Calligraphy Westwood Village

Request a transfer of criminal record clearance

Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above in not having (4) facility staff associated on Guardian before the day of annual inspection which poses an immediate health, safety or personal rights risk to persons in care.

87218 Theft and Loss(a) The licensee shall ensure an adequate theft and loss program as specified in Health and Safety Code Section 1569.153. (2) A licensee who fails to make reasonable efforts to safeguard resident property, shall reimburse a resident for or replace stolen or lost resident property at its current value. The licensee shall be presumed to have made reasonable efforts to safeguard resident property if there is clear and convincing evidence of efforts to meet each requirement specified in Section 1569.153.This requirement was not met as evidence by: Based on a review of records and interviews, the facility failed to create and give the LIC 621 form to (R#1) upon admission on 2023 and second time they move on 2024, also, the facility failed to train facility staff regarding the orientation to the policies and procedures for all employees within 90 days of employment.This poses a potential health and safety risk to all residents in care.

Request a transfer of criminal record clearance

Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above in not having 9 facility staff associated including the executive director which poses an immediate health, safety or personal rights risk to persons in care.

Health screening and fitness requirements

Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above in not having a TB test on file for (3) facility employees which poses/posed a potential health, safety or personal rights risk to persons in care.

Right to personal privacy in daily care

87468.2 Additional Personal Rights of Residents in Privately Operated Facilities (a) In addition to the rights listed in Section 87468.1, Personal Rights of Residents in All Facilities, residents in privately operated residential care facilities for the elderly shall have all of the following personal rights:(1) To have a reasonable level of personal privacy in accommodations, medical treatment, personal care and assistance, visits, communications, telephone conversations, use of the Internet, and meetings of resident and family groups.This requirement was not met as evidenced by: Based on records reviews, the licensee failed to accommodate the privacy level of the residents in care by having audio in the video camera system in place by the facility, this poses a potential health and sefety risk for the residents in care.

Facilities shall have signal systems which shall meet the following criteria: All facilities licensed for 16 or more... shall have a signal system which shall: operate from each resident's living unit. transmit a visual and/or auditory signal to a central staffed location or produce an auditory signal at the living unit loud enough to summon staff. Identify the specific resident living unit. Based on interviews and records review the facility transition from watermark retirement communities a to integral senior living the signal system was not operation with includes residents pendants, this poses a health and safety

Report serious outbreaks and major accidents

Occurrences, such as epidemic outbreaks, poisonings, catastrophes or major accidents which threaten the welfare, safety or health of residents, personnel or visitors, shall be reported within 24 hours either by telephone or facsimile to the licensing agency and to the local health officer when appropriate. This requirement was not met as evidence by: during an interview with the acting Administrator, it was revealed he did not report 6 positive covid-19 cases to licensing. This poses a potential health and safety risk to residents in care.

Maintain facility in clean, safe, sanitary condition

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 was not met as evidence by: observation of the patio being in disrepair due to the ground lifters caving inward.

Food quality controls and rejected damaged goods

Based on observation, interview, record review, the licensee did not comply with the section cited above. LPA and staff did observed the facility perishable and nonperishable food supply. Licensee and staff stated they did not have any expired or out dated food. LPA did observe expired and/or out dated food, which poses/posed a potential health, safety or personal rights risk to persons in care.

Hazardous areas restricted from residents

Based on observation, interview, record review, the licensee did not comply with the section cited above. LPA and staff when entering memory care on the 3rd floor noticed a machine blocking emergency exit door. LPA and staff did observe no lights in one fire escape/stairway, and water that obstructed the 14 floors of stairway. LPA observed exposed walls clearly visible with holes. No posted signs were observed of work being conducted in fire escape/stairway on ALL 14 floors. LPA detected 14 floors of exposed walls in the fire escape/stairway, which poses an immediate health, safety or personal rights risk to persons in care.

Passageways and stairways kept clear

Based on observation, interview, record review, the licensee did not comply with the section cited above. LPA and staff observed a watermark van non-operational, and parked in front of the gate entrance to parking garage, which poses/posed a potential health, safety or personal rights risk to persons in care.

Ensure hazardous items are locked and not unattended

Based on observation, interview, record review, the licensee did not comply with the section cited above. At 10:37AM LPA toured the facility with administrator S1 and S2 to include the kitchen area, LPA did observe knifes left on the counter box, and did find violations of Title 22 regulations regarding unlocked knifes which are meant to be kept in locked drawers. Additionally, LPA observed chemicals that were not stored or kept under lock drawers. LPA interviewed S2 about staff and chemicals and unlocked knifes, S2 stated he addressed the concern that very moment when observed and made corrections, which poses/posed a potential health, safety or personal rights risk to persons in care.

Based on observation, interview, record review, the licensee did not comply with the section cited above. LPA did not observe educational verification for a number of staff, which poses/posed a potential health, safety or personal rights risk to persons in care.

Maintain records of centrally stored medication dosages

Based on observation, interview, record review, the licensee did not comply with the section cited above. LPA observed that follwoing R01 centrally stored medication log stated R01 should take a specific medication on a specific date, however, centrally stored medication did not correspond to specific dates observed on 03/28/23, which poses/posed a potential health, safety or personal rights risk to persons in care.

Based on observation, interview, record review, the licensee did not comply with the section cited above. LPA observed no CPR training for staff, which poses/posed a potential health, safety or personal rights risk to persons in care.

Care of Persons with Dementia. There is an adequate number of direct care staff to support each resident’s physical, social, emotional, safety and health care needs as identified in his/her current appraisal. This requirement was not met as evidence by: Based on interviews and record review the facility failed to adhere to Title 22. Facility did not have sufficient staff to meet the needs of residents in memory care and assisted living. This poses a potential health and safety risk.

Basic services shall at a minimum include:Personal assistance and care as needed by the resident and as indicated in the pre-admission appraisal, with those activities of daily living such as dressing, eating, bathing and assistance with taking prescribed medications This requirement was not met as evidence by: Based on interviews and record review the facility failed to adhere to Title 22. Facility failed to ensure medication was dispense according to doctors’ orders. This poses a potential health and safety risk.

Facility personnel sufficiency and competence

Personnel Requirements - General. Facility personnel shall at all times be sufficient in numbers, and competent to provide the services necessary to meet resident needs. In facilities licensed for sixteen or more, sufficient support staff shall be employed to ensure provision of.... additional staff for the provision of adequate services. This requirement was not met as evidence by: Based on interviews and record review the facility failed to adhere to Title 22. Facility failed to ensure there were sufficient staff to meet the needs of residents and to respond to pendants. This poses a potential health and safety risk to resident in care.

Safe, healthful, comfortable accommodations

87468.1 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: (2) To be accorded safe, healthful and comfortable accommodations, furnishings and equipment. This requirement was not met as evidence by: Based on interviews and record review the facility failed to adhere to Title 22. Facility staff were not testing unvaccinated staff per PIN 21-32.1 ASC

87705 Care of Persons with Dementia. Licensees who accept and retain residents with dementia shall be responsible for ensuring the following:(2) The Emergency Disaster Plan, as required in Section 87212, addresses the safety of residents with dementia. This requirement was not met as evidence by: Based on interviews and record review the facility failed to adhere to Title 22. Facility did not train staff or capable community members on the Emergency Disaster Plan.