The Cottages at Artesia Anaheim

1569.625(b)(2) Staff TrainingTraining requirements shall also include an additional 20 hours annually... This training shall be administered on the job, or in a classroom setting, or both, and may include online training. This requirement was not met as evidence by: Upon interviews and records reviewed, it was revealed that S1 and S2 were passing medications to residents with expired trainings. This poses a potential health safety and personal rights risk to residents in care.

Care Of Persons With Dementia 87705(e)(5) Facility staff shall ensure the continued safety of residents if they wander away from the facility...This requirement is not met as evidence by: Licensee did not ensure supervision of resident with continued safety when wandering from the facility. This poses an immediate health and safety risk to persons in care.

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: Based on interviews and record review the licensee did not assist in appropriate medical arrangements for R1 even though staff observed the injured arm at 8:00am resulting in R1 being taken to the hospital by their responsible party with an admission time of 3:41pm.

Basic Services 87464(f)(1)Care and supervisionThis requirement was not met as evidence by: Based on interviews and record review the licensee did not ensure R1 had care and supervision resulting in a hospital visit due to pain, weakness and redness on their arm even though 2 of 4 staff stated they observed the injured arm.

Basic Services 87464(f)(1) Basic services shall at a minimum include: Care and supervision This requirement is not met as evidence by: The licensee did not ensure staff were changing R1's socks resulting in R1 developing a stage 2 ulcer that was not observed or treated timely. Based on interview and R1 physicians report, R1 required assistance with dressing. This poses a potential risk to resident's health and safety in care.

Personal Rights of Residents in All Facilities 87468.1(a)(8)To have their representatives regularly informed by the licensee of activities related to care or services, including ongoing evaluations, as appropriate to their needs.The requirement is not met as evidence by: Based on interview and record review the licensee did not comply with the section cited above due to the responsible party not being informed of the resident's medical needs. This poses a potential risk to resident's health and safety in care.

Based on observation, the licensee did not comply with the section cited above due to the refrigerator reading at 48 degrees Fahrenheit which poses a potential health, safety or personal rights risk to persons in care.

87465(c) Incidental Medical and Dental Care (2) Once ordered by the physician the medication is given according to the physician's directions.This requirement is not met as evidence by: Based on interview and file review administrator did not ensure that S1 gave R1 the correct medication. This poses an immediate health and safety 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 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. Medication audit revealed medications are not being administered per physician order. This poses an immediate health and safety risk to residents in care.

Based on the individual's preadmission appraisal.. Postural supports may be used under the following condition: A written order from a physician indicating the need for the postural support shall be maintained in the resident’s record. This req is not being met as evidenced by: Based on record review, Licensee failed to ensure there is a written physician order for half rails for R1. 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 due to a tray of desserts being uncovered in the refrigerator at the time of inspection which poses a potential health risk to persons in care.

Based on observation, the licensee did not comply with the section cited above due to the signal system console not being plugged in at the time of inspection which posed a potential safety risk to persons in care.

Per CCR 87303(i)(1)(A) regarding Maintenance and Operations: "Facilities shall have signal systems which shall meet the following criteria: (A) Operate from each resident's living unit."This requirement is not met as evidenced by: Based on interviews and observation conducted, the signal system was found to be either inaccessible or non-operational due to the absence of a pull cord in multiple units, constituting a potential risk to the health and safety of residents in care.

Per CCR Section 87705(f)(1) on the Care of Persons with Dementia: "The following shall be stored inaccessible to residents with dementia: (1) Knives, (...), tools and other items that could constitute a danger to the resident(s)". This requirement is not met as evidenced by: Based on observations made during the visit, two pairs of scissors are observed to be freely accessible in an unlocked drawer. This constitutes an immediate risk to the health, safety and personal rights of individuals in care.

Based on observation, interview and record review, licensee did not comply with the section cited above to lock other items that could constitute a danger to the resident(s) which could post a danger. LPA observed, boxes of needles in a bag next to the resident’s bed. Staff on duty removed bag of needles and placed it in the medication room. Threat reduced. This poses an immediate health, safety or personal rights risk to persons in care.