Humble Haven Rcfe Ii

Based on LPA's observations of staff files, the licensee did not comply with the section cited above. The caregivers did not receive training when they began working at the facility which poses/posed a potential health, safety or personal rights risk to persons in care.

Based on LPA's observation, the licensee did not comply with the section cited above. The water temperature was 123 degrees F which poses/posed a potential health, safety or personal rights risk to persons in care.

Based on LPA's observation, the licensee did not comply with the section cited above in two out of four egress devices which poses/posed a potential health, safety or personal rights risk to persons in care.

Based on LPA's review of the resident's file, the licensee did not comply with the section cited above in one out of four resident files which poses/posed a potential health, safety or personal rights risk to persons in care.

Based on LPA's observations, the licensee did not comply with the section cited above. LPA observed a resident's medications were not locked and the staff medications were not locked which poses/posed a potential health, safety or personal rights risk to persons in care.

Based on LPA's review of staff records, the licensee did not comply with the section cited above. Three staff members have not completed a health screening which poses/posed a potential health, safety or personal rights risk to persons in care.

Based on LPA's review of the resident's file, the licensee did not comply with the section cited above in one out of four resident files which poses/posed a potential health, safety or personal rights risk to persons in care.

Based on LPA's observations of staff files, the licensee did not comply with the section cited above. The caregivers did not receive training when they began working at the facility which poses/posed a potential health, safety or personal rights risk to persons in care.

87507 Admissions Agreements (a) The licensee shall complete an individual written admission agreement… with each resident or the resident's representative, if any. This is evidenced by: The Licensee failed to obtain the Admissions Agreement for Resident two. This poses a personal rights violation to residents in care.

87309 Storage Space & Access (a) Except as specified in subsection (b), the licensee shall ensure…knives, matches…are in locked storage & are not left unattended if outside the locked storage. This is evidenced by: The staff failed to securely lock the knives and medications in a secure location. This poses an immediate health and safety risk to residents in care.

87458 Medical Assessment (a) Prior to person's acceptance as a resident, the licensee shall obtain documentation of a medical assessment... to be kept in the resident's record. This is evidenced by: The Licensee failed to obtain the Physician's Assessment (LIC 602) for Resident one, and resident 5. This poses an immediate health and safety risk to residents in care.

87761 Penalties (b) Notwithstanding Section 87761(a) above, an immediate penalty of $100 per cited violation per day….shall be assessed…requested a transfer of a criminal record clearance…This is evidenced by: The Licensee failed to ensure a staff member had been associated to the facility. This poses an immediate health and safety risk to residents in care.

87761 Penalties(b)…a immediate penalty of $100 …per day for a maximum of five (5) days shall be assessed if any individual required to be fingerprinted …has not obtained a California clearance or a criminal record exemption… This is evidenced by: The Licensee failed to ensure a staff member had obtained a California Clearance or a criminal record exemption. This poses an immediate health and safety risk to residents in care.

87705 Care of Persons with Dementia (j) The licensee shall have an auditory device…to monitor exits, if exiting presents a hazard to any resident. This requirement is not met as evidenced by: Due to LPA's observations, the Licensee failed to ensure the auditory devices were working at the front door and exit doors in Rooms 2 and 5

87202(a)(2) All facilities shall maintain a fire clearance approved by fire dept... Prior to accepting any of the following types of persons, licensee shall obtain an appropriate fire clearance approved by fire dept, (2) Bedridden persons. This requirement is not met as evidenced by The Licensee failed to follow Title 22 Regulations regarding approved fire clearance, by placing bedridden resident R1 to the room that had no bedridden fire clearance. This poses an immediate health and safety risk to residents in care.

87506 Resident Records (b) each resident’s record shall contain….(8) names, address, & telephone numbers of resident’s representative….. This is evidenced by: LPA Spaeth observed the five residents' files did not contain a completed LIC 605 I.D. & Emergency Information and LIC 613C Personal Rights documents

87632 Hospice Care Waiver (a) In order to accept or retain terminally ill residents & permit them to receive care from a hospice agency, the licensee shall have obtained a facility hospice waiver …(1) Specification of the maximum number of terminally ill resident which the facility wants to have…. This is evidenced by: The facility has an approved hospice waiver for three residents. However, LPA observed there are four out of five residents who are on hospice.

Based on LPA's observation the licensee did not comply with the section cited above. The two caregivers have not completed the required job training which poses a potential health, safety or personal rights risk to persons in care.

