Horizon Assisted Living Facility

Based on [(observation)i the licensee did not comply with the section cited above due to Several window screens torn or missing, side gate not properly fixed-drags scrapes and/or scrapes across concrete, bolts exposed hangs, front and/or back yard overgown, patio area overgrowth tripping hazard, multiple wasp nest under the eaves of roof, walk path has growth of weeds/crabgrass which poses a potential health, safety or personal rights risk to persons in care.

Based on [(observation] Food on hand does not meet requirement to have both nonperishable (1 week) and perishable (2days) on the premises which poses a potential health, safety or personal rights risk to persons in care.

Prohibited Health Conditions (a) Persons who require health services for or have a health condition including, but not limited to, those specified below shall not be admitted or retained in a residential care facility for the elderly: (1) Stage 3 and 4 pressure injuries. This requirement was not met as evidenced by: Based on record reviews & interviews, R1 wounds not healing, developed unstageable wounds while in care which poses an immediate health and safety risk to residents in care.

87465(g) Incidental Medical and Dental Care. The licensee shall immediately telephone 9-1-1 if an injury or other circumstance has resulted in an imminent threat to a resident’s healthThis requirement was not met as evidenced by: Based on the investigation, the licensee did not comply with the section cited, as staff did not seek medical attention for R1 in a timely manner, which posed an immediate health and safety risk to R1

The licensee shall ensure that residents are regularly observed for changes in physical, mental, emotional and social functioning and that appropriate assistance is provided when such observation reveals unmet needs. This requirement was not met as evidenced by. Based on information obtained during the course of the investigation the licensee/ administrator did not comply with the cited section by not having knowledge of R1's various pressure injuries not being treated by hospice and ensuring proper medical care was obtained prior to hospitalization which posed an immediate health and safety, and personal rights risk to resident in care.

In addition to Section 87411(d), facility staff shall have knowledge and the ability to recognize and respond to problems and shall contact the physician, appropriately skilled professional, and/or vendor as necessary. This requirement was not being met as evidenced by: Based on Information obtained during the course of the investigation the facility staff did not comply with the cited section by not having knowledge and ability to properly document respond and obtain medical care of R1's various pressure injuries not being treated by the hospice agency which posed an immediate health and safety, and personal rights risk to resident in care.

FIRE CLEARANCE. All facilities shall maintain a fire clearance. Prior to accepting persons over 60 years of age none ambulatory and/or bedridden the licensee shall notify the licensing agency and obtain an appropriate fire clearance.This requirement is not met as evidenced by: This requirement is not met as evidenced by: Based on observation, the licensee did not comply with the section cited by retaining bedridden resident in room with non ambulatory fire clearance (R1)which poses an immediate health, safety and personal rights risk to R1.

The following initial and continuing requirements shall be met for the licensee to lock exterior doors or perimeter fence gates:(2) The licensee shall ensure that the fire clearance includes approval of locked exterior doors or locked perimeter fence gates. This requirement is not being met as evidenced by Based on observation and interview the licensee did not comply with the section cited by locking the backyard exit doors/gates of the facility without the approval of the fire department which poses an immediate health and safety and personal rights violation to persons in care.

Criminal Record Clearance (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 . This requirement is not met as evidenced byBased on observation and interview the licensee/administrator did not comply with the section cited by allowing S2 to work at the facility prior to obtaining criminal record clearance which poses an immediate health and safety risk to residents in care.

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 was not met as evidenced by: Based on the information obtained by LPA during the visit the licensee/administrator and staff did not comply with he cited section by providing false/misleading statements to LPA regarding Staff/volunteer which posed an immediate personal rights violation to residents in care.

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 was not met as evidenced by: Based on IB investigation record review and interview, the licensee/administrator failed to provide proper care and supervision by not having knowledge of R1's various pressure injuries, which due to neglect were diagnosed as prohibited health conditions upon hospitalization posed an immediate health and safety and personal rights risk to R1

The licensee shall ensure that residents are regularly observed for changes in physical, mental, emotional and social functioning and that appropriate assistance is provided when such observation reveals unmet needs. the licensee shall ensure that such changes are documented and brought to the attention of the resident's physician and the resident's RP This requirement was not met as evidenced by: Based on IB investigation record review and interview, the licensee/administrator did not comply with the cited section by not having knowledge of R1’s pressure injuries prior to hospitalization which posed an immediate health and safety and personal rights risk to R1

the licensee shall be permitted to accept or retain a resident who has a healing wound under the following circumstances:(3)Residents with a stage 1or2 pressure injury must have the condition diagnosed by a physician/appropriately skilled professional. (A)The resident shall receive care for the pressure injury from a physician/appropriately skilled professional. This requirement was not met as evidenced by: Based on IB investigation record review & interview, the licensee/admin did not comply with the cited section by not having R1's pressure injuries diagnosed & treated by a physician/appropriately skilled prof. Which posed an immediate health and safety risk to R1

Postural support-Bed rails that extend the entire length of the bed are prohibited except for residents who are currently receiving hospice care and have a hospice care plan that specifies the need for full bed rails. This requirement was not met as evidenced by: Based on interviews conducted facility used two half bed rails on R1's bed when they were sleep when only a half bed rail was noted to be used by physician which created a full bed rail. This posed an immediate health and safety risk to residents in care.