Hayworth Terrace

87458 Medical Assessment -(a) Prior to a person's acceptance as a resident, the licensee shall obtain documentation of a medical assessment... to be kept in the resident's record.(b)The licensee shall obtain an updated medical assessment when required by the Department.This requirement is not met as evidence by: Based on record review, the licensee did not ensure that (R1) had a current medical assessment, as required by Title 22. The resident’s Physician’s Report (LIC 602) was not obtained and maintained in the resident’s record. This failure poses a potential health and safety risk to residents in care,

Regular observation and documentation of resident changes

87466 – Observation of the Resident The licensee shall ensure that residents are regularly observed for changes in physical, mental, emotional and social functioning and that appropriate assistance...observation reveals unmet needs… brought to the attention of the resident's physician and the resident's responsible person, if any.This requirement is not met as evidence by Based on interviews and record reviews, the facility did not ensure that (R1) received timely medical attention after a fall, allowing more than 6 hours to pass before seeking emergency services. This poses an immediate health and safety risk to residents 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...This requirement is not met as evidence by Based on interviews and record reviews, the facility did not ensure that (R1) was free from neglect and received safe accommodations after a fall. As a result of this failure, the resident sustained multiple fractures and injuries. This violation poses an immediate health and safety risk to residents in care.

Keep bathing and hygiene facilities in operating condition

Based on observation], the licensee did not comply with the section cited above. LPA observed a non working toilet seat cover for room #22. This violaiton 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. LPA identified in 7 out of 10 rooms did not have operable or missing emergency call buttons. This violation which poses/posed a potential health, safety or personal rights risk to persons in care.

Store disinfectants separately from food supplies

Based on observation, the licensee did not comply with the section cited above. LPA identified room #17 #65 and #18 had disfectants, toxic chemicals and scissors accessible in their rooms. This violation which poses an immediate health, safety or personal rights risk to persons in care.

First aid training requirements

Based on observation and record review, the licensee did not comply with the section cited above. Staff #2, #3, and #5 did not have First Aid/CPR on file. This violation which poses/posed a potential health, safety or personal rights risk to persons in care.

Health screening and fitness requirements

Based on observation and record review, the licensee did not comply with the section cited above. LPA identified Staff #4 and Staff #6 did not have TB or Health Screening on file. This violation which poses/posed a potential health, safety or personal rights risk to persons in care.

Perform a pre-admission resident appraisal

Based on observation and record review, the licensee did not comply with the section cited above. LPA identified no Needs Service Plan Appraisal for Resident #1, #2, #3, #5. This violation which poses/posed a potential health, safety or personal rights risk to persons in care.

Store centrally held medications in locked secure place

Based on observation, the licensee did not comply with the section cited above. LPA identified room #18 and #65 had prescription medication stored in their rooms. Resident are not able handle medications or store meds. This violation which poses an immediate health, safety or personal rights risk to persons in care.

Provide resident hot water for personal care

Based on observation, the licensee did not comply with the section cited above for the water testing in 9 out of 10 rooms tested at between 95.0 - 97.0, which poses/posed a potential health, safety or personal rights risk to persons in care.

Certified administrator requirements and substitute coverage

87405 Administrator - Qualifications and Duties (a) All facilities shall have a qualified and currently certified administrator. The licensee and the administrator may be one and the same person. The administrator shall have sufficient freedom from other responsibilities and shall be on the premises a sufficient number of hours to permit adequate attention to the management and administration of the facility as specified in this section. When the administrator is not in the facility, there shall be coverage by a designated substitute who shall have qualifications adequate to be responsible and accountable for management and administration of the facility as specified in this section. The Department may require that the administrator devote additional hours in the facility to fulfill his/her responsibilities when the need for such additional hours is substantiated by written documentation. This requirement was not met as evidence by:Based on record review and interview the licensee fail to provide the require proof that the administrator qualifications by submission of required RCFE documentations. This violation poses a potential health and safety risk to all residents in care.

