Raya's Paradise of San Clemente

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 met as evidenced by: Based on records reviewed and interviews conducted, Licensee failed to ensure care and supervision was provided to R1. R1 sustained an unexplained fracture as well as pressure injury while in care which poses an immediate health and safety risk to residents in care. CIVIL PENALTY ASSESSED

Residents in all residential care facilities for the elderly shall have all of the following personal rights: To leave or depart the facility at any time and to not be locked into any room, building, or on facility premises by day or night...This requirement is not met as evidenced by: Based on interviews conducted, Licensee did not ensure R1 was allowed to leave the facility. Facility staff prohibited R1 from leaving the facility with visitors. This poses an immediate health and safety risk to residents in care.

Residents in all residential care facilities for the elderly shall have all of the following personal rights:To be accorded dignity in their personal relationships with staff, residents, and other persons. This req is not met as evidenced by: Based on record review and interviews conducted, Licensee failed to ensure R1 and R2 were provided dignity at the facility. Facility staff accessed resident’s bank accounts and spent the resident’s funds for personal use. This poses an immediate health and safety risk to residents in care. CIVIL PENALTY ASSESSED

The licensee..., shall exercise general supervision over the affairs of thelicensed facility.. concerning its operation in conformance with these regulations andthe welfare of the individuals it serves. This req is not met as evidenced by: Based on record review and interviews conducted, the licensee failed to ensure oversight was provided for facility operations resulting in multiple resident’s being financially abused and personal rights being violated.This poses an immediate health and safety risk to residents 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. This requirement is not met as evidenced by: Based on interviews conducted, Licensee failed to ensure that R1 was provided requested documents which poses a potential health and safety risk to residents in care.

The licensee shall comply with all applicable terms and conditions set forth in the admission agreement, including all modifications and attachments. This req is not met as evidenced by: Based on record review, Licensee failed to ensure admission agreement was followed. R1 and R2's room rate was increased after 1 year when admission agreement stated increases after 2 years. This poses a potential health and safety risk to residents in care.

In addition to the rights... residents in privately operated residential care facilities for the elderly shall have all of the following personal rights: To be free from... financial exploitation... humiliation, intimidation, and verbal, mental, physical, or sexual abuse. This req is not met as evidenced by: Based on record review and interviews conducted, Licensee failed to provide a refund to R1/ R2 which poses a potential health and safety risk to residents in care.

Prescription medications which are not taken with the resident upon termination of services.. or which are otherwise to be disposed of shall be destroyed in the facility by the facility administrator and one other adult who is not a resident. Both shall sign a record, to be retained for at least three years..This req is not met as evidenced by: Based on record review and interview, Licensee failed to ensure medication destruction is occurring with facility administrator and another adult and including two signatures. This poses a potential health and safety risk to residents in care.

Each licensee shall furnish to the licensing agency such reports as the Department may require, including, but not limited to, the following: Any incident which threatens the welfare, safety or health of any resident...This requirement is not met as evidenced by: Based on record review, Licensee failed to ensure incident regarding missing Morphine IN October 2024 was reported to the department. This poses a potential health and safety risk to residents in care.

The following requirements shall apply to medications which are centrally stored: 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 req is not met as evidenced by: Based on interviews conducted, Licensee failed to ensure R1's Morphine Sulfate was in a safe and locked place. The medication was inadvertently given to R2's family. This poses an immediate health and safety risk to resident's in care.

Every facility shall take appropriate measures to safeguard residents' cash resources, personal property and valuables which have been entrusted to the licensee or facility staff. The licensee shall give the residents receipts for all such articles or cash resources. Based on interviews conducted, Licensee failed to ensure R2's ring was safeguarded. R1 put R2's ring on and had to be cut off. Licensee did not compensate R2's family for the loss. This poses a potential health and safety risk to resident's in care.

A refund of any fees paid in advance covering the time after the resident’s personal property has been removed from the facility shall be issued to... to the resident’s estate, within 15 days after the personal property is removed. This req is not met as evidenced by: Based on record review, Licensee failed to ensure a refund was paid to R1's family within 15 days of R1's belongings being removed after death. This poses a potential health and safety risk to residents in care.

Based on observation, the licensee did not comply with the section cited above in one out of four residents (R8) without physician orders for bed rails which poses an immediate health, safety or personal rights risk to persons in care.

Based on observation, the licensee did not comply with the section cited above. Per LPA's file review, there is no updated LIC 308 designating a back up for Administrator Westphaln. During the visit, facility did not have a back up administrator and the department initially met with a third party vendor to obtain documents 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 three out of eight staff (S1-3) without first aid training which poses a potential health, safety or personal rights risk to persons in care.

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 evidenced by: Based on interviews conducted, Licensee failed to ensure R1 was provided care and supervision. R1 left the facility unattended to travel to another community. This poses an immediate health and safety risk to residents in care.

To have reasonable access to telephones, to both make and receive confidential calls. The licensee may require reimbursement for long distance calls. This requirement is not being met as evidenced by: Based on observation and interviews conducted, Licensee failed to ensure R1 had access to the resident's phone. Staff removed the resident's phone and LPA observed blocked family member's number on phone. This poses an immediate health and safety risk to resident's in care.

Except as provided in approved continuing care agreements, no licensee or employee of a facility shall: accept any general or special power of attorney for any such person; This req is not being met as evidenced by: Based on record review and interview, Licensee failed to ensure an employee of the facility was not designated as a power of attorney for R1. This poses an immediate health and safety risk to residents in care.