Pacifica Senior Living South Coast

Incidental Medical and Dental Care 87465(a)(1) The licensee shall arrange, or assist in arranging, for medical and dental care appropriate to the conditions and needs of residents. This requirement was not met as evidence by: The Licensee did not follow up with R1’s primary care physician as instructed per hospital discharge paperwork following R1’s fall on 5/26/25. This poses an immediate risk to resident’s health and safety.

Reappraisals 87463(c)(3)… the licensee shall document all of the following in the resident’s reappraisal: Interventions to be implemented to minimize the risks to the health and safety of the resident or others associated with the resident's behavioral expression… This requirement is not met as evidence by:The Licensee failed to document interventions to be implemented to minimize falls after identifying R1 as a fall risk. This poses a potential risk to resident’s health and safety.

Basic Services 87464(f)(1)Basic services shall at a minimum include: Care and supervision as defined in Section 87101(c)(3) and Health and Safety Code section 1569.2(c). This requirement is not met as evidence by: The Licensee failed to identify fall preventative measures needed to meet R1’s needs resulting in R1 sustaining a second fall with closed fracture diagnosis. This poses an immediate risk to resident’s health and safety.

87507(f) Admission AgreementsThe licensee shall comply with all applicable terms and conditions set forth in the admission agreement, including all modifications and attachments.The requirement is not met as evidenced by: The facility did not adhere to a 90 day rate increase notice as indicated in R1's admission agreement which poses a potential personal rights risk to persons in care.

Based on record review, the licensee did not comply with the section cited above in 3 out of 5 staff files which poses/posed 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 2 out of 2 caregiver files which poses/posed a potential health, safety or personal rights risk to persons in care.

Maintenance and Operation. Water supplies and plumbing fixtures shall be maintained as follows: Toilet, handwashing and bathing facilities shall be maintained in operating condition. This requirement was not met as evidenced by: based on record review and interview the Licensee did not ensure the toilets were properly maintained. This poses a potential risk to the health & safety of residents in care.

Termination of admission agreement upon death of resident; removal of resident’s property; refund of fees paid; notice of contract termination and refunds...removed. This requirement is not met as evidenced by: based on resident record review and interviews conducted, the Licensee failed to provide a refund of monies due R1’s family. This poses a potential risk to the health and safety of residents in care.

Incidental Medical and Dental Care. The licensee shall immediately telephone 9-1-1 if an injury or other circumstance has resulted in an imminent threat to a resident’s health...specified in Sections 87469...or (c)(4). This requirement is not met as evidenced by: based on resident record review & interviews conducted the licensee failed to call 911 following R1’s unwitnessed fall on 04/10/2022. This poses an immediate risk to the health & safety of residents in care.

Observation of the Resident. The Licensee to ensure that residents are regularly observed for changes in physical, mental, emotional and social functioning and that appropriate assistance is provided when such observation reveals unmet needs. This requirement is not met as evidenced by: based on resident record review & interviews conducted the licensee failed to observe R1’s change in condition following the unwitnessed fall on 04/10/2022.

Reporting Requirements. Each Licensee shall furnish...reports as the Department may require...the following: A written report shall be submitted to the licensing agency and to the person responsible for the resident seven days of the occurrence of...events specified in (A)...below. This requirement is not met as evidenced by: based on resident record review & interviews conducted the Licensee failed to submit an Incident & Death Report to Licensing for R1. This poses a potential risk to the health and safety of the residents in care.

Enumerated rights; severability. Residents of residential care facilities for the elderly shall have all of the following rights: To have prompt access to review all of their records and to purchase photocopies...records shall be promptly provided, not to exceed two business days. This requirement is not met as evidenced by the Licensee's failure to provide R1's records to their legal representative. This poses a potential risk to the health & safety of residents in care.

Incidental Medical and Dental Care. If the resident's physician... provided all of the following requirements are met: Once ordered by the physician the medication is given according to the physician's directions. This requirement is not met as evidenced by: based on record review and interview the Licensee did not ensure the medications for R1 and R2 were given according to physician's orders. This poses an immediate risk to the health & safety of residents in care.

Maintenance and Operation. The facility shall be clean, safe, sanitary and in good repair at all times. This requirement was not met as evidenced by: based on interview and record review the facility did not ensure the furnace and AC units were in operating condition. This poses a potential risk to the health and safety of residents in care.

Based on observation, the licensee did not comply with the section cited above in 3 out of 10 bathrooms where the hot water temperature exceed 120 degrees F which poses an immediate health, safety or personal rights risk to persons in care.