Fountain Valley Senior Homes

Maintenance and Operation-87303(a): (a) The facility shall be clean, safe, sanitary and in good repair at all times...This requirement is not met as evidenced by, during today's inspection tour LPA Quiroz observed trash/crumbs underneath and on recliner couches. LPA Quiroz observed loose case on lower part of dishwasher and tape on top areas of dishwasher in kitchen area. This was verified by CG1 and L/AD Almiranez. L'AD Almiranez indicated "I will call and have it repaired."This poses a potential risk to residents in care.

Maintenance and Operation 87303(a)(1): (a)The facility shall be clean, safe, sanitary and in good repair at all times. Maintenance shall include provision of maintenance services...(1)Floor surfaces in bath, laundry and kitchen areas shall be maintained in a clean, sanitary, and odorless condition. CONTINUED BELOW This requirement was not met as evidenced by: On or about 10:01am-10:12am, while conducting inspection tour of kitchen area and living-room area, LPA Quiroz observed unkept floor not kept free of debris, dust, dirt, what appeared to be pet hair, and what appeared to be food particles in between couches, on couches, and between... CONT

Care of persons with Dementia: 87705(f)(2):(f)The following shall be stored inaccessible to residents with dementia:(2) Over-the-counter medication, nutritional supplements or vitamins...This requirement was not met as evidenced by:At 9:50am, LPA Quiroz observed... CONT BELOW... cabinet between kitchen and livingroom area opened. LPA Quiroz inquired what was stored in that cabinet. Caregiver Caniga indicated "Oh the medications but it's supposed to be locked." This was verified with Caregiver Caniga at 9:50am. This poses an immediate risk to residents in care.

87211(a)(2)Reporting Requirements:(a)Each licensee shall furnish to the licensing agency such reports...(2)Occurrences, such as epidemic outbreaks...shall be reported within 24 hours either by telephone or facsimile to the licensing agency and to the local health officer when appropriate. CONTINUED BELOW This requirement was not met as evidenced by:3 of 3 interviewees indicated "There was Covid few weeks ago," LPA Quiroz reviewed COVID-19 share-point and COVID FAS entries, and verified there were no reported COVID-19 entries from this facility sinceCONTINUED...

Incidental Medical and Dental Care (87465)(h)(2): Centrally stored medicines shall be kept in a safe and locked place that is not accessible to persons other than employees responsible for the supervision of the centrally stored medication. This requirement was not met as evidence by: At 9:39am, LPA Quiroz observed R1's Humulin N Kwin pen insulin suspension unlocked being stored on second shelf on side of refrigerator. This poses an immediate risk for residents in care.

Maintenance & Operation 87303(a):The facility shall be clean,safe,sanitary and in good repair at all times...for the safety and well-being of residents, employees and visitors. This requirement was not met as evidenced by: At 9:10am, LPA Quiroz observed broken/ripped screen door leading to patio and R2's bedroom, spider webs throughout facility, mold on 2 shower curtain, dust on top of refrigerator and in pantry, unlocked disinfectants, broken lock where disinfectants are stored and hole on garage door leading to garage area. This poses a potential risk for residents in care.

Care of Persons with Dementia (5): Each resident with dementia shall have an annual medical assessment as specified in Section 87458,...reappraisal done at least annually, both of which shall include a reassessment of the resident’s dementia care needs.This requirement was not met as evidence by: During today's visit, at 10:50am, LPA Quiroz observed R2's last physician report was completed on 2/22/2019. This poses a potential risk for residents in care.