Palace of Joy

Based on observation and interview, the licensee did not comply with the section cited above in one (1) out of three (3) alarms not functional and operational 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 by not having a shaded area in the backyard of the facility to residents in care 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. LPA observed medication unlocked and accessible to resident in care in bedroom #4, which poses an immediate health and safety risk to persons in care.

Based on (observation) (interview) (record review)], the licensee did not comply with the section cited above in not assuring that R2's prescribed medications were given as prescribed, which poses an immediate health, safety or personal rights risk to persons in care.

Based on LPA’s observation, licensee did not comply with the section cited above by blocking the exit door in bedroom #4 by putting resident's wheelchair. This poses a potential health and safety risk to residents in care.

Based on observation, the licensee did not comply with the section cited above, LPA measured the hot water in one of the bathrooms to be 131.5F, which poses/posed a potential health, safety or personal rights risk to persons in care.

87211(a)(1)A,B&D-Reporting Requirements: (a) Each licensee shall furnish to the licensing agency such reports... (1) A written report shall be submitted to the licensing agency and to the person... ... any of the events specified in (A), (B) & (D)...This requirement is not met as evidenced by: Based on interviews and record reviews, the licensee did not comply with the section cited above by not notifying CCLD regarding R1's and R2's incident reports which poses a potential health and safety risk to persons in care.

87411-Personnel Requirements General-(d)(3)Skill and knowledge required to provide necessary resident care and supervision, including the ability to communicate with residents.,.This requirement is not met as evidenced by: Based on LPA’s interview and observation, the administrator does not have staff available to communicate with residents to provide care which poses a potential risk to the residents in care.

General Food Service Requirements: The following food service requirements shall apply: 15) All persons engaged in food preparation and service shall observe personal hygiene and food services... ...which protect the food from contamination.This requirement is not met as evidence by Based on credible witness and LPA's observations the licensee did not comply with the section cited above by not properly securing the peanut butter jar and an ice cream tub which poses a potential health and safety risk to the persons in care.

87465 Incidental Medical & Dental Care (h) The following requirements shall apply to medications which are centrally stored: (2) Centrally stored medicines shall be kept in a safe & locked place…This requirement is not met as evidenced by: Based on the credible witness and LPA's observation, the licensee did not comply with the section cited above in by leaving medications unlocked and accessible to residents in care which poses/posed an immediate health, safety or personal rights risk to persons in care.

87309 Storage Space and Access: (a) Except as specified in subsection (b), the licensee shall ensure that disinfectants, cleaning solutions, poisonous substances, knives, matches, tools, sharp objects..... pose a danger to residents are in locked storage and are not left unattended if outside the locked storage.This requirement is not met as evidenced by: Based on the credible witness and LPA's observation, the licensee did not comply with the section cited above in by leaving a lighter, a knife, and cleaning solutions accessible to residents in care which poses/posed an immediate health, safety or personal rights risk to persons in care.

87555(b)(28) General Food Service Requirements All food shall be protected against contamination. Contaminated food shall be discarded immediately upon discovery.This requirement is not met as evidenced by: Based credible witness and LPA's observations the Licensee did not comply by having old/rotten perishable foods and expired milk in the refrigerator which poses a potential health and safety risk to the residents in care.

Based on record review, the licensee did not comply with the section cited above. Resident records were incomplete and or missing documents, 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. Upon LPA's request Licensee/Administrator was unable to provide complete staff records. This poses/posed a potential health, safety or personal rights risk to persons in care.

The facility shall be clean, safe, sanitary and in good repair at all times. Maintenance shall include provision of maintenance services and procedures for the safety and well-being of residents, employees and visitors.This requirement is not met as evidenced by: Based on LPA observation during physical plant tour, the licensee failed to ensure that the facility is in good repair which poses a potential health and safety risk to the residents in care.

Posting requirements: The license shall be posted in a prominent location in the licensed facility accessible to public view.This requirement was not met as evidenced by Based on observations made by LPA, during today's visit, the licensee did not comply with the section cited above. LPA did not observe license issued by the Department of Social Services being posted by the main entry door, which poses a potential health, safety risk to persons in care.

Additional Personal Rights of Residents in Privately Operated Facilities (a) residents in…shall have all of the following personal rights: ... The licensee shall post the telephone numbers and addresses for the local offices of the … OmbudsmanThis requirement was not met as evidenced by: Based on observations, interviews the licensee did not comply with the section cited above by not having the Obudsman poster posted from middle of March 2023 until April 10th, 2023, which posed apontiential health, safety, or Personal rights risk to persons in care.

87705 Care of Persons with Dementia. The following items shall be made inaccessible to residents with dementia: Over-the-counter medication, nutritional supplements or vitamins, alcohol, ...and disinfectants. This requirement is not met as evidenced by: Based on todays observation, two bottles of beer were found accessible in the facilitly refrigerator. This poses an immediate health risk to residents in care.

87507 Admissions Agreement (c) Admission agreements shall be signed and dated, acknowledging the contents of the document, by the resident or the resident’s representative if any and the licensee…no later than seven days following admissions. This requirement was not met as evidenced by: Based on LPA's interviews of the resident, resident's famly member and Administrator, the Admissions Agreement was not signed by the resident and a payment of $2,500.00 was received by facility staff when R1 moved into the facility.

87470 infection Control Requirements. (a) A licensee shall ensure that infection control practices are maintained..: (5) All staff... .. shall practice and maintain respiratory etiquette….to minimize exposure to potential illness. .. This requirement was not met as evidenced by: Upon entering the facility, LPA observed staff member was not wearing a mask which poses an immediate health and safety risk to residents in care.

87355 (e)(1) Criminal record Clearance All individuals subject to a criminal record review pursuant to Health & Safety Code Section 1569.17(b) shall prior to working... in a licensed facility: (1) obtain a California clearance or a criminal record excemption as required by the Dept..... This requirement is not met as evidenced by: LPA observed a caregiver assisting R1 in the living room. Caregiver working at the facility prior to obtaining criminal record clearance which poses an immediate health and safety risk to residents in care.

§1569.651 Preadmission fee (g) If the applicant decides not to enter the facility prior to the facility’s completion of a preadmission appraisal or if the facility fails to provide full written disclosure of the preadmission fee charges and refund conditions, the applicant shall be entitled to a refund of 100 percent of the preadmission fee. Based on interviews, the licensee did not comply with the section cited above in 1 out of 1 preadmission fees which poses a potential risk to the Heatlh, Safety, or Personal Rights of persons in care.

Based on observation and interview, the licensee did not comply with the section cited above in 1 out of 3 auditory alarms 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 1 out of 1 pool gate 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 6 cleaning solutions which poses an immediate health, safety or personal rights risk to persons in care.