Ararat Board and Care

Based on interview and record review, the licensee did not comply with the section cited above in 1 staff did not have a health screening and TB test on file which poses/posed a potential health, safety or personal rights risk 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:This requirement was not met as evidenced by: Vagan Alikyan, son of the Licensee does not have a clear criminal record clearance as of ths visit. The Associate status reads "invalid"Civil Penalties in the amount of $500 were assessed.

Based on observation, the licensee did not comply with the section cited above in nonperishable foods including peanuts, ketchup and mac and cheese in food pantry area were expired dating 04/03/2024; 01/23/2024 and 01/25/2024 which poses/posed a potential health, safety or personal rights risk to persons in care.

Based on interview, the licensee did not comply with the section cited above per information provided during the interview that the Administrator did not know that a dedicated computer, tablet or any internet access device that can support real time interactive application, equipped with videoconferencing was to be provided for resident use and no one asked which poses/posed a potential health, safety or personal rights risk to persons in care.

Based on interview, the licensee did not comply with the section cited above per information provided during the interview that the facility does not have a plan in place that will allow residents to access the device for discussion of personal or confidential information with a reasonable level of personal privacy which poses/posed a potential health, safety or personal rights risk to persons in care.

Based on interview, the Licensee did not comply with the section cited above per information provided that the facility does not have a plan in place to ensure that the device is available to residents in a manner that permits shared access among the residentsi in the facility during reasonable hours, 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 per tour of all 3-1/2 bathrooms inspected, the private bathroom located inside Bedroom #4 did not have grab bars in the bath tub or in the shower stall which poses/posed a potential 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 per review of facility sketch and tour of the physical plant that there were 2 additional bathrooms added and without notification to the Department and without permits 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 per tour of the residents' bedrooms, residents beds had a mattress cover, fitted sheet and a comforter. Beds did not have a flat sheet, blanket/comforter. An extra fitted sheet and a flat sheet were stored in the bottom of the dresser drawers. The quantity does not allow for weekly changing or as needed which poses/posed a potential health, safety or personal rights risk to persons in care.

Based on record review and interview, the licensee did not comply with the section cited above per information obtained, Ashkhik Kebabjian, present at the facility for her first day of work today-9/25/23, was not cleared and associated to the facility prior to being present at the facility 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 since the Licensee could not provide a copy of the First Aid Manual to LPA for review, which poses/posed a potential health, safety or personal rights risk to persons in care.

Based on record review, the licensee did not comply with the section cited above per review or of Resident #6 file, it was observed that there is no PRN Authorization letter on file to establish that the physician has determined that Resident #6, who is diagnosed with Alzheimer, is able to to determine his/her need for the PRN Medication - Acetominophen, SM Stool Softener and Vitamin B-1 which poses/posed a potential health, safety or personal rights risk to persons in care.

Based on record reivew, the licensee did not comply with the section cited above per information reviewed revealed that the facility does not have any physician's orders on file for any of the centrally stored medications] which poses/posed a potential health, safety or personal rights risk to persons in care.

Based on observations, the licensee did not comply with the section cited above per tour of the facility, it was observed that the Licensee stored prescribed insulin, Lantus in the butter compartment of the refrigerator without securing the medication from other residents 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 per tour of the facility, LPA observed that the file cabinet used to store the medications were left unlock and in an unlocked office while staff were assisting other residents and while they were outside the facility 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 per review of medications for Resident #****, medications were prepared and stored in 2 pill boxes labeled Monday through Sunday 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 that there is no poster or information posted for contacting Community Care Licensing 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 per review of posted posters by kitchen, there was no posters advising the residents in care of Additional Personal Rights of Residents in Privately Operated Facilities 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 per inspection of the facility postings that there is no information posted regarding the right to create a family council which poses/posed a potential health, safety or personal rights risk to persons in care.

Based on record review, the licensee did not comply with the section cited above per review of resident records and Admission Agreement that there is no written information provided to the families regarding the right to form a family council which poses/posed a potential health, safety or personal rights risk to persons in care.

Based on record review, the licensee did not comply with the section cited above per request to review facility training logs and Licensee was not able to provide evidence of ongoing taff training which poses/posed a potential health, safety or personal rights risk to persons in care.

Based on record review and observation, the licensee did not comply with the section cited above per review of the Admission Agreement and postings, there is no information provided by the facility regarding the formation of a resident council provided in the Admission Agreement or posted in the facility 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 per review of posting, there is no Rights of Resident Council posted in a prominant place at the facility 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 per tour of the 4 resident bedrooms, Bedrooms #2 and Bedroom #3 do not have a chest of drawers that meet Title 22 requirements of 8 cubic feet for 2 of the residents, which poses/posed a potential health, safety or personal rights risk to persons in care.

