Hacienda Grande Senior Assisted Living

Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above as staff #2-4 do not have a completed and physician signed health screening 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 as during facility tour LPA gibbs observed bedroom #206 to be without a smoke detector which poses/posed a potential health, safety or personal rights risk to persons in care.

87468.1(a)(1)(3) Personal Rights of Residents in All Facilities (a) Residents in all residential care facilities for the elderly shall have all of the following personal rights:(1) To be accorded dignity in their personal relationships with staff, residents, and other persons. (3) To be free from punishment, humiliation, intimidation, abuse, or other actions of a punitive nature, such as withholding residents’ money or interfering with daily living functions such as eating, sleeping, or elimination. This requirement is not met as evidenced by: Based on a record review of the eviction notice dated 9/11/24. The licensee failed to ensure the residents’ personal rights due to the nature of and items in the eviction notice to the resident by making inappropriate statements. The licensee stated in the eviction notice that the resident knows how to ride the system, is a manipulator, and threatened to have R1 removed from a state funded program, which poses a potential personal rights risk to residents in care.

87468.1(a)(15) Personal Rights of Residents in All Facilities (a) Residents in all residential care facilities for the elderly shall have all of the following personal rights: (15) To send and receive unopened correspondence in a prompt manner. This requirement is not as evidenced by: Based on interviews, the licensee failed to ensure resident's personal rights due to staff opening their personal mail without prior consent.

87224(d)(1)(B)(C)(D) Eviction Procedures. (d) The licensee shall set forth in the notice to quit the reasons relied upon for the eviction... (1) The notice to quit shall include the following information: (B) Resources available to assist ...Referral services...(C) A statement informing residents of their right to file a complaint with the licensing agency…(D)…the residential care facility for the elderly must file an unlawful detainer action. This requirement is not met as evidenced by: Based on interviews and records reviewed, the licensee failed to serve resident (R1) with an eviction notice in accordance with tittle 22 regulations. This poses a potential personal rights risk to residents in care.

Based on observation, interview, record review, the licensee did not comply with the section cited above as there was no LIC 500 nor a document detailing facility staff titles nor listed work days and hours made available during LPAs visitwhich 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 as the downstairs library has a wall in disrepair and is dirty which poses/posed a potential health, safety or personal rights risk to persons in care.

Based on [(observation), (interview), and (record review)], the licensee did not comply with the section cited above as LIC 503 was observe without physicians signature which poses/posed a potential health, safety or personal rights risk to persons in care.

Incidental Medical and Dental CareIf the resident is unable to determine his/her own need for a prescription...The date and time of each contact with the physician, and the physician's directions, shall be documented and maintained in the resident's facility record. This requirement is not met as evident by based on interviews conducted and records review, the licensee failed to document contact with R1's physician when R1 refused medication(s). This poses a health and safety risk to residents in care.

Observation of the Resident...When changes such as unusual weight gains or losses or deterioration of mental ability or a physical health condition are observed, the licensee shall ensure that such changes are documented and brought to the attention of the resident's physicians and the resident's responsible person, if any. Based on interviews conductedand reocrds reviewed, R1 had a change in condition in physical and mental functioning, and R1 was refusing meds and the licensee failed to document shuch changes. This poses a health and safety risk to residents in care.

Each licensee shall furnish to the licensing agency...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 in (A) through (D) below... This requirement is not met as evidet by, based on records review the licensee did not submit incident reports dated 4/17/24, and 4/19/24 to licensing within 7 days of the occurence. This poses potential health and safety risk to residents in care.

87466 Observation of the Resident. Licensee failed to observe or conduct an assessment of Resident #1’s level of care during which time the resident was receiving home health care services while at the facility from 01/26/21 thru 02/25/21. On 02/22/21, Resident #1 was diagnosed with a “right hip pressure ulcer – Stage 4” – measured: 5x5.5 x 0.8 cm. On 02/24/21, HHA Registered Nurse recommended R1 be referred to a higher level of care; as the resident required total care. On 02/25/21, R1 was transferred to Long Beach Memorial Medical Center for wound debridement. This poses an immediate health, safety, personal rights risk to residents in care

87615(a)(1) Prohibited Health Conditions: Persons who require health services 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: Stage 3 and 4 pressure sores (dermal ulcers). The standard of evidence was not met: based on the evidence provided, R1 was diagnosed with unstageable and Stage 4 dermal ulcers on 02/22/21 and 02/24/21 and referred to a higher level of care due to requiring total care.This poses an immediate health, safety and personal rights risk to residents in care

Personal rights (a) Residents in all residential care facilities for the elderly shall have all of the following personal rights: (3) To be free from punishment, humiliation, intimidation, abuse, or other actions of a punitive nature, such as withholding residents’ money or interfering with daily living functions such as eating, sleeping, or elimination. Based On LPA interviews the standard of evidence was not met. Residents were left on floor for unspecified amount of time. These poses a potential health, safety, personal rights in care.

Maintenance and Operation (i)(1)(A)(1) All facilities licensed for 16 or more and all residential facilities having separate floors or buildings shall have a signal system which shall: (A)Operate from each resident's living unit. Based On LPA Observation the standard of evidence was not met. Call light was not consistency working. These poses a potential health, safety, personal rights in care.

Personal rights (a) Residents in allresidential care facilities for the elderly shallhave all of the following personal rights: (3)To be free from punishment, humiliation, intimidation, abuse, or other actions of a punitive nature, such aswithholding residents’ money or interfering with daily living functions such as eating, sleeping, or elimination. Based On LPA interviews the standard of evidence was not met. Residents were left on floor for unspecified amount oftime. These poses a potential health, safety,personal rights in care

87468(a)(6) Personal RIghts.Residents in all residential care facilities for the elderly shall have all of the following personal rights:(6) To leave or depart the facility at any time and to not be locked into any room, building, or on facility premises by day or night. This does not prohibit a licensee from establishing house rules, such as locking doors at night to protect residents, or barring windows against intruders, with permission from the Department Based On LPAS interviews this standard was not met and poses a potential health and safety and personal rights violations to resident in care.