Amelia Rose Senior Care Cottage

Onsite food stock levels for nonperishables and perishables

Based on observation, the licensee did not comply with the section cited above LPA did not observe enough 2 day non perishable food for six (6) residents which poses an immediate health, safety or personal rights risk to persons in care.

Fire approval and staff access to unlock systems

Based on observation, the licensee did not comply with the section cited above combination lock was observed on perimeter fence without waiver from this licensing agency, no approval from on fire clearance inspection sheet and/or notification from Licensee's intent to lock perimeter gates which poses/posed a potential health, safety or personal rights risk to persons in care.

Annual routine visit with medical professional

Based on record review, the licensee did not comply with the section cited above in two (2) out of six (6) residents did not have updated 602 physician reports which poses/posed a potential health, safety or personal rights risk to persons in care.

Passageways and stairways kept clear

Based on observation, the licensee did not comply with the section cited above LPA observed paint and other obstructions in backyard side of house which poses/posed a potential 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 in one (1) out of three (3) bathrooms did not deliver the required water temperature of 105 in bathroom #2 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... 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 … Based on observation and document review licensee did not ensure to notify or appoint via LIC 308 a designee of responsibility before going on vacation which poses a potential risk to the health, safety, or personal rights of the persons in care.

Licensee reports required by licensing agency

87211 Reporting Requirements: (a) Each licensee shall furnish to the licensing agency …the following: (1) A written report shall be submitted … within seven days of the occurrence of any of the events … Based on interviews and documents reviewed the licensee did not ensure to report R3 was taken to the hospital via emergency personnel which poses a potential risk to the health, safety, and personal rights of the persons in care.

Maintain separate complete record for each resident

87506 Resident Records (a) 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 is not met as evidence by: Based on observation and document review licensee did not ensure staff was accurately noting the medication sheets to show current medication which poses a potential risk to the health, safety, and personal rights of the persons in care.

87411 Personnel Requirements - General (c) All RCFE staff who assist residents with personal activities of daily living shall receive initial and annual training as specified in Health and Safety Code sections 1569.625 and 1569.69. This requirement is not met as evidence by: Based on observations and document review licensee did not ensure that S2 received, and records were maintained for training provided which poses a potential risk to the health, safety, or personal rights of the persons in care.

Submit and maintain current mailing address

(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: (1) Obtain a California clearance or a criminal record exemption as required by the Department orThis requirement is not met as evidenced by:S4 did not have proof of criminal clearance prior to gaining employment at the facility.

Fire approval and staff access to unlock systems

(f) The following shall be stored inaccessible to residents with dementia: (2) Over-the-counter medication, nutritional supplements or vitamins, alcohol, cigarettes, and toxic substances such as certain plants, gardening supplies, cleaning supplies and disinfectants.This requirement is not met as evidenced by: 1 bottle of laundry sanitizer and 1 spray bottle of disinfectant spray was observed in bathrooms#1 and 2.

Fire approval and staff access to unlock systems

Based on observation, 1 bottle of laundry sanitizer and 1 spray bottle of disinfectant spray was observed in bathrooms#1 and 2, the licensee did not comply with the section cited above in 3 out of 5 out of residents with dementia, which poses an immediate health, safety or personal rights risk to persons in care.

(a) Any duly authorized officer, employee or agent of the licensing agency may, upon proper identification and upon stating the purpose of his/her visit, enter and inspect the entire premise of any place providing services at any time, with or without advance notice. This requirement was not met as evidenced by: LPA Ramirez was denied entry to backyard to complete inspection.

Based on observation, combination lock was observed on perimeter fence without waiver from this licensing agency, no approval from on fire clearance inspection sheet and/or notification from Licensee's intent to lock perimeter gates, the licensee did not comply with the section cited above in 5 out of 5 residents which poses/posed a potential health, safety or personal rights risk to persons in care.

Based on observation and record reviewed, R2 does not have an order for full bed rails, the licensee did not comply with the section cited above in 1 out of 5 residents which poses/posed a potential health, safety or personal rights risk to persons in care.

Based on record review, no proof of documented drills for 2024, the licensee did not comply with the section cited above in 5 out of 5 residents, staff and/or visitors which poses/posed a potential health, safety or personal rights risk to persons in care.

Obtain and evaluate recent medical assessment

Based on record review, R1 did not have any recent medical assessment, the licensee did not comply with the section cited above in 1 out of 5 residents which poses/posed a potential health, safety or personal rights risk to persons in care.

Maintain records of centrally stored medication dosages

Based on record review, R5 was missing centrally stored medications record, the licensee did not comply with the section cited above in 1 out of 5 residents, which poses/posed a potential health, safety or personal rights risk to persons in care.

Maintain facility in clean, safe, sanitary condition

Based on observation,facility door bell is in disrepair, 1 out of 3 light bulbs in bathroom#1 and #2 were in disrepair, the licensee did not comply with the section cited above in 5 out of 5 residents, staff and/or vistors which poses/posed a potential health, safety or personal rights risk to persons in care.

Based on observation, license was not posted in prominent location in the facility, the licensee did not comply with the section cited above in 5 out of 5 residents which poses/posed a potential health, safety or personal rights risk to persons in care.

Address and clearance obligations before facility work

Based on record review, S4 did not have proof of criminal clearance prior to gaining employment at the facility, the licensee did not comply with the section cited above in 5 out of 5 residents which poses an immediate health, safety or personal rights risk to persons in care.