clearance or criminal record exemption.This requirement was not met by evidence of: Based on observation during the physical plant inspection of the garage "staff room". Staff (S1) was observed hiding in the restroom. Staff does not have Criminal Background clearance. This poses a potential health and safety threat to residents in care. Civil penalties are being assessed in the amount of $ 500.00.