Glen Park at Long Beach

87465 Incidental Medical and Dental Care (a) A plan for incidental medical and dental care shall be developed by each facility.The plan shall encourage routine medical and dental care and provide for assistance in obtaining such care, by compliance with the following: (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 evidenced by Based on observation, records, and interviews, the facility failed to ensure that routine, time-sensitive medications for Resident R1 were administered at the prescribed times. This violation poses/posed a potential health and safety risk to persons in care.

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 by: Based on interviews & records review, the facility did not have any written refusals of showers for R1 on file nor could staff provide an exact date of the last time R1 received a shower and or bed bath.

87224 Eviction Procedures (d) The licensee shall set forth in the notice to quit the reasons relied upon for the eviction with specific facts to permit determination of the date, place, witnesses, and circumstances concerning those reasons.This requirement is not met as evidenced by: Based on interviews and records review the licensee did not comply with the section cited above in the 30-day notice issued by the licensee on 05/07/2025 did not state specific facts on why R1 was not an appropriate fit for the facility, which poses/posed a potential health, safety or personal rights risk to persons in care.

Personal Rights of Residents: (3) To be free from punishment, humiliation, intimidation, abuse, or actions of a punitive nature, such as withholding money or interfering with daily living functions. This requirement was not met as evidenced by: Based on interview & records review, facility Staff 1 (S1) sexually abused Resident 1 (R1) by kissing R1 on the neck & touching their own groin area in front of R1. This violation poses an immediate health, safety, and personal rights risk to persons in care.

87465 Incidental Medical and Dental Care (h) The following requirements shall apply to medications which are centrally stored: (2) Centrally stored medicines shall be kept in a safe and locked place that is not accessible to persons other than employees responsible for the supervision of centrally stored medications.This requirement was not met as evidence during record review, observation, and interviews, during medication audit staff were unable to locate 3 of R4’s PRN medications, 4 of R6’s medications, and 1 of R9’s medications.

Reporting Requirements(a)(1)Each licensee shall submit serious incident reports to. . . the Department may require, including the following: (1) A written report shall be submitted to the licensing agency & to the person responsible for the resident within 7 days of the occurrence of any of the events This requirement was not met as evidenced by: based observation, LPA observed that the facility did submit a LIC 624 to the department within 7 day of incident occurring.

Incidental Medical and Dental Care (h) The following requirements shall apply to medications which are centrally stored: (1) Medications shall be centrally stored under the following circumstances: (A) The preservation of medicines requires refrigeration, if the resident has no private refrigerator.This requirement is not met as evidenced by: Based on observation and record review the licensee did not comply with the section cited above in not preserving medication as required because the medication that required refrigeration was in a refrigerator that was too hot, the refrigerator was at 55 degrees Fahrenheit and insulin medication and other medications needed to be refrigerated at 36 to 46 degrees Fahrenheit, which poses/posed a potential health, safety or personal rights risk to persons in care.

Diabetes (a) The licensee shall be permitted to accept or retain a resident who has diabetes if the resident is able to perform his/her own glucose testing with blood or urine specimens, and is able to administer his/her own medication including medication administered orally or through injection, or has it administered by an appropriately skilled professional.This requirement is not met as evidenced by: Based on interviews and records reviewed, the licensee did not comply with the section cited above by not ensuring a skilled professional was administering insulin through injections to residents in care which poses/posed a potential health and safety risk to persons in care.

Diabetes (b) In addition to Section 87611, General Requirements for Allowable Health Conditions, the licensee shall be responsible for the following: (1) Assisting residents with self-administered medication as specified in Section 87465, Incidental Medical and Dental Care Services. (2) Ensuring that sufficient amounts of medicines, testing equipment, syringes, needles and other supplies are maintained and stored in the facility as specified in Section 87465(c). (3) Ensuring that syringes and needles are disposed of as specified in Section 87303(f)(2).This requirement is not met as evidenced by: Based on observation, interviews and records reviewed the licensee did not comply with the section cited above in not assisting residents with self-administering medications such as insulin injections and glucose testing with a glucometer, the facility did not ensure that sufficient amounts of testing equipment such as glucometers were in the facility, and the facility has improperly disposed of needles, which poses/posed a potential health, safety or personal rights risk to persons in care.