87465 Incidental Medical and Dental Care (e) For every prescription and nonprescription PRN medication for which the licensee provides assistance there shall be a signed, dated written order from a physician, on a prescription blank, maintained in the residents file... Both the physician's order and the label shall contain at least all of the following information. This requirement was not met as evidence by:Based on record review and interview the licensee fail to provide did not comply with Title 22 regulations. LPA identified that care staff were providing over-the-counter medications to Resident #1 (R1) without a physician's written authorization, prescription, or other documentation and the reason for administration.This violation poses a potential health and safety risk to all residents in care.

Regular observation and documentation of resident changes

87466 Observation of the Resident - The licensee shall ensure that residents are regularly observed for changes... and that appropriate assistance is provided... when such observation reveals unmet... When changes such as... 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 physician. This requirement is not met as evidenced by: Based on interviews, observation, and record reviews, the Licensee was aware of (R1's) the Licensee knew R1 had significant pain for a week but didn't seek medical attention, leading to hospitalization and surgery for fracture. This violation poses an immediate health and safety risk to residents in care.

Call 9-1-1 for imminent health threats

87465 Incidental Medical and Dental Care (g) The licensee shall immediately telephone 9-1-1 if an injury or other circumstance has resulted in an imminent threat to a resident’s health including, but not limited to, an apparent life-threatening medical crisis... This requirement is not met as evidenced by: Based on interviews, observation, and record reviews,(R1) experienced significant pain for a week, but there was inadequate communication about arranging Non-Emergency Medical Transportation (NEMT). This violation poses a potential health and safety risk to residents in care.

Certified administrator requirements and substitute coverage

87405 Administrator - Qualifications and Duties (a) All facilities shall have a qualified and currently certified administrator. The licensee and the administrator may be one and the same person. The administrator shall have sufficient freedom from other responsibilities and shall be on the premises a sufficient number of hours to permit adequate attention to the management and administration of the facility as specified in this section. When the administrator is not in the facility, there shall be coverage by a designated substitute who shall have qualifications adequate to be responsible and accountable for management and administration of the facility as specified in this section. The Department may require that the administrator devote additional hours in the facility to fulfill his/her responsibilities when the need for such additional hours is substantiated by written documentation. This requirement was not met as evidence by:Based on observation and interview the licensee fail to provide the require proof that the administrator on duty is meeting the qualifications of hours spent at the facility. This violation poses a potential health and safety risk to all residents in care.

87211 Reporting Requirements (a) Each licensee shall furnish to the licensing agency such reports...(1) A written report shall be submitted to the licensing agency...of the occurrence of any of the events... (D) Any incident which threatens the welfare, safety or health of any resident...,or unexplained absence of any resident. This requirement was not met as evidence by:Based on LPA's interviews conducted and record reviews, the Licensee failed to report incident (R1's) A/C system not working 09/01/25. This violation poses a potential health and safety risk to all residents in care.

Regular observation and documentation of resident changes

87466 Observation of the Resident The licensee shall ensure that residents are regularly observed for changes in physical, mental, emotional and social functioning and that appropriate assistance is provided when such observation reveals unmet needs. 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 physician and the resident's responsible person, if any. This requirement is not as evidenced by: Records reviewed revealed that R1 was seen on several occasions at Cedars-Sinai Medica Network for health-related issues. This poses a potential personal rights violation 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: (3) Request a transfer of a criminal record clearance as specified in Section 87355(c) orThis requirement is not met as evidenced by: This has not been met as evidenced by: Based on [(observation) (interview) (record review)], the facility has allowed one (1), uncleared, staff member to be employed at the facility.

Private visitor access without prior notice

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:(11) To have their visitors, including ombudspersons and advocacy representatives, permitted to visit privately during reasonable hours and without prior notice, provided that the rights of other residents are not infringed upon.This requirement is not as evidenced by: Based on interview, S1 admitted denying W1 entrance to facility. This poses a potential personal rights violation to persons in care.

Right to confidential records and approved disclosure

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:(2) To have their records and personal information remain confidential and to approve their release, except as authorized by law.This requirement is not as evidenced by: Based on interview, S1 divulged confidential information and did not agree to release R1. This poses a potential personal rights violation to persons in care.

