Arc Facility at Camino 2

(b) If the licensee is a corporation or an association, the governing body shall be active, and functioning in order to assure accountability.This requirement is not met as evidenced by: Based on records reviewed, the licensee did not comply with the section cited above which poses an potential health, safety and personal rights risk to persons in care. LPA observed that the licensee, Adams Residential Care Facilities LLC, is not active and was suspended on 12/1/11.

Based on observation and record review, the licensee did not comply with the section cited above which poses/posed a potential health, safety or personal rights risk to persons in care. LPA observed that the most recent Reappraisal on file for Resident #3 (R3) was completed on 11/03/24.

Based on observation and record review, the licensee did not comply with the section cited above which poses/posed a potential health, safety or personal rights risk to persons in care. LPA observed that there was no Medical Assessment on file for Resident #1 (R1).

Based on observation, interview, and record review, the licensee did not comply with the section cited above which poses/posed a potential health, safety or personal rights risk to persons in care. LPA observed that the Administrator listed on file, Michael Adams, does not have a valid Administrator certificate on file, and that there is no pending application at this time.

Based on observation, interview, and record review, the licensee did not comply with the section cited above which poses/posed a potential health, safety or personal rights risk to persons in care. LPA also observed that the annual fees for the facility were not paid in 2024 or in 2025.

Based on observation, interview, and record review, the licensee did not comply with the section cited above which poses an immediate health, safety or personal rights risk to persons in care. LPA observed that the licensee, Adams Residential Care Facilities, LLC, is not active and was suspended on December 1, 2011.

Meals shall consist of an appropriate variety of foods and shall be planned with consideration for cultural and religious background and food habits of residents. This requirement is not being met as evidenced by... The facility does not serve a variet of foods as observed by the LPA. This poses a potentional, health, safety and personal righst risk to residents in care.

The facility shall be clean, safe, sanitary and in good repair at all times. This requirement is not being met as evidenced by LPA observed the facility has torn carpet in the living room, paint is chipping the kitchen and dining room, the kitchen cabinet doors are broken and the vanity in the bathroom in the hallway is broken. This poses a potential, health, safety and personal rights risk to residents in care.

To be accorded dignity in their personal relationships with staff, residents, and other persons. This requirement is not being met as evidenced by. The Administrator has yelled at residents as reported by staff and residents, this poses an immediate personal rights violation to residents in care.

To have a reasonable level of personal privacy in accommodations, medical treatment, personal care and assistance, visits, communications, telephone conversations, use of the Internet, and meetings of resident and family groups. This requirement is not being met as evidenced by The Administrator walked in R1's room without notice on June 24, 2024, which poses an immediate personal rights violation to residents in care.

Based on observation and interview, the licensee did not comply with the section cited above which poses/posed a potential health, safety or personal rights risk to persons in care. During a tour of the physical plant, LPA observed that the facility does not have a sufficient three day emergency food supply on hand.

Based on record review, the licensee did not comply with the section cited above in which poses an immediate health, safety or personal rights risk to persons in care. During resident medication review, LPA observed that the facility did not have a record of centrally stored prescription medication for Resident #2 (R2). The facility did not have a record R2's Lorazepam and Ondansetron.

Based on record review, the licensee did not comply with the section cited above in which poses/posed a potential health, safety or personal rights risk to persons in care. During resident file review, LPA observed the Reappraisals for Resident #1 (R1) and Resident #2 (R2) were outdated. LPA observed that the most recent Reappraisal on file for R1 was completed on 04/30/23. LPA observed that the most recent Reappraisal on file for R2 was completed on 01/09/23.

Based on observation, interview, and record review, the licensee did not comply with the section cited above in R1 had a full bed rail and is not receiving hospice services, R2 and R3 have 1/2 bed rails no written order from a physician were found in files. This poses/posed 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 that Licensee failed to pay the annual licensing fees which were due 02/20/2024; however; the Licensee has not paid the annual fees by the due date in the past 3 years, and for this reason, late fees have been accrued. This poses/posed a potential health, safety or personal rights risk to persons in care.

Based on observation and interview, the Licensee did not comply with the section cited above; Licensee stated Fire Extinguisher had not been serviced in a couple years; Licensee failed to ensure Fire Extinguisher was serviced annually, which poses an immediate health, and safety risk to the residents in care.

Based on observation, the licensee did not comply with the section cited above in that he Licensee failed to keep the facility clean and in good repair at all times. LPA observed a leak under kitchen sink, kitchen cabinets needing repair, medication cabinet locks needs to be replaced, refrigerator needs deep cleaning, dining area needs to be cleaned and organized, common areas need deep cleaning and electric wires are a tripping hazard, hallway bathroom has a leak under the sink, both bathrooms need deep cleaning, garage needs to be organized and decluttered and walkway on side of garage has items blocking walkway going out to exit gate. Also, window screens need to be repaired/replaced. 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 in that the Licensee did not ensure the swimming pool to be secured, which poses an immediate health, safety or personal rights risk to persons in care.

Based on observation and interview, the licensee did not comply with the section cited above in that Licensee failed to ensure food on hand met the minimum of one week non-perishable and minimum of two days perishables. Food observed is not enough to feed 5 residents for 7 days. This poses/posed a potential health, safety or personal rights risk to persons in care.

To receive or reject medical care or other services. This requirement is not being met as evidenced by... R1 ran out of their Venlafaxine 225MG for 16 days which poses an immediate health, safety and personal rights risk to residents in care.

Basic Services. Basic services shall at a minimum include: Personal assistance and care as needed by the resident and as indicated in the pre-admission appraisal with those activities of daily living such as dressing, eating, bathing..., as specified in Section 87608...This requirement is not being met as evidenced by: Based on interviews the Administrator did not transfer R1 on July 24, 2024 when they requested to be transferred, This poses an immediate health and safety risk to residents in care.

Plan of Operation (a)Each facility shall have and maintain a current, written definitive plan of operation...The plan and related materials shall contain the following:(12)The Infection Control Plan pursuant to Section 87470. This requirement was not met as evidence by: Based on LPA observations S1 was not wearing Personal Protective Equipment (PPE) during the initial visit. Based on interviews conducted R1 was not allowed to have an in-person visit. This poses an immediate risk to resident’s health and safety.

Based on observation, the licensee did not ensure the pool in the backyard was lockable, which poses an immediate health and safety risk to persons in care.

Based on observation, the licensee did not ensure the fireplace in the living room had a screen, which poses a potential health and safety risk to persons in care.