Incidental Medical and Dental Care (a) A plan for incidental medical and dental care shall be developed by each facility. The plan shall encourage routine medical and dental care and provide for assistance in obtaining such care, by compliance with the following: (1) The licensee shall arrange, or assist in arranging, for medical and dental care appropriate to the conditions and needs of residents. (2) The licensee shall provide assistance in meeting necessary medical and dental needs. This includes transportation which may be limited to the nearest available medical or dental facility which will meet the resident's need. In providing transportation the licensee shall do so directly or make arrangements for this service. (3) When residents require prosthetic devices, vision and hearing aids, the staff shall be familiar with the use of these devices, and shall assist such persons with their utilization as needed. (4) The licensee shall assist residents with self-administered medications as needed. (5) Facility staff, except those authorized by law, shall not administer injections, but staff designated by the licensee may assist persons with self-administration as needed. Assistance with self-administered medications shall be limited to the following: (A) Medications usually prescribed for self-administration which have been authorized by the person's physician. (B) Medications during an illness determined by a physician to be temporary and minor. (C) Assistance required because of tremor, failing eyesight and similar conditions. (D) Assistance with self-administration does not include forcing a resident to take medication, hiding or camouflaging medications in other substances without the resident's knowledge and consent, or otherwise infringing upon a resident's right to refuse to take a medication. (6) When requested by the prescribing physician or the Department, a record of dosages of medications which are centrally stored shall be maintained by the facility. (7) There shall be adequate privacy for first aid treatment of minor injuries and for examination by a physician if required. (8) If a facility has no medical unit on the grounds, a complete first aid kit shall be maintained and be readily available in a specific location in the facility. The kit shall be a general type approved by the American Red Cross, or shall contain at least the following: (A) A current edition of a first aid manual approved by the American Red Cross, the American Medical Association or a state or federal health agency. (B) Sterile first aid dressings. (C) Bandages or roller bandages. (D) Scissors. (E) Tweezers. (F) Thermometers. (9) The licensee shall ensure that infection control practices are maintained in the facility as specified in Section 87470, Infection Control Requirements. (b) If the resident's physician has stated in writing that the resident is able to determine and communicate his/her need for a prescription or nonprescription PRN medication, facility staff shall be permitted to assist the resident with self-administration of his/her PRN medication.(c) If the resident's physician has stated in writing that the resident is unable to determine his/her own need for nonprescription PRN medication but can communicate his/her symptoms clearly, facility staff designated by the licensee shall be permitted to assist the resident with self-administration, provided all of the following requirements are met: (1) There is written direction from a physician, on a prescription blank, specifying the name of the resident, the name of the medication, all of the information in Section 87465(e), instructions regarding a time or circumstance (if any) when it should be discontinued, and an indication when the physician should be contacted for a medication reevaluation. (2) Once ordered by the physician the medication is given according to the physician's directions. (3) A record of each dose is maintained in the resident's record. The record shall include the date and time the PRN medication was taken, the dosage taken, and the resident's response. (d) If the resident is unable to determine his/her own need for a prescription or nonprescription PRN medication, and is unable to communicate his/her symptoms clearly, facility staff designated by the licensee, shall be permitted to assist the resident with self-administration provided all of the following requirements are met:(1) Facility staff shall contact the resident's physician prior to each dose, describe the resident's symptoms, and receive direction to assist the resident in self-administration of that dose of medication. (2) 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. (3) The date and time the PRN medication was taken, the dosage taken, and the resident's response shall be documented and maintained in the resident's facility record. (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, and a label on the medication. Both the physician's order and the label shall contain at least all of the following information. (1) The specific symptoms which indicate the need for the use of the medication. (2) The exact dosage.(3) The minimum number of hours between doses. (4) The maximum number of doses allowed in each 24-hour period. (f) Emergency care requirements shall include the following: (1) The name, address, and telephone number of each resident's physician and dentist shall be readily available to that resident, the licensee, and facility staff. (2) The name, address and telephone number of each emergency agency to be called in the event of an emergency, including but not limited to the fire department, crisis center or paramedical unit or medical resource, shall be posted in a location visible to both staff and residents. (3) The name and telephone number of an ambulance service shall be readily available. (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 except as specified in Sections 87469(c)(2), (c)(3), or (c)(4). (h) The following requirements shall apply to medications which are centrally stored: (1) Medications shall be centrally stored under the following circumstances: (A) The preservation of medicines requires refrigeration, if the resident has no private refrigerator. (B) Any medication is determined by the physician to be hazardous if kept in the personal possession of the person for whom it was prescribed. (C) Because of potential dangers related to the medication itself, or due to physical arrangements in the facility and the condition or the habits of other persons in the facility, the medications are determined by either a physician, the administrator, or Department to be a safety hazard to others. (2) Centrally stored medicines shall be kept in a safe and locked place that is not accessible to persons other than employees responsible for the supervision of the centrally stored medication. (3) Each container shall carry all of the information specified in (6)(A) through (E) below plus expiration date and number of refills. (4) All centrally stored medications shall be labeled and maintained in compliance with state and federal laws. No persons other than the dispensing pharmacist shall alter a prescription label. (5) Each resident's medication shall be stored in its originally received container. No medications shall be transferred between containers. (6) The licensee shall be responsible for assuring that a record of centrally stored prescription medications for each resident is maintained for at least one year and includes: (A) The name of the resident for whom prescribed. (B) The name of the prescribing physician. (C) The drug name, strength and quantity. (D) The date filled. (E) The prescription number and the name of the issuing pharmacy (F) Instructions, if any, regarding control and custody of the medication.(i) Prescription medications which are not taken with the resident upon termination of services, not returned to the issuing pharmacy, nor retained in the facility as ordered by the resident’s physician and documented in the resident’s record nor disposed of according to the hospice’s established procedures or which are otherwise to be disposed of shall be destroyed in the facility by the facility administrator and one other adult who is not a resident. Both shall sign a record, to be retained for at least three years, which lists the following: (1) Name of the resident. (2) The prescription number and the name of the pharmacy. (3) The drug name, strength and quantity destroyed. (4) The date of destruction. (j) In all facilities licensed for sixteen (16) persons or more, one or more employees shall be designated as having primary responsibility for assuring that each resident receives needed first aid and needed emergency medical services and for assisting residents as needed with self-administration of medications. The names of the staff employees so responsible and the designated procedures shall be documented and made known to all residents and staff.This requirement is not met as evidenced by: Based on interviews, observation, and records reviewed, the licensee did not comply with the section cited above, the facility did not ensure that residents received their required medical care, in not having a skilled professionals provide injections and blood sugar checks for residents in care, thus, residents missed said medical care and medication, furthermore, insulin medication/medication that had to be kept refrigerated was in refrigerator that was too hot; moreover, needles were improperly discarded, which poses/posed a potential health, safety or personal rights risk to persons in care.

