The Vincent

Regular observation and documentation of resident changes

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 record review and interviews conducted, Licensee did not ensure that Resident 1 (R1) received timely medical care. R1 had an incident with their hoyer lift on 8/17/25. They were observed to have swelling and redness on 8/18/25 but did not get assessed until 8/22/25. This poses an immediate health, safety, or personal rights risk to residents in care.

Apply centrally stored medication safeguards

87465 Incidental Medical and Dental Care(h) The following requirements shall apply to medications which are centrally stored: (6) The licensee shall be responsible for assuring that a record of centrally stored prescription medications for each resident…This requirement is not met as evidenced by: Based on observations made, Licensee did not comply with the section cited above and did not ensure that resident medications were centrally stored and recorded on the LIC622 as required. This is a potential health and safety rights risk to residents in care.

87211 Reporting Requirements: (a) Each licensee shall furnish to the licensing agency...(1) A written report shall be submitted...within seven days...(D)Any incident which threatens the welfare, safety or health of any resident...This requirement was not met as evidenced by: Licensee did not comply with the section cited above. Per record review, Licensee did not submit an incident report for R1 timely. This poses a potential health and safety risk to residents in care.

Maintain and operate facility under definitive plan

87208 Plan of Operation(a)The licensee shall have and maintain a current, written definitive plan of operation for the facility. The licensee shall operate the facility in accordance with the terms specified in the plan of operation... pursuant to Health and Safety Code…This requirement was not as evidenced by: Based on interviews conducted, Licensee did not comply with the section cited above. Medication records were being documented as given when medication was not readily available. This poses an potential health and safety risk to residents in care.

Assist residents with self-administered medication

87465 Incidental Medical and Dental Care(a)...each facility...shall provide for assistance...(4) The licensee shall assist residents with self-administered medications as needed. This requirement was not met as evidenced by: Based on document review and interviews, Licensee did not comply with the section cited above and R1 was being administered expired medications. Interviews conducted also stated that medications were being left unattended in resident rooms after being dispensed. This poses an immediate health and safety risk to residents in care.

Assist residents with self-administered medication

87465 Incidental Medical and Dental Care(a)...each facility...shall provide for assistance...(4) The licensee shall assist residents with self-administered medications as needed. This requirement was not met as evidenced by: Based on document review and interviews, Licensee did not comply with the section cited above. 6 Incident Reports received and 3 of 7 interviews conducted stated that residents have either missed medication, received late medications, or have been given someone else's medication. This poses an immediate health and safety risk to residents in care.

Assist residents with self-administered medication

87465 Incidental Medical and Dental Care(a) A plan... shall be developed... The plan shall... provide for assistance in obtaining such care, by compliance with the following:(4) The licensee shall assist residents with self-administered medications as needed. This requirement was not met as evidenced by: Based on document review, interviews, and observations made, Licensee did not comply with the section cited above. R1 did not receive medication as prescribed due to facility running out of their medication. This poses an immediate health and safety risk to residents in care.

Right to confidential records and approved disclosure

87468.2 Additional Personal Rights of Residents in Privately Operated Facilities:(a)...residents...shall have all of the following...:(2) to have their records and personal information remain confidential and to approve their release...This requirement was not met as evidenced by: Based on interviews and document review, Licensee did not comply with the section cited above. Facility staff posted a video with resident care information and failed to ensure narcotic medication confidentiality. This poses an potential health and safety risk to residents in care.

Based on record review, the Licensee did not comply with the section cited above. Licensee did not ensure that 5 of 11 staff completed their annual 2023 training. This poses/posed a potential health, safety or personal rights risk to residents in care.

Give PRN medication by physician order

87465 Incidental Medical and Dental Care(c)If resident...unable to determine... need for nonprescription PRN medication... facility...shall assist..with self-administration...(2)Once ordered by the physician the medication is given according to the physician's directions. This requirement was not met as evidenced by: Based on document review, Licensee did not comply with the section cited above. R1, R2, and R3 were not given medications as prescribed and R3 was also given PRN medication. This poses an immediate health, safety or personal rights risk to residents in care.

Assist residents with self-administered medication

87465 Incidental Medical and Dental Care(a) A plan... shall be developed... The plan shall... provide for assistance in obtaining such care, by compliance with the following:(4) The licensee shall assist residents with self-administered medications as needed. This requirement was not met as evidenced by: Based on document review, interviews, and observations made, the Licensee did not comply with the section cited above. R1 did not have a physician's order on file to verify a medication change that was being given. 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...(1)A written report shall be submitted to the licensing agency...within seven days of the occurrence of...(D)Any incident which threatens the welfare, safety or health of any resident... This requirement is not met as evidenced by:Based on interviews conducted, the Licensee did not comply with the section cited above and did not submit reports to CCL as required. This poses a potential health and safety risk to residents in care.

Right to confidential records and approved disclosure

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...:(2) to have their records and personal information remain confidential and to approve their release, except as authorized by law.This requirement was not met as evidenced by: R1 went to the hospital with R2's medical paperwork and R2's medical information was not kept confidential as required. This poses an immediate health, safety or personal rights risk to persons in care.

87307(d)(3)(B): Facility failed to protect the personal rights of residents in care to receive safe and healthful accommodations and engaged in conduct inimical to the health, welfare, and safety of residents in care, in that staff members failed to properly wear face coverings while providing care and supervision to residents in care*, in violation of official government orders requiring the wearing of face coverings while working underThis requirement is not met as evidenced by:Based on interviews with a witness, staff members failed to properly wear face coverings while providing care and supervision to residents in care.

87465(a)(4)(5) 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:(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. This requirement is not met as evidenced by:Based on a review of the Medication Assessment Record (MAR), the facility missed a medication pass for a resident on April 17, 2022 which is an immediate health, safety and personal rights risk to the residents in care.

Maintenance and operation requirements for facilities

87303 Maintenance and Operation: (i) Facilities shall have signal systems which shall meet the following criteria:(1) All facilities licensed for 16 or more and all residential facilities having separate floors or buildings shall have a signal system which shall:(A) Operate from each resident's living unit.(B) Transmit a visual and/or auditory signal to a central staffed location or produce an auditory signal at the living unit loud enough to summon staff. This requirement was not met as evidenced by:Based off of record review, it was determined that a resident had to wait 1 hour and 40 minutes to be attended to which presents a health, safety and personal rights risk to the residents in care.

Health and Safety Code1569.626 Training requirements for direct care staff:(a) All residential care facilities for the elderly shall meet the following training requirements, as described in Section 1569.625, for all direct care staff:(1) Twelve hours of dementia care training, six of which shall be completed before a staff member begins working independently with residents, and the remaining six hours of which shall be completed within the first four weeks of employment. All 12 hours shall be devoted to the care of persons with dementia. The facility may utilize various methods of instruction, including, but not limited to, preceptorship, mentoring, and other forms of observation and demonstration. The orientation time shall be exclusive of any administrative instruction. This requirement was not met as evidenced by:Based off of staff record review, LPA identified 9 staff members that have not had the training that is identified in the Health and Safety Code to work with Dementia residents. Therefore, the staff members are out of compliance.

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.(14) Current centrally stored medications as specified in Section 87465, Incidental Medical and Dental Care Services. This requirement was not met as evidenced by:Based on observation of the Medication Assessment Record (MAR), the staff member passing medication on April 17, 2022 did not document that a medication was missed for a resident which is a potential health, safety and personal rights risk to the residents in care.