Ardent Care

87465(c)(3) Incidental Medical and Dental CareA record of each dose is maintained in the resident's record...This requirement was not met as evidence by: LPA observed 2 of 5 residents to not have the medication administration record signed off when medications have been given. This poses a potential health, safety or personal rights risk to residents in care.

87303 Maintenance and Operation(a) The facility shall be clean, safe, sanitary and in good repair at all times...This requirement was not met as evidence by:Based on interviews and record review LPA observed that room 3 had a broken faucet with no hot water causing R1 to go to a different room to shower. This poses a potential health, safety or personal rights risk to residents in care.

87468.1(a)(2) Personal Rights of Residents in all Facilities(2) To be accorded safe, healthful and comfortable accommodations, furnishings and equipment.This requirement was not met as evidence by: LPA observed a camera in room 4 and a live feed picture was observed showing 2 resident beds. LPA did not observe conservatorship papers from R1 and R1 did not consent to the camera. This poses an immediate personal rigths risk to residents in care.

87555 (b)(26) General Food Service Requirements (26) Supplies of nonperishable foods for a minimum of one week and perishable foods for a minimum of two days shall be maintained on the premises. This requirement was not met as evidence by: LPA did not observe a 2 day perishable and 7 day nonperishable food supply at the facility at the time of the investigation. This poses an immediate health and safety risk to residents in care.

(a) Residents in all residential care facilities for the elderly shall have all of the following rights: (3) to be free from punishment, humiliation, intimidation, abuse, or other actions of a punitive nature, ….This requirement was not met as evidenced by: based on interview and records review, the licensee did not provide a safe environment for resident R2 due to R1 entering bedroom naked and trying to force R2 to open their mouth to engage in inappropriate behavior at the facility, which poses an immediate safety and personal rights risk for persons in care.

Based on observation, the licensee did not comply with the section cited above in resident restrooms water testing at 122.1 and 125.6 degrees Farenheit which poses an immediate health, safety or personal rights risk to persons in care.

Based on observation and record review, the licensee did not comply with the section cited above in 1 resident having half bed rails with no physicians order on file which poses 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 1 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 record review, the licensee did not comply with the section cited above in 1 of 3 staff not having 16 hours of initial training on file which poses 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 1 out of 3 staff not having a health screening 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 putting 3 residents in one bedroom which poses an immediatel health, safety or personal rights risk to persons in care going against the approved fire clearance that was given on May 4, 2016. A civil penalty was assessed at the time of the inspection.

Based on record review, the Licensee did not comply with the section cited above in 4 medication records out of 4 medication records. Each reviewed record had missing signatures from medication administered to residents. This causes a potential personal rights risk to persons in care.

87507 Admission Agreements … (g) … (4) … (B) The conditions under which a licensee may increase or change rates shall be specified in the admission agreement, pursuant to Health and Safety Code sections 1569.655 and 1569.657… This requirement was not met as evidenced by: Based on interviews and documents, the licensee did not provide notice of a rate increase based on a change in the level of care of R1 within 2 business days after initially providing services at the new level of care, which poses a potential personal rights risk to persons in care.

Personnel Records (1) training and orientation shall be documented: (A)...at least ten hours of initial training within the first four weeks of employment, and at least four hours of training annually thereafter...(B)For staff who provide direct care to residents with dementia...the licensee shall document ...orientation received as specified in Section 87707(a)(1)...in-service training received as specified in Section 87707(a)(2).This requirement is not met as evidence by: Based on LPA observations and file review S1 and S2 did not complete eight hours of dementia in-service training within their first 12 months of employment.

Personnel Records (1) training and orientation shall be documented: (A)...at least ten hours of initial training within the first four weeks of employment, and at least four hours of training annually thereafter...(B)For staff who provide direct care to residents with dementia...the licensee shall document ...orientation received as specified in Section 87707(a)(1)...in-service training received as specified in Section 87707(a)(2).This requirement is not met as evidence by: Based on LPA observations and file review S1 and S2 did not complete eight hours of dementia in-service training within their first 12 months of employment.

87355 Criminal Record Clearance (e) "All individuals subject to a criminal record review...(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..." This requirement is not met as evidenced by:Based on observations, interviews, and record review, S5 was working in the facility without being associated according to regulation guidelines. This poses a potential safety threat to residents in care.

(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). This requirement was not met as evidence by resident was noted as a fall risk and resident was left in wheelchair due to pain for over 24 hours. This poses an immediate risk to health and safety to persons in care.

87355 Criminal Record Clearance (3)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. This requirement is not met as evidende by:Based on observation and AD admission staff began working at the facility prior to having a Background Clearance.

In all facilities licensed for sixteen (16) persons or more, one or more employees shall be designated as having primary responsibility for assuring that each resident receives needed first aid and needed emergency medical services...staff. This requirement was not met as evidenced by: based on observation, interview and record review the licensee did not provide first aid to R3 when R3's injury was noted. This poses an immediate risk to the health and safety of residents in care.

Administrator Certfication Requirements: 87406 (g)(g) Certificates issued under this section shall be renewed every two (2) years provided the certificate holder has complied with all renewal requirements. This requirement was not met as evidenced by... Based on interview and review of Administrator Certificate for Administrator Melinda Flores, certificate #6033680740 expired on 1/8/2019. AD Flores verfied via telephone at 12:06pm indicating "I can't afford the $400 late renewal fee so haven't renewed it." This poses an immediate risk to residents in care.

Residents in all residential care facilities... shall have all of the following personal rights: To have their visitors...., permitted to visit privately during reasonable hours and without prior notice... This req is not being met as evidenced by: Based on interview conducted, facility failed to ensure facility residents were allowed visitation. Public health and department guidelines allow for visitation at the facility. This poses an immediate health and safety risk for residents in care.