General Food Service Requirements (b) The following food service requirements shall apply: (8) All food shall be of good quality. Commercial foods shall be approved by appropriate federal, state and local authorities. Food in damaged containers shall not be accepted, used or retained. (9) Procedures which protect the safety, acceptability and nutritive values of food shall be observed in food storage, preparation and service. (28) All food shall be protected against contamination. Contaminated food shall be discarded immediately upon discovery.This requirement is not met as evidenced by: Based on observation the licensee did not comply with the section cited above in not having all food of good quality, not having all food in storage, and not protecting food from contamination, which poses/posed a potential health, safety or personal rights risk to persons in care.

87211 Reporting Requirements (a) Each licensee shall furnish to the licensing agency such reports as the Department may require, including, but not limited to, the following:(1) 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 report shall include the resident's name, age, sex and date of admission; date and nature of event; attending physician's name, findings, and treatment, if any; and disposition of the case. (D) Any incident which threatens the welfare, safety or health of any resident, such as psychological abuse of a resident by staff or other residents, or unexplained absence of any resident.This requirement is not met as evidenced by: Based on interviews and records review the licensee did not comply with the section cited above in not submitting Unusual Incident Reports to the facility regarding having Sherriffs coming out to the facility and providing R1 with a L.A. Superior Court, Long Beach, Eviction Restoration Notice dated 10/06/2025.

