La Casita Residential Care Inc.

Based on record review, S3 health screening was not maintained in personnel record, the licensee did not comply with the section cited above in 1 out of 3 staff, which poses/posed a potential health, safety or personal rights risk to persons in care.

87211 Reporting Requirements; (a) Each licensee shall furnish...: (1) A written report shall be submitted to the licensing agency...within seven days of the occurrence... (A) Death of any resident from any cause regardless of where the death occurred...This requirements is not met as evidence by: Based on documents reviewed, and facility failed to report death of R#1 within the seven days of occurrence which poses a potential Health, Safety, and Personal Risk to persons in care.

(a) Based on the individual's preadmission appraisal, and subsequent changes to that appraisal, the facility shall provide assistance and care for the resident in those activities of daily living which the resident is unable to do for himself/herself. Postural supports may be used under the following conditions. (2) Postural supports shall be fastened or tied in a manner that permits quick release by the resident.This requirement is not met as evidenced by: LPA observed 4 residents wearing gait belts without a quick release which poses/pose a health and safety hazard for residents in care.

(a) Except as specified in Section 87611(a), the licensee shall be permitted to accept or retain a resident who requires the use of oxygen gas administration under the following circumstances:(b) In addition to Section 87611(b), the licensee shall be responsible for the following:(A) A report shall be made in writing to the local fire jurisdiction that oxygen is in use at the facility.This requirement is not met as evidenced by: LPA observed one resident using oxygen and no written report has been submitted to fire department.

Hospice Care WaiverThe licensee shall notify the Department in writing within five working days of the initiation of hospice care services for any terminally ill resident in the facility or within five working days of admitting a resident already receiving hospice care services. The notice shall include the resident's name and date of admission to the facility and the name and address of the hospice.This requirement is not met as evidenced by: Facility has four residents currently on Hospice and failed to notify the departmentwhich poses a potential Health, Safety, and Personal Risk to persons in care.

Based on record review,, the licensee did not comply with the section cited above in (2) of (6) staff missing health screening on file, which poses 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 several of R5's medications without record of centrally stored medications, which poses 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 in surveillance cameras in use, without proper waiver/approval from the department, which poses a potential health, safety or personal rights risk to persons in care.

87355 Criminal Record Clearance (e) All individuals subject to a criminal record review... shall prior to working, residing or volunteering in a licensed facility:(1) Obtain a California clearance or a criminal record exemption as required by the Department. This requirement is not met as evidenced by: 1/11/2022 4 p.m. LPA observed S1 was present at the facility but does not have a California clearance or criminal record exemption as required by the Department. Based on observation and interview, the licensee did not comply with the section cited above which poses an immediate health, safety or personal rights risk to persons in care.

Fire ClearanceAll facilities shall maintain a fire clearance approved by the city, county, or city and county fire department, or district providing fire protection services, or the State Fire Marshal. Prior to accepting or retaining any of the following types of persons, the applicant or licensee shall notify the licensing agency and obtain an appropriate fire clearance approved by the city, county, or city and county fire department, or district providing fire protection services, or the State Fire Marshal. This requirement was not met as evidenced by:LPAs learned through interviews with 3 out of 4 staff, and review of resident roster that the facility had 7 residents up until Oct 2021. Also the facility fire clearance is approved for only 6 residents. This poses a health and safety risk to residence in care.