Belmont Village Aliso Viejo

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 req is not met as evidenced by: Based on interviews conducted and record review, Licensee failed to ensure care and supervision was provided to R1. R1 had 14 falls within a five month period which poses an immediate health and safety risk to residents in care. CIVIL PENALTY ASSESSED

Based on LPA observation, a bottle of acetaminophen was found in a resident 1's medicine cabinet. The physician's report for this resident stated resident cannot self administer PRN medication which poses an immediate health and safety risk to persons in care.

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. Photocopied records shall be promptly provided, not to exceed two business days..This req is not being met as evidenced by: Based on records reviewed, Licensee failed to submit requested documents to resident's agent. This poses a potential health and safety risk to residents in care.

Basic services shall at a minimum include:Care and supervision as defined in Section 87101(c)(3) and Health and Safety Codesection 1569.2(c). This requirement is not being met as evidenced by: Based on record review, Licensee failed to ensure care was being provided to R1. Per hospice documentation, R1's oxygen was turned off on two different occasions when hospice arrived. R1 was prescribed continuous oxygen. This poses an immediate health and safety risk to residents in care.

Basic services shall at a minimum include:Personal assistance and care as needed by the resident..., with those activities of daily living such as dressing, eating, bathing and assistance with taking prescribed medications..This req is not being met as evidenced by: Based on records reviewed, Licensee failed to ensure R1 was being assisted with medication assistance. Per hospice documentation, resident was not receiving prescribed pain management at end of life. This poses an immediate health and safety risk to residents in care.

In addition to the rights listed in Section 87468.1, residents in.. residential care facilities for the elderly shall have all of the following personal rights: To have a reasonable level of personal privacy....This requirement is not being met as evidenced by:. Based on observation, Licensee failed to ensure residents are afforded privacy. Facility is in the "Safely You" program and is not fulfilling guidelines for the program. Facility does not have video surveillance signage posted nor all consents required. LPA observed 24/27 consents. This poses a potential health and safety risk.

Basic services shall at a minimum include:Care and supervision as defined in Section 87101(c)(3) and Health and Safety Codesection 1569.2(c). This requirement is not being met as evidenced by: Based on interviews conducted, Licensee failed to ensure R1 was provided care and supervision. R1 eloped out of the facility and staff were unaware the resident was gone. This poses an immediate health and safety risk to residents in care. CIVIL PENALTY ASSESSED.

Basic services shall at a minimum include:Care and supervision as defined in Section 87101(c)(3) and Health and Safety Codesection 1569.2(c). This req is not being met as evidenced by: Based on observation and interview, Licensee failed to ensure care and supervision was provided to R1 and R2. R1 received no medication on June 7, 2022 and R2 received R1's medications. This poses an immediate health and safety risk to residents in care.

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... assistance with taking prescribed medications...This req is not being met as evidenced by: Per interviews conducted, Licensee failed to ensure medication assistance was provided to R1. R1 was at the facility for four days and did not receive medication. Physician report dated 01/10/2022 indicates R1 is unable to manage medications. This poses an immediate health ansd safety risk to residents in care.

The department may deny an application for a license or may suspend or revoke a license...(3) Conduct that is inimical to the health, morals, welfare, or safety of either an individual in or receiving services from the facility or the people of the State of California. This poses an immediate health and safety risk to residents in care.

Basic services shall at a minimum include:Care and supervision as defined in Section 87101(c)(3) and Health and Safety Codesection 1569.2(c). This requirement is not being met as evidenced by: Based on interview, Licensee failed to ensure care and supervision was provided to R2. R2 took a large amount of Tramadol. Tramadol was located in the resident's room. Physician report dated 08/30/2019 indicates R2 is unable to manage meds. This poses an immediate health risk to residents in care.

Basic services shall at a minimum include: Care and supervision as defined in Section 87101(c)(3) and Health and Safety Codesection 1569.2(c). This requirement is not being met as evidenced by: Based on observation and interview, Licensee failed to ensure care and supervision was provided to R1. R1 was inadvertently given seven medications belonging to another resident. R1 was hospitalized for observation. This poses an immediate health and safety risk to residents in care.

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:Request a transfer of a criminal record clearance as specified in Section 87355(c). This requirement is not being met as evidened by: Based on observation, Licensee failed to ensure S1's criminal clearance was transferred to the facility. This poses an immediate health and safety risk to residents in care.