Carewell Manor

Based on record review, the licensee did not comply with the section cited above in 2 of 5 residents not having a TB test on file which poses 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 observing resident medications still in the bubble packs and signed off as given on the MAR with no explanation which poses an immediate health, safety or personal rights risk to persons in care.

87705 Care of Persons with Dementia (f) Licensees that lock exterior doors or perimeter fence gates shall meet the following initial and continuing requirements:The Licensee did not comply with the section cited above due to the presence of a locked front door that requires a key to open from inside the facility. LPA determined the facility has not fulfilled the requirements to maintain a locked exterior door. The requirements are found in Title 22 Regulations 87705(f)(1)-(f)(4). This presents a potential personal rights and safety risk to residents in care.

87411 Personnel Requirements-General (d)All personnel shall be given on the job training or have related experience in the job assigned to them.The Licensee did not comply with the section cited above due to the presence of a staff member who is providing food preparation and medication administration without prior experience or training to do so. This poses a potential health and safety risk to 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 (3)(D) Policies and procedures regarding medications, including the knowledge in Section 87411(d)(4). The Licensee did not comply with the section cited above due to being unable to show proof that all staff who provide medication assistance have adequate medication administration training and/or experience. This poses a potential health and safety risk to persons in care.

87207 False Claims; No licensee, officer or employee of a licensee shall make or disseminate any false or misleading statement regarding the facility or any of the services provided by the facility.The Licensee did not comply with the section cited above due to the presence of a falsified CPR certification. This poses a potential health, safety or personal righs risk to persons in care.

Based on medication review, the licensee did not comply with the section cited above in due to multiple residents' medication being transferred between containers which poses a potential health or safety risk to persons in care.

Based on record review, the licensee did not comply with the section cited above due to the absence of a dementia care plan. This poses a potential health, safety or personal rights risk to persons in care.

Based on observations, the licensee did not comply with the section cited above due to the presence of nails on the backyard table, an inoperable shower, a missing igniter knob on the oven, an inoperable light in the refrigerator, a broken drawer in the kitchen and two bathroom sinks not draining. This poses a potential safety or personal rights risk to persons in care.

Based on observation, the licensee did not comply with the section cited above due to the absence of lids on three trash cans. This poses a potential health risk to persons in care.

Based on observation, the licensee did not comply with the section cited above due to the presence of accessible bleach in two locations in the facility. This poses an immediate safety or risk to persons in care.

Based on medication and medication record review, the licensee did not comply with the section cited above due to the absence of a record of doses administered to residents in care. This poses a potential health, safety or personal rights risk to persons in care.

Based on PRN medication review and PRN medication record review, the licensee did not comply with the section cited above due to the absence of a record of PRN doses administered to residents in care. This 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 due to the appearance of dirt and other indicators in the kitchen and bathroom in the shared room. This posesd 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 due to the facility maintaining record of only one disaster drill in at least the last year. This poses a potential safety or personal rights risk to persons in care.

Per CCR 87606(c) on the Care of Bedridden Residents: "To accept or retain a bedridden person, other than for a temporary illness or recovery from surgery, a facility shall obtain and maintain an appropriate fire clearance(...). This requirement is not met as evidenced by: Based on interview conducted, facility observation and a review of records, resident R1 has been assessed to be bedridden while the facility is not in possession of an adequate fire clearance. This constitutes an immediate risk to the health and safety of residents in care.

87468.2 Additional Personal Rights of Residents in a Privately Operated Facilities (a) In addition to the rights listed in Section 87468.1, Personal Rights of Residents in All Facilities, residents in privately operated residential care facilities for the elderly shall have all of the following personal rights: (4) To care, supervision, and services that meet their individual needs …” This requirement was not met as evidenced by: Based on observations and interviews, LPA and staff observed that diaper for one out of the six residents were soiled during the inspection which poses a potential Health, Safety, and Personal Rights risk to persons in care.

87464 Basic Services (f) Basic services shall at a minimum include: (1) Care and supervision as defined in Section 87101(c)(3) and Health and Safety Code section 1569.2(c)… (c) “…means the facility assumes responsibility for, or provides or promises to provide in the future, ongoing assistance with activities of daily living…” which “includes assistance with taking medications, money management, or personal care.” This requirement was not met as evidenced by: Based on record review and interviews, one out of the two residents and two out of the three staff confirmed that care and supervision is not provided at all times which poses a potential Health, Safety, and Personal Rights risk to persons in care.

87355 Criminal Record Clearance "(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: (2) Request a transfer of a criminal record clearance..."This requirement was not met as evidenced by: Based on LPA's observations, interviews, and review of records, S1 was not associated at the time of the visit which poses an immediate Health, Safety, or Personal Rights risk to persons in care.