Blue Sky Manor Inc

Accountability of Licensee Governing Body 87205 (a) The licensee, whether an individual or other entity, shall exercise general supervision over the affairs of the licensed facility… This requirement was not met as evidence by licensee did not exercise general supervision over the financial affairs of the facility in a manner consistent with the facility’s operation and the welfare of residents in care, as required by Section 87205(a), Accountability of Licensee Governing Body which poses a potential Health, Safety, and/or Personal Rights risk to persons in care.

87208 Plan of Operation (a) "The licensee shall have and maintain a current, written definitive plan of operation for the facility. The licensee shall operate the facility in accordance with the terms specified in the plan of operation and may be cited for not doing so..."This requirement was not met as evidenced by: Based on interviews and record review, the facility is/did not comply with the section cited above by not adhering to the plan of operation approved by Department which poses a potential Health, Safety, or Personal Rights risk to persons in care.

87506 Resident Records (a) The licensee shall ensure that a separate, complete, and current record is maintained for each resident in the facility or in a central administrative location readily available to facility staff and to licensing agency staff.This requirement is not met as evidenced by: Based on observation, interview, and record review, facility did not maintain complete records in three out of three residents which poses a potential Personal Rights risk to persons in care.

87224 Eviction Procedures (a)-(i)This requirement was not met as evidenced by: Based on the interviews and record review, facility did not issue valid eviction notices to STPHH residents which poses a potential Health, Safety, and/or Personal Rights risk to persons in care.

87468.1 Personal Rights … (a) … (1) To be accorded dignity in their personal relationships with staff, residents, and other persons. This requirement was not met as evidenced by: Based on interviews, the licensee did not ensure a resident was accorded dignity when S1 attempted to put a banana into a resident’s mouth against their will when they were having respiratory issues, which poses an immediate personal rights risk to persons in care.

87555 General Food Service Requirements (b) … (17) In facilities licensed for fifty (50) or more, and providing three (3) meals per day, a full-time employee qualified by formal training or experience shall be responsible for the operation of the food service… This requirement was not met as evidenced by: Based on interviews, the licensee did not ensure the facility had a full-time chef for over a month, which poses a potential health risk to persons in care.

Based on documents, the facility does not have an Infection Control Plan, which poses a potential health risk to persons in care.

Based on documents, the licensee did not ensure the files of S1, S2, S4, and S5 contained documentation of the required number of hours and topics of annual training, which poses a potential health risk to persons in care.

Based on documents, the licensee's last emergency disaster drill was almost 4 months ago (not quarterly) and only involved 2 out of 3 shifts, which poses a potential safety risk to persons in care.

87465 Incidental Medical and Dental Care (c)(2) Once ordered by the physician the medication is given according to the physician's directions.This requirement was not met as evidenced by: Based on observations and review of records, two out of the five residents did not receive one medication as prescribed during the month of February 2024 which poses an immediate Health risk to persons in care.

87555 General food Service Requirements (b) The following food service requirements shall apply: (8) All food shall be of good quality.This requirement was not met as evidenced by: Based on interviews, facility did not provide adequate food service when food was prepared by S1 which poses a potential Personal Rights risk to persons in care.

87464 Basic Services … (f) Basic services shall at a minimum include: (1) Care and supervision... This requirement was not met as evidenced by: Based on observation and interviews, the licensee did not ensure 1 out of 7 residents received care and supervision when their hygiene needs were not met, which poses an immediate health risk to persons in care.

87555 General Food Service Requirements … (b) … (5) Meals shall consist of an appropriate variety of foods and shall be planned with consideration for … food habits of residents. This requirement was not met as evidenced by: Based on interviews, the licensee did not ensure an appropriate variety of food when the food served was too often a sandwich or otherwise cold, which poses a potential personal rights risk to persons in care.

Incidental Medical and Dental Care. 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 were given according to physician's orders. R1 was not administered 5 medications on 10 different days. This poses an immediate risk to the health & safety of residents in care.

87218 Theft and Loss (a) The licensee shall ensure an adequate theft and loss program as specified in Health and Safety Code Section 1569.153. (2) A licensee who fails to make reasonable efforts to safeguard resident property, shall reimburse a resident for or replace stolen or lost resident property at its current value. The licensee shall be presumed to have made reasonable efforts to safeguard resident property if there is clear and convincing evidence of efforts to meet each requirement specified in Section 1569.153. This requirement is not met as evidenced by:Based on interviews, three of four individuals confirmed the meat was stolen which poses a potential Health, Safety, or Personal Rights risk to persons in care.

87355 Criminal Record Clearance (e) 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: (2) Request a transfer of a criminal record clearance as specified in Section 87355(c) This requirement is not met as evidenced by: Based on observations, interviews, and record review, two of two staff were not associated prior to working at the facility which poses an immediate Health, Safety, or Personal Rights risk to persons 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 evidenced by: Based on observations and interviews, the licensee did not prevent insects from getting into the facility and causing an infestation, which poses a potential personal rights and safety risk to residents in care.