Certified administrator requirements and substitute coverage

87405 Administrator - Qualifications and Duties (a) All facilities shall have a qualified and currently certified administrator. The licensee and the administrator may be one and the same person. The administrator shall have sufficient freedom from other responsibilities and shall be on the premises a sufficient number of hours to permit adequate attention to the management and administration of the facility as specified in this section. When the administrator is not in the facility, there shall be coverage by a designated substitute who shall have qualifications adequate to be responsible and accountable for management and administration of the facility as specified in this section. The Department may require that the administrator devote additional hours in the facility to fulfill his/her responsibilities when the need for such additional hours is substantiated by written documentation.This requirenment was not met by: Based on observation and interview the licensee fail to provide the require documents to the regional office to update administrator in the system. This poses a potential health and safety risk to all residents in care.

Facility must safeguard entrusted cash and valuables

87217 Safeguards for Resident Cash, Personal Property, and Valuables (b)Every facility shall take appropriate measures to safeguard residents' ..., personal property and valuables which have been entrusted to the licensee or facility staff. This requirement was not met as evidence.Based on interviews and record reviews, the licensee did not comply with the section. Interviews with R2-R5 indicated loss of property and facility did not have LIC 621 for R1. This violation which poses/posed a potential health, safety or personal rights risk to persons in care.

(a) A plan for incidental medical and dental care shall... encourage routine medical and dental care and provide for assistance in obtaining such care... (1) The licensee shall arrange, or assist in arranging, for medical and dental care appropriate to the conditions and needs of residents. This requirement is not met as evidence:Based on interviews and record reviews, the licensee did not comply with the section. (S1) admitted (R1) has been neglected with dental care and medical care needs were being provided routinely but failed to provide medical records as evidence that medical care are being met. This violation which poses/posed a potential health, safety or personal rights risk to persons in care.

Include hazardous health condition records

Based on [(observation) (record review)], the licensee did not comply with the section cited above in Based on records review LPA did not observe required training certificates for staff 1-5 in personnel files, LPA only observed training schedules which poses a health and safety concern for residents in care. which poses/posed a potential health, safety or personal rights risk to persons in care.

Notify agency before locking doors or gates

Based on [(observation) , the licensee did not comply with the section cited above in LPAs identified two perimeter gate doors the northeast and the southwest gates had locks. Northeast gate has an egress device which poses an immediate health, safety or personal rights risk to persons in care.

Based on [(observation) (record review)], the licensee did not comply with the section cited above in not having the the telecommunications Device form on file for the 5 resident records reviewed which poses/posed a potential health, safety or personal rights risk to persons in care.

Maintain required personnel records for staff

Based on [(observation) (record review)], the licensee did not comply with the section cited above in Based on records review LPA observed that the first aid trainings for staff 1-5 are expired which poses a health and safety concern for residents in care. which poses/posed a potential health, safety or personal rights risk to persons in care.

Requirement for building permit before construction

Based on [(observation) , the licensee did not comply with the section cited above in LPAs identified room #48 is altered into a suite combine with room #72. Room #5 was converted into a laudry room with notification from CCLD or obtain local building permit and inspections which poses/posed a potential health, safety or personal rights risk to persons in care.

Track resident cash safeguard records

Based on [(observation) (record review)], the licensee did not comply with the section cited above in not having SPV forms in file for the 5 resident records that were reviewed which poses/posed a potential health, safety or personal rights risk to persons in care.

Certified administrator requirements and substitute coverage

87405 Administrator - Qualifications and Duties(a) All facilities shall have a qualified and currently certified administrator. The licensee and the administrator may be one and the same person. The administrator shall have sufficient freedom from other responsibilities and shall be on the premises a sufficient number of hours to permit adequate attention to the management and administration of the facility as specified in this section. When the administrator is not in the facility, there shall be coverage by a designated substitute who shall have qualifications adequate to be responsible and accountable for management and administration of the facility as specified in this section. The Department may require that the administrator devote additional hours in the facility to fulfill his/her responsibilities when the need for such additional hours is substantiated by written documentation.This requirement was not met as evidenced by: Based on records review and interview, the licensee did not comply with the section cited above in which not having a qualified and certified administrator could pose a potential safety risk to persons in care.