87224 Eviction Procedures (a) The licensee may evict a resident for one or more of the reasons listed in Section 87224(a)(1) through (5). Thirty (30) days written notice to the resident is required.(1) Nonpayment of the rate for basic services within ten days of the due date ...(3) Failure of the resident to comply with general policies of the facility. Said general policies must be in writing, must be for the purpose of making it possible for residents to live together and must be made part of the admission agreement. (4) If, after admission, it is determined that the resident has a need not previously identified and a reappraisal has been conducted pursuant to Section 87463, and the licensee and the person who performs the reappraisal believe that the facility is not appropriate for the resident...(f) A written report of any eviction shall be sent to the licensing agency within five (5) days.This requirement is not met as evidenced by: Based on interviews and records review the licensee did not comply with the section cited above in not describing how R1 did not follow the general policies of the facility nor explain how R1 is not an appropriate fit for the facility. Furthermore, the facility did not provide a written report to the department within 5 days of providing an eviction to R1.

Incidental Medical and Dental Care. The following...shall apply to medications...stored: The licensee shall be responsible for assuring that a record of...medications for each resident is maintained...medication. This requirement was not met as evidence by: Based on observation and record review, the licensee did not comply with the section cited above,On 07/25/2025, 3 out of 3 resident medications were missing and unaccounted for this poses/posed a potential health, safety or personal rights risk to persons in care.

Basic Services. . .However, if a facility chooses to accept a particular resident for care, the facility shall be responsible for meeting the resident's needs as identified in the pre-admission appraisal . . . Based on conducted interviews and records review the licensee failed provide the dietary needs as specified in Replacement Appraisal and Appraisal/Needs & Service Plan for Resident (R1).This poses a potential Health, Safety, or Personal Rights risk to persons in care.

Based on observation, interview and records review the licensee did not comply with the section cited above as staff #9 did not have a personnel record on file for LPA to review which poses/posed a potential health, safety or personal rights risk to persons in care.

Based on observation and record review, the licensee did not comply with the section cited above for LPA observed 9 out of 9 resident MARs to indicate that medication was given but no signature. LPA also observed medication not administered but had signature indicated that it was administered, this poses/posed a potential health, safety or personal rights risk to persons in care.

87464(f)(4) 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, as specified in Section 87608, Postural Supports.This requirement was not met as evidenced by: Based on records reviewed and interviews, On 07/23/25, MAR's for R1, R3, and R4 for March-May 2025 revealed discrepancies, and various medications were missed on various dates for R1, R3, and R4, for the months of March, April, and May 2025which poses/posed a potential health, safety, or personal rights risk to persons in care.

Basic Services. . .However, if a facility chooses to accept a particular resident for care, the facility shall be responsible for meeting the resident's needs as identified in the pre-admission appraisal . . . Based on conducted interviews and records review the licensee failed provide the dietary needs as specified in Replacement Appraisal and Appraisal/Needs & Service Plan for Resident (R1). This poses a potential Health, Safety, or Personal Rights risk to persons in care.

Each licensee shall furnish to the licensing agency such reports as the Department may require...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 report shall include the resident's name, age, sex and date of admission; date and nature of event; attending physician's name, findings, and treatment, if any; and disposition of the case. Based on interviews conducted and records review licensee failed to report that R1 was placed on a 5150 hold which poses a health and safety risk to residents in care

The licensee may evict a resident for one or more of the reasons... (30) days written notice to the resident is required except...If, after admission, it is determined that the resident has a need not previously identified and a reappraisal has been conducted pursuant... and the licensee and the person who performs the reappraisal believe that the facility is not appropriate for the resident. Based on interviews and record review the licensee did not comply with the section cited above as there was no indication that there was significant change in R1, R1 did not have a need that was not previously identified. which poses a health and safety risk to residents in care.