Based on LPA's observation the licensee did not comply with the section cited above. The two caregivers have not completed the required job training which poses a potential health, safety or personal rights risk to persons in care.

Based on the LPA's observations, the licensee did not comply with the section cited above. The two caregiers have not completed the CPR and first aid training which poses an immediate health, safety or personal rights risk to persons in care.

Based on LPA's observation, the licensee did not comply with the section cited above. The two caregivers have not completed the above-referenced training which poses a potential health, safety or personal rights risk to persons in care.

Based upon LPA's observation, the licensee did not comply with the section cited above. The two caregivers working at the facility verbally confirmed they had not completed CPR and first aid training which poses an immediate health, safety or personal rights risk to persons in care.

Based on LPA's observation, the licensee did not comply with the section cited above. The two caregivers have not completed the above-referenced training which poses a potential health, safety or personal rights risk to persons in care.

Based on LPA's observation, the licensee did not comply with the section cited above. The two caregivers have not completed the above-referenced training which poses a potential health, safety or personal rights risk to persons in care.

Based on LPA's observation, the licensee did not comply with the section cited above. The two caregivers have not completed the above-referenced training which poses a potential health, safety or personal rights risk to persons in care.

Based on LPA's observation, the licensee did not comply with the section cited above. The two caregivers have not completed the above-referenced training which poses a potential health, safety or personal rights risk to persons in care.

Based on LPA's observation during the tour of the facility, the licensee did not comply with the section cited above. The water temperature was tested in the resident's bathroom and was 126.6 degrees F which poses an immediate health, safety or personal rights risk to persons in care.

Based on the LPA's observation the licensee did not comply with the section cited above. The two caregivers have not completed the health screening including the chest x-ray or an intradermal test which poses an immediate health, safety or personal rights risk to persons in care.

87468.1 Personal Rights of Residents in All Facilities (2) To be accorded safe, healthful and comfortable accommodations, furnishings and equipment.This requirement is not met as evidenced by Based on interviews and record reviews, the licensee did not comply with the section. The faciltiy failed to accept (R1) upon discharge from hospital. This violation which poses a potential health, safety or personal rights risk to persons in care.

87224(b) The licensee may, upon obtaining prior written approval from the licensing agency, evict the resident upon three (3) days written notice to quit. The licensing agency may grant approval for the eviction upon a finding of good csafety... mental and/or physical health or safety of others in the facility.ause. Good cause exists if the resident is engaging in behavior which is a threat to the mental and/or physical health or This requirement is not met as evidenced by: Based on interviews and record reviews. The facility failed to properly inform CCLD of the 30-Day Notice of Eviction for (R1) and failed to provide evidence of notice submitted. The notice is not valid unless CCLD approves. This violation posed a potential health risk to residents in care.

87458 Medical Assessment (a) Prior to a person’s acceptance as a resident, the licensee shall obtain and keep on file documentation of a medical assessment, signed by a physician, made within the last year….This requirement is not met as evidenced by: Based on LPA's file review, the licensee did not comply with the section cited above in two out of four resident files which poses a potential health, safety or personal rights risk to persons in care.

87507 Admissions Agreements (b) Admissions agreements shall be signed and dated,…by the resident. This requirement is not met as evidenced by: Based on LPA's file review, the licensee did not comply with the section cited above in two out of four resident files.

Based on LPA Spaeth's record review, the licensee did not comply with the section cited above in five of the five residents' records which poses a potential health, safety or personal rights risk to persons in care.

Based on LPA's records review, the licensee did not comply with the section cited above in two out of four resident files which poses/poses a potential health, safety or personal rights risk to persons in care.

Based on LPA Spaeth's file review, the licensee did not comply with the section cited above in three of five residents' files which poses a potential health, safety or personal rights risk to persons in care.

Based on LPA's record review, the licensee did not comply with the section cited above in two out of four residents' records which poses/posed a potential health, safety or personal rights risk to persons in care.

Based on LPA's resident records review, the licensee did not comply with the section cited above in five of the five residents' files which poses a potential health, safety or personal rights risk to persons in care.

Based on LPA's file review, the licensee did not comply with the section cited above in two out of four staff files which 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 in in that three (3) bottles of chemicals and disposable needles were accessible under the kitchen sink that did not have a proper lock, 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 which team observed cleaning chemicals to be accesible to residents located in both the resident restroom and garage which poses an immediate health, safety or personal rights risk to persons in care.