Queens Home 3

Based on observations and records reviewed the Licensee did not comply with the cited as R9 had full bed rails and is not on hospice. This poses an immediate health and safety risk to persons in care.

Based on records reviewed Licensee did not comply with the cited above in 5 out of 6 staff files reviewed. 6 staff file reviewd was Administrators. The staff training did not include times of trainings provided and the topics of restricted health conditions and postural supports were not covered. This poses a potential health and safety risk to persons in care.

Based on observations made the licnesee did not comply with the cited above in 1 out of 5 bathrooms. The water temperature measured at 133.5 in staff bathroom which poses an immediate health and safety risk to persons in care.

Based on observations and records reviewed the licensee did not comply with the cited above in 1 out of 12 residents. R9 did not have an updated medical assessment. This poses an immediate health and safety risk to persons in care.

Based on observations made licensee did not comply with the cited above as there were expired seasonings in Unit A. This poses a potential risk to persons in care.

87207 False ClaimsNo licensee, officer or employee of a licensee shall make or disseminate any false or misleading statement regarding the facility or any of the services provided by the facility.This requirement is not being met as evidenced by: Three staff members, including AD, admitted to making false claims to the department during the course of a complaint investigation. This a potential threat to the health, safety, and personal rights of residents

Reporting Requirements(a) Each licensee shall furnish to the licensing agency such reports as the Department may require, including, but not limited to, the following:(1) A written report shall be submitted to the licensing agency and to the person responsible for the resident within seven days of the occurrence of any of the events specified in (A) through (D) below. This report shall include the resident's name, age, sex and date of admission; date and nature of event; attending physician's name, findings, and treatment, if any; and disposition of the case.This requirement was not met as evidenced by: The facility failed to accurately report R1’s falls and injuries to R1’s responsible person. The facility also failed to accurately report R1’s fall and injuries to the department. The incident report with no date contains false information and there’s no incident report for R1 from Queens Home 3 in the departments data base for all incident and death reports.This poses a potential threat to the health, safety, and personal rights of residents

Basic Services(f) Basic services shall at a minimum include:(1) Care and supervision as defined in Section 87101(c)(3) and Health and Safety Code section 1569.2(c).Health and Safety Code section 1569.2(c) provides:(c) "Care and supervision" means the facility assumes responsibility for, or provides or promises to provide in the future, ongoing assistance with activities of daily living without which the resident’s physical health, mental health, safety, or welfare would be endangered. Assistance includes assistance with.., or personal care.This requirement was not met as evidenced by: Three staff members including Licensee Maghbouleh, confirmed R1 was left unattended, resulting in the resident falling and sustaining skin tears to both arms and bruising to the forehead. This poses a threat to the health, safety, and personal rights of residents in care.

Personal Rights of Residents in All Facilities(a) Residents in all residential care facilities for the elderly shall have all of the following Personal Rights:(1) To be accorded dignity in their personal relationships with staff, residents, and other persons.This requirement was not met as evidenced by: On April 14, 2024, a caregiver was recorded on video handling R1 in a rough manner. While being changed, R1 was carelessly flipped over by one of the caregivers. Multiple individuals, including Licensee Maghbouleh confirmed the now former caregiver’s actions captured on video. This poses a threat to the health, safety, and personal rights of residents in care.

1569.269(a) Residents of residential care facilities for the elderly shall have all of the following rights: (21) 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, at a cost not to exceed the community standard for photocopies.The licensee did not comply with the section cited above because the investigation revealed, the facility exceeded two days to get the requested documents sent out.