Grace Blossom Care

Based on record review, the licensee did not comply with the section cited above S1, and S2 did not have correct annual training in file 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 three (3) out of five (5) residents did not have a annual physicians report 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 two (2) residents did not have posted signs on bedroom doors 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 LPA observed a large open bag of fertilizer in back yard which poses an immediate health, safety or personal rights risk to persons in care.

Based on record review, the licensee did not comply with the section cited above in three (3) out of three (3) staff files reviewed did not have a cuurent CPR card 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 room number 1 did not have a window screen 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 room number 3 had a hole in the wall, and kitchen drawer was broken and being held together with black tape 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 S3 did not have a health screening with TB in file which poses/posed a potential health, safety or personal rights risk to persons in care.

Based record review, the licensee did not comply with the section cited above in 2 out of 5 resident's prescriptions which poses an immediate health, safety or personal rights risk to persons in care. Resident 1 (R1), two medications (Docusate Sodium 250 mg and Ferrous Sulfate 325 mg) had not been refilled. Resident 2 (R2) did not have medication refilled (Memantine HCL 10mg, Vitamin D3 50 mg, Donepezil 5m). Resident 3 (R3) did not received medication as prescribed (Melatonin 5 mg) on 4 days.

Based on record review, the licensee did not comply with the section cited above 1 out 5 resident records. Resident 1 (R1) had PRN prescription (Furosemide 20 mg) was given to resident but there was no documentation. Resident 3 (R3) did not received medication as prescribed (Melatonin 5 mg) and did not include the exact dosage, the minimum number of hours between doses or the maximum number of doses allowed in each 24-hour period.

Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above in [count] out of [total count] [(objects) (persons)] [identifiers] 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 in three (3) out of (3) staff files which poses/posed a potential health, safety or personal rights risk to persons in care. LPA conducted annual visit and did not have access to staff/client files. Administrator was contacted and givien ample amount of time to respond. Caregiver did not have key to file room.

Based on record review the licensee did not comply with the section cited above in one (1)out six (6) residents which poses an immediate health, safety or personal rights risk to persons in care. R1 medication was not present at facility and listed on medication MAR log. Doenepizil 5MG Daily.

Based on observation the licensee did not comply with the section cited above in which poses/posed a potential health, safety or personal rights risk to persons in care.

Prohibited Health Conditions(a) Persons who require health services for 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: (1) Stage 3 and 4 pressure injuries.This requirement was not met by evidence of: Based on interviews and records reviewed, on February 14, 2020 during a doctor’s appointment, it was confirmed that the resident had a stage 3 wound which is a prohibited health condition yet the resident returned to the facility the same day, which poses an immediate health, safety or personal rights risk to persons in care.

Based on record review, the licensee did not comply with the section cited above in 3 out of 6 residents. R1, R2, and R3 all have dementia and the physician report in their files are older than 1 year 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 in 6 out of 7 staff files. Administrator did not have a health screening for S1, S2, S4, S5, S6 and S7 to provide to the LPA 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 in 6 out of 7 staff files. Administrator did not have a valid First Aid/CPR certificate for S1, S2, S3, S4, S5 and S6 to provide to the LPA 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 2 out of 2 bathrooms. The water temperature was tested in both bathrooms and measured at 78.5 degrees F (residents bathroom) and 80.1 degrees F (staff bathroom) which poses/posed a potential health, safety or personal rights risk to persons in care.

Reporting RequirementsEach 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)......This requirement has not been met as evdience by: The Licensee/Administrator failed to submit incident reports for R1 on 11/10/19 and 02/14/20.

Administrator - Qualifications and Duties.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 accountable for management and..., The administrator shall have the qualifications specified in Sections 87405(d)(1) through (7). If the licensee is also the administrator, all requirements for an administrator shall apply...,This requirement was not met as evidenced by: It was discovered that the administrator did not seek medical attention for R1 after staff

Incidental Medical and Dental Care; A plan for incidental medical ... shall be developed by each facility. The plan shall encourage routine medical... and provide for assistance in obtaining such care, by compliance with the following: The licensee shall arrange, or assist in arranging, for medical and... appropriate to the conditions and needs of residents. This requirement was not met as evidenced by: On 11/10/19 Medical reports/ER documentation confirmed that R1 had a stage 2 PI(Sacrum), ComCar Home health provdied daily wound care and observed R1's dressing to be saturated in urine andbowel, suggested for facility staff to change

**Citation Continued**discovered the PI had worsened and there was no documentation and no evidence to prove the Administrator or staff documents the resident's activity or change in health condition/observation of Pressure Injuries.