Almavia of San Rafael

Based on observations made, Licensee did not comply with the section cited above. Five instances of expired foods were observed in facility's arts and crafts refrigerator and activity cabinets, including expired milk, cheese, canned frosting, blueberries, opened boxed beef broth, and chocolate sauce. This poses/posed a potential health, safety or personal rights risk to persons in care.

Based on observations made, Licensee did not comply with the section cited above. LPA observed two residents with medications in their room that should have been centrally stored and inaccessible. This poses an immediate health, safety or personal rights risk to persons in care.

87468.2 Additional Personal Rights of Residents in Privately Operated Facilities:(a) In addition to...Section 87468.1... residents...shall have...following personal rights: (4) To care, supervision, and services that meet their...needs and are delivered by staff that are sufficient in numbers, qualifications & competency...Requirement was not met as evidenced by: based on record review, Licensee did not comply with section cited above & did not ensure that R1's pendant call was responded to timely. This poses a potential health/safety 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 is not met as evidenced by: based on observations made and record review, the Licensee did not comply with the section above and did not ensure that R1 was provided their modified diet. This poses an immediate health & safety risk to the residents in care.

87465 Incidental Medical and Dental Care:(a)A plan for incidental medical and dental care shall be developed by each facility...(4) The licensee shall assist residents with self-administered medications as needed. This requirement was not met as evidenced by: based on record review, Licensee did not comply with the section cited above and did not ensure that medication was administered to R1 as required. R1 was not administered multiple medications due to it being unavailable or awaiting refill. This is an immediate health and safety risk to residents in care.

87468.2 Additional Personal Rights of Residents in Privately Operated Facilities:(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...this requirement was not met as evidenced by: based on record review and observations made, Licensee did not ensure that resident received weekly skin checks as agreed upon during a resident care conference.

87211 Reporting Requirements: (a) Each licensee shall furnish to the licensing agency such reports as the Department may require...(1) A written report shall be submitted...within seven days of the occurrence of any of the events specified...below. This requirement was not met as evidenced by: Licensee did not comply with section cited above. Per record review, Licensee did not submit incident reports timely. This poses a potential health and safety risk to residents in care.

87616 Exceptions for Health Conditions(a) ...the licensee may submit a written exception request if he/she agrees that the resident has a prohibited... health condition but believes that the intent of the law can be met through alternative means. This requirement was not met as evidenced by: based on record review, interviews, and observations, Licensee did not submit the proper paperwork to Community Care Licensing once it was believed that R1 had a Stage 3 wound. R1 was then diagnosed with a Stage 4 wound. This is a potential health and safety risk to residents in care.

87466 Observation of the Resident: The licensee shall ensure that residents are regularly observed for changes...and that appropriate assistance is provided...This requirement was not met as evidenced by: based on records, interviews and observations, Licensee did not ensure that Resident 1 (R1) received timely medical care. R1's pressure injury was observed to be a big hole, very bad looking, and was leaking a white liquid on 12/17/25. R1 did not receive medical care until 12/22/25. This poses an immediate health, safety, or personal rights risk to residents in care.

87211 Reporting Requirements: (a) Each licensee shall furnish to the licensing agency such reports as the Department may require...(1) A written report shall be submitted...within seven days of the occurrence of any of the events specified...below. This requirement was not met as evidenced by: Licensee did not comply with section cited above. Per record review, Licensee did not submit incident reports timely. This poses a potential health and safety risk to residents in care.

87465(a)(5) Incidental Medical and Dental Care. 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: The licensee shall assist residents with self administered medications as needed. This requirement was not met as evidenced by: Based on statement from facility Administrator, staff did not ensure 16 residents received their medication timely. Subsequently, 16 residents missed medication which poses an immediate health and safety risk to residents in care.

87705(b)(2) Care of Persons with Dementia: Safety measures to address behaviors such as wandering. This requirement was not met as evidenced by: Based on record review the facility didn't comply with this section for 1of1 residents which poses an immediate Health, Safety risk to residents in care. Resident R1 isn't allowed to leave facility unassisted; left on 01/01/2022 through the egress doors after an associate left through the same door. Resident was found at the gas station by local law enforcement.

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:(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. This requirement was not met as evidenced by:Based on an email conversation dated for July 23, 2021, it was disclosed that facility missed a Urinalysis order for R1 in May 2021. This poses an immediate 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.(A) Death of any resident from any cause regardless of where the death occurred, including but not limited to a day program, a hospital, en route to or from a hospital, or visiting away from the facility.(B) Any serious injury as determined by the attending physician and occurring while the resident is under facility supervision.(C) The use of an Automated External Defibrillator.(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 was not met evidenced by:Based on interviews with facility staff, and research of incident reports submitted for Almavia of San Rafael to CCL, did not properly report an incident to the CCL as required by Title 22 regulation. This poses a potential health, safety or personal rights risk to persons in care.