Belmont Village Calabasas

Personal Rights of Residents in All Facilities To be accorded safe, healthful and comfortable accommodations, furnishings and equipment.This requirement is not met as evidenced by: Based on records review and interviews conducted, the licensee did not comply with the section cited above. R1 is to be on continous oxygen use. Staff did not ensure R1 was with oxygen when out the room from approximately 1/9/2025 to 1/17/2025.

(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.This requirement is not met as evidence by: Based on interviews conducted, the licensee did not comply with the section cited above. R1's portable oxygen charging cord was missing/lost.

87465(a)(4) Incidental Medical and Dental Care. (a) A plan for incidental medical and dental care shall be developed by each facility…(4) The licensee shall assist residents with self-administered medications as needed. This requirement is not met as evidenced by: Based on record review and observations, the licensee did not comply with the section cited above, as the facility staff did not properly assist with R1’s self-administered medications per physician’s order which poses an immediate health and safety risk to residents in care.

87468.2(a)(4)residents…shall have all of the following personal rights: To care, supervision, and services that meet their individual needs and are delivered by staff that are sufficient in numbers, qualifications, and competency to meet their needs. This requirement is not met as evidence by: Based on interviews, and records review, the licensee did not comply with the section cited above as Staff did not respond to residents calls for assistance in a timely manner due to staff lacking room’s keys to access residents, which poses a potential health and safety risk to residents in care.

Basic services shall at a minimum include: (a) Care and supervision as defined in Section 1569.2.This requirement is not met as evidenced by: Based on interviews and records review, the licensee did not comply with the section cited above. Due to a lack of supervision, R1 sustained multiple falls resulting in multiple injuries, which posed an immediate health and safety risk to residents in care.

(a) Each licensee shall furnish to the licensing agency...(B) Any serious injury as determined by the attending physician and occurring while the resident is under facility supervision.This requirement is not met as evidenced by: Based on records review, the licensee did not comply with the section cited above. Licensee did not submit incident reports for R1’s numerous unwitnessed falls which required hospital visits, which posed a potential health and safety risk to residents in care.

The licensee shall notify the Department in writing within five working days... name and date of admission to the facility and the name and address of the hospice.This requirement is not met as evidenced by: Based on records review, the licensee did not comply with the section cited above. Licensee did not submit hospice notification to CCL when R1 was placed on hospice 07/30/2023, which posed a potential health and safety risk to residents in care.

Incidental and Medical Care: ....Once ordered by the physician the medication is given according to the physician's directions.This requirement has not been met as evidenced by: Based on interviews and record review, the licensee did not comply with the section cited above as R1 did not receive their prescribed medications on 12/30/23,which poses an immediate health and safety risk to residents in care.

Any illness, injury, trauma, or change in the health care needs of the resident that results in a circumstance or condition specified in Sections 87455(c) or 87615, Prohibited Health Conditions. This requirement is not met as evidenced by: Based on record review, the licensee did not comply with the section cited above as R1 was observed to have sustained (8) falls and a reappraisal was only conducted (2) times. This poses / posed a potential health, safety and personal right rights risk to persons in care.

Based on observation, the licensee did not comply with the section cited above in water temperature was tested throughout the visit including resident unit restroom and common areas, and water measured between 107.4– 121.0 degrees Fahrenheit which poses an immediate health, safety or personal rights risk to persons in care.

Based on an observation and record review, the licensee did not comply with the section cited above, as the records, CSMDR were not updated or were missing for six (6) out of six (6)resident medications which poses a potential health and safety risk to persons in care.

87211(a)(2) Reporting Requirements. Occurrences, such as epidemic outbreaks, poisonings, catastrophes or major accidents which threaten the welfare, safety...shall be reported within 24 hours either by telephone or facsimile to the licensing agency and to the local health officer when appropriate. This requirement is not met as evidenced by:Based on interview, the licensee did not comply with the section cited above as the facility is not following reporting requirements to the local public health department, which poses an potential health, safety and personal rights risk to persons in care.

Basic Services. (f) Basic services shall at a minimum include: (1) Care and supervision as defined in Section 87101(c)(3) and Health and Safety Code section 1569.2(c).This requirement is not met as evidenced by: Based on interview and records review, the licensee did not comply with the section cited above, as the facility failed to ensure that R1 did not leave the facility unassisted per the physician report, which poses an immediate health and safety risk to residents in care.