87465 Incidental Medical and Dental CareEach facility shall develop a planned routine of medical and dental care and assisting in obtaining such care.When requested by the physician or Department, the facility shall maintain a record of centrally stored medication dosages. Based on observation, interview, and record review, the licensee did not comply with the cited section. During medication reviews, LPA observed MAR documentation showing resident didnt receive their medication which posing a potential health, safety, or personal rights risk.

87506 (a) Resident Records The licensee shall ensure that a separate, complete, and current record is maintained for each resident in the facility or in a central administrative location readily available to facility staff and to licensing agency staff. This requirement was not met as evidence by: On 01/23/25 around 2:15 PM, LPA received partial records controlled medication count records for Residents #1 - 5 which poses a potential personal rights risk to residents in care. LPA did not receive medication administration records issued by the former Executive Director (S1).

87465 Incidental Medical and Dental Care(a) A plan for incidental medical and dental care shall be developed by each facility. The plan shall encourage routine medical and dental care and provide for assistance in obtaining such care. (4) The licensee shall assist residents with self-administered medications as needed.This requirement was not met as evidenced by: Based on interviews and records review, records revealed that there were three medications with dates with no entries made by Med Techs for R-1 and there were three prescribed medications that were not dispensed and still in the bubble pack. This action poses as an immediate health and safety risk to persons in care.

(f) All personnel, including the licensee and administrator, shall be in good health, and physically and mentally capable of performing assigned tasks. This requirement was not met as evidence:Based on interviews, records review, Executive Director Gloriella Jara stated that an employee had admitted to being under the influence while at work, which posed an immediate health, safety, and personal rights risk to residents in care.

87468.1 (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. This requirement was not met as evidence:Based on interviews, records review, Executive Director Gloriella Jara stated that an employee had physically assaulted R4, which posed an immediate health, safety, and personal rights risk to R4.

87303 Maintenance and Operation(a) 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 evidenced by: Based on interviews and observations, R-9’s bathroom medicine cabinet is rusted in the inside which poses a possible health and safety risk to persons in care.

Maintenance and OperationThe 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. There was a water leak on the right side of the resident's bed caused by the air conditioning unit, which dripped water onto the bed, soaking the linens and mattress.The violation poses a potential health and safety risk to residents in care.

87468.1 (a) (2) Personal Rights of Residents in All Facilities.To be accorded dignity in their personal relationships with staff, residents, and other persons.Staff engaged in an intimate relationship with a resident. This violation poses an immediate health and safety risk to residents in care.

87356 Criminal Record Exemption(a)The Department shall notify a licensee to act immediately to terminate the employment of, remove from the facility or bar from entering the facility any person described in Sections 87356(a)(1) through (5) below while the Department considers granting or denying an exemption. Upon notification, the licensee shall comply with the notice. (2) Any person who has been convicted of a felony;(3) Any person who has been convicted of an offense specified in Sections 243.4, 273a, 273d, 273g, or 368 of the Penal Code or any other crime specified in Health and Safety Code Section 1569.17(c)(3); This was not met based on observation, record review, and interview, the licensee failed to ensure S1 is fingerprint cleared prior to working in the facility. This poses a health, saftey, and/or persoanl rights risk to residents in care.

87555 General Food Service Requirements (b) The following food service requirements shall apply: (7) Modified diets prescribed by a resident's physician as a medical necessity shall be provided. This requirement was not met as evidenced by: based on interview, observation, andrecord review the licensee failed to ensure R1 received accomodations for a modified dieat prescribed by residents physician as a medical necessity.

(a) In addition to the rights listed in section 87468.1... residents... shall have all of the following personal rights: (4)To care, supervision, and services that meet their individual needs and are delivered by staff that are sufficient in numbers, qualifications, and competency to meet their needs. This requirement is not met as evidence by:Based on interviews and record review the licensee did not ensure R1's individual needs were met and delivered by staff during transfer which posed an immediate health, safety, and personal rights risk to R1.

Based on observation, interview, and record review, the licensee did not comply with the section cited above as during medication reviews, LPA observed documentation on the MAR indicating if residents refused or missed taking medication throughout the week which poses/posed a potential health, safety or personal rights risk to persons in care.

