Blue Skies Ranch

Based on [(observation) the licensee did not comply with the section cited above in [1] out of [4] resident rooms, LPA was informed that staff share the room with resident. This poses/posed a potential health, safety or personal rights risk to persons in care.

Basic Services-87464(d)A facility need not accept a particular resident for care. However, if a facility chooses to accept a particular resident for care, the facility shall be responsible for meeting the resident's needs as identified in the pre-admission appraisal specified in Section 87457, Pre-admission Appraisal and providing the other basic services specified below, either directly or through outside resources.This requirement was not met as evidenced by: Based on the LPA's observation, file review and interviews the administrator did not ensure one out of one file at the facility to have a preappriasal, resident appraisal and correct information on the physician's reportl which poses an Immediate Health, Safety or Personal Rights/risks to persons in care.

Facility personnel shall at all times be sufficient in numbers, and competent to provide the services necessary to meet resident needs. This requirement was not met as evidenced by: Based on interviews and direct witnesses facility does not have adequate staff to care for residents. This pose a potential health & safety risk to the residents in care.

(a) The services provided by the facility shall be conducted so as to continue and promote, to the extent possible, independence and self-direction for all persons accepted for care. Such persons shall be encouraged to participate as fully as their conditions permit in daily living activities both in the facility and in the community. This requirement was not met as evidenced by: Based on direct witnesses Staff left R1 in bed for an extended period of time. This pose a potential health & safety risk to the residents in care.

To have their visitors, including ombudspersons and advocacy representatives, permitted to visit privately during reasonable hours and without prior notice, provided that the rights of other residents are not infringed upon. This requirement was not met as evidenced by: Based on information obtained Staff did not allow resident visitors. This pose a potential health & safety risk to the residents in care.

§ 87468.1 - Personal Rights of Residents (8) To have their representatives regularly informed by the licensee of activities related to care or services, including ongoing evaluations, as appropriate to their needs. This requirement was not met as evidenced by: Administrator didn't notify R1's responsible party regarding the new medication perscribed and administred.This pose a potential health & safety risk to the residents in care.

87625 Managed Incontinence (b) (3) Ensuring that incontinent residents are kept clean and dry and that the facility remains free of odors from incontinence. This requirement was not met as evidenced by: Based on interviews and direct witnesses R1 was left in soiled for an extended period of time. This pose a potential health & safety risk to the residents in care.

General Food Services (5) Meals shall consist of an appropriate variety of foods and shall be planned with consideration for cultural and religious background and food habits of residents. This requirement was not met as evidenced by: Based on interviews and direct witnesses R1 was left without food or provided an alternative options. This requirement was not met as evidenced by:

Original or photographic reproduction of all client records shall be retained for at least three years following termination of service to the client. This requirement was not met as evidenced by: Based on interview, Administrator lost hospice records for R1. This pose a potential health & safety risk to the residents in care.

Based on record review, the licensee did not comply with the section cited above in two (02) out of two (02) employees which poses a potential health, safety or personal rights risk to persons in care.

Plan of Operation: Each facility shall have and maintain a current, written definitive plan of operation. The plan and related materials shall be on file in the facility and shall be submitted to the licensing agency with the license application. This requirement was not met as evidenced by: Review of the facility's medication policy indicates that the facility will maintain their LIC 622 Centrally Stored Medications up to date. Licensee failed to demonstrate their plan of operation pertaining to medications, which can pose a potential health & safety risk to the residents in care.

87465 Incidental Medical and Dental Care(h)The following requirements shall apply to medications which are centrally stored(2)Centrally stored medicines shall be kept in a safe and locked place that is not accessible to persons... This requirement is not met as evidenced by Based on observations the medication door room was unlocked and accessible to residents. The Licensee did not ensure that the medication room is locked and inaccessible to residents in care. This poses an immediate health and safetyhazard to residents in care.