Based on interview , the licensee did not comply with the section cited above per information received, the Licensee is administering insulin injections to Resident #5 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 per inspection of posters on the facility wall, there were no personal rights posted in the facility 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 per review of facility posting by the kitchen that the facility does not provide information on the appropriated reporting agency in case of a complaint, with contact information 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 per review of posting, that the facility does not have the required complaint poster meeting the above requirements posted in the main entry way of the facility, which poses/posed a potential health, safety or personal rights risk to persons in care.

Based on interview, the licensee did not comply with the section cited above as per information provided, the used needles for Resident #5 are tossed in the trash can 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 per tour of the physical plant, all fiive doors exiting to the outside were not equipped with auditory devices and the facility retains residents with dementia which poses/posed a potential health, safety or personal rights risk to persons in care.

Reporting Requirements:Failure to comply with Section 87211(d), or Section 87211(e), or both, may result in a civil penalty of one hundred dollars ($100) for each day of the failure to provide the required notification, not to exceed two thousand dollars ($2,000)1) If a resident is relocated without the specified notification, and the resident suffers transfer trauma as defined in Section 87101, or other harm to their health or safety, the Department may suspend or revoke the license or other specified actions pursuant to Health and Safety Code section 1569.686(c) Licensee did not notify Resident #1's Conservator of relocation

(a) Each licensee shall furnish to the licensing agency such reports as the Department may require, including, but not limited to, the following: A written report shall be submitted to the licensing agency and to the person responsible for the resident within seven days of the occurrence of any of the events specified (A) through (D) below. This report shall include the resident's name, age, sex and date of admission; date and nature of event; attending physician's name, findings, and treatment, if any; and disposition of the case. Licensee did not report Resident #1's hospitalization on 5/202/3

Resident Record- Each resident’s record shall contain at least the following information:(1) Resident's legal name and preferred name, as indicated by the resident.(2) Social Security number.(3) Gender identity and preferred pronoun, as indicated by the resident.(4) Dates of admission and discharge.(5) Last known address..(6) Birthdate.(7) Religious preference, if any, and name and address of clergyman or religious advisor, if any(8) Names, address, and telephone numbers of the resident’s representative, as defined in Section 87101(r), to be notified in case of accident, death, or other emergency.(9) Name, address and telephone number of physician and dentist to be called in an emergency.(10) Reports of the medical assessment specified in Section 87458, Medical Assessment, and of any special problems or precautions.(11) The documentation required by Section 87611 for residents with an allowable health condition.(12) Ambulatory status.(13) Continuing record of any illness, injury, or medical or dental care, when it impacts the resident's ability to function or needed services.(14) Current centrally stored medications as specified in Section 87465, Incidental Medical and Dental Care Services.(15) The admission agreement and pre-admission appraisal, specified in Sections 87507, Admission Agreements and 87457, Pre-admission Appraisal.(16) Records of resident's cash resources as specified in Section 87217, Safeguards for Resident Cash, Personal Property, and Valuables.(17) Documents and information required by the following:(A) Section 87457, Pre-Admission Appraisal;(B) Section 87459, Functional Capabilities;(C) Section 87461, Mental Condition;(D) Section 87462, Social Factors;(E) Section 87463, Reappraisals; and(F) Section 87505, Documentation and Support.

a) The licensee shall complete an individual written admission agreement, as defined in Section 87101(a), with each resident or the resident's representative, if any. 1) The text of the admission agreement, including any attachments and modifications, shall be(A) Printed in black type of not less than 12- -point type size, on plain white paper. The print shall appear on one side of the paper only.(B) Written in clear, understandable, coherent, and unambiguous language, using words with common and everyday meanings, and shall be appropriately divided with each section appropriately titled.Resident #1 does not have an admission agreenmer

Based on observation, the licensee did not comply with the section cited above, as accessible chemicals were observed in the cabinet under the sink, 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 the exterior gate and latched gate were locked, which did not allow residents to egress the facility without a key, which poses an immediate safety and personal rights risk to persons in care.

Based on observation, the licensee did not comply with the section cited above, as staff were observed not wearing appropriate face coverings and did not ask COVID-19 screening questions upon the LPA's arrival, which poses a potential personal rights risk to persons in care.

Based on observation, the administrator did not comply with the section cited above, as the fire extinguishers did not display date of service, which poses an immediate safety and personal rights risk to persons in care.

Based on observation, the administrator did not comply with the section cited above as one resident (R1) out of six (6) residents does not have a facility file which poses potential health and safety risk to residents in care.