87555 General Food Service Requirements (b)The following food service requirements shall apply: (5) Meals shall consist of an appropriate variety of foods and shall be planned... requirement was not met as evidenced by: Based on interviews and record reviews the licensee did not ensure that a diabetic meal plan is provided to 7 out of 8 residents who had diabetes, who poses a potential health, safety, and personal rights risk to residents in care.

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 is not met as evidenced by: Based on interview, observation, video, and record review the licensee failed to secure R1’s room after viewing R2 entering R1’s room 3 times and taking R1’s personal property which posed a potential health and safety to residents in care.

87303Maintenance and Operation (a) 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 interview, observation, and record review the licensee failed to ensure that the facility is free of, cockroaches as reported to LPA on 8/10/23, per 1 of 3 staff and 8 of 8 clients interviewed. Roaches were located in the rooms and hallways, which posed a Potential health and safety to residents in care.

87555 General Food Service Requirements (7) Modified diets prescribed by a resident's physician as a medical necessity shall be provided.(7) Modified diets prescribed by a resident's physician as a medical necessity shall be provided. This requirement is not met as evidenced by: Based on interview, observation, and record review the licensee failed to ensure that the facility has a diabetic meal plan for residents in care as reported to LPA on 8/10/23. Per 3 of 3 staff and 7 of 8 residents facility did not provide a diabetic menu meal plan option which poses a Potential l health and safety to residents in care.

Based on observation, the licensee did not comply with the section cited above in room 220 the fan in the bathroom did not have a cover over it, 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 in the activity room there was a paper cutter accesibe to residents and in the garden area there was a shovel and pick axe out and storage sheds 1 and 2 were unlocked whose contents contained chemicals and gardening tools which poses an immediate health and safety risk to persons in care.

Reappraisals The pre-admission appraisal shall be updated, in writing... This requirement not met as evidenced by: LPA reviewed R1s file and found facility failed to reappraise resident after inital fall.

Any violation that the department determines resulted in the injury or illness of a resident. This requirement not met as evidenced by: On 09/28/2021 R1 had a fall and sustanined left femoral neck fracture. This poses an immediate health and safety risk to residents.

Each resident with dementia shall have an annual medical assessment as specified in Section 87458, Medical Assessment, and a reappraisal done at least annually, both of which shall include a reassessment of the resident’s dementia care needs...This requirement not met as evidenced by: Durin record review LPA observed inital Physician report dated 4/9/19, second report was dated 10/27/2020 which doesnt comply with required annual medical assessment.

Care of Persons with Dementia. Safety measures to address behaviors such as wandering..This requirement not met as evidenced by: During interviews and observations R2 eloped from the facility. This poses a potential health and safety risk to resident in care.

Personnel Requirements - General(a) Facility personnel shall at all times be sufficient in numbers, and competent to provide the services necessary to meet resident needs. This requirement is not met as evidenced by: Facility neglected to develop a care plan to assist R#1 with adequate supervision due to wandering and being a fall risk, which resulted in R#1 falling three times in the facility in June 2019 and sustained a fracture of the left clavicle and right femoral neck (Right Hip).

Incidental Medical and Dental Care(a) (2) The licensee shall provide assistance in meeting necessary medical and dental needs. This requirement is not met as evidenced by: The facility did not seek medical treatment immediately after the 06/22/19 incident and waited for several days to have R#1 evaluated by a medical professional, R#1 was seen by a medical professional on 06/26/19 for an unrelated condition and seen on 06/27/19 after falling again in the facility. R#1 X Ray’s dated 06/26/19 and 06/27/19 revealed R#1 sustained a fractured left clavicle and a fracture right hip.

Observation of the ResidentThe 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. This requirement is not met as evidenced by: The facility failed to follow up with R#1 physician regarding residents falls and securing R#1's medication Prednisone, which R#1 relied on to relieve muscle pain and stiffness. R#1 medical records indicated that R#1 medication Prednisone was discontinued and R#1 had greater difficulty ambulating.

Safeguards for Resident Cash, Personal Property, and Valuables Every facility shall take appropriate measures to safeguard residents' cash resources, personal property and valuables which have been entrusted to the licensee or facility staff. This requirement was not met as evidence by: The administrator failed to safeguard residents' money and personal items.