Granite Bay Countryhouse Llc

87211 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... (D) Any incident which threatens the welfare, safety or health of any resident, such as psychological abuse of a resident by staff or other residents, or unexplained absence of any resident.This requirement is not met as evidenced by: Based on records reviewed, the facility did not ensure they notified CCLD of the mismangement of R1's medications within seven days, which poses a potential health, safety, and personal rights risk to the residents in care.

87466 Observation of the Resident The licensee shall ensure that residents are regularly observed for changes in physical, mental, emotional and social functioning and that appropriate assistance is provided... the licensee shall ensure that such changes are documented and brought to the attention of the resident's physician and the resident's responsible person, if any. This requirement is not met as evidenced by: Based on records review and interviews, facility staff did not monitor R1's feet which resulted in R1 being admitted to the hospital for septic shock and had a right lower extremity angioplasty and a right trans metatarsal amputation. This poses an immediate health and safety risk to residents in care.

87465 Incidental Medical and Dental Care (c)If the resident's physician . . . nonprescription PRN medication but can communicate his/her symptoms clearly,(2) Once ordered by the physician the medication is given according to the physician's directions. This requirement was not met as evidenced by R1's PRN medication begin given routinely at 7am 8/24 - 8/28/2023. This poses a direct threat to the health and safety of residents in care.

87468.1 Personal Rights of Residents in All Facilities (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. This requirement was not met as evidenced by R1's POA not being notified of 2 falls. This poses an indirect threat to the health and safety of residents in care.

87468.2 Additional Personal Rights of Residents in Privately Operated Facilities 19) To have prompt access to review all of their records and to purchase photocopies of their records. . . . (2) business days and at a cost that does not exceed the community standard for photocopies. This requirement was not met as evidenced by R1's repeated attempts to obtain R1's file while took approximately 4 weeks. This poses an indirect threat to the health and safety of residents in care.

Managed Incontinence(3) Ensuring that incontinent residents are kept clean and dry and that the facility remains free of odors from incontinence. This requirement was not met as evidenced by R1's incontinence needs not being met as evidenced by soiled bedding and clothings. This poses a direct threat to the health and safety of residents in care.

87468.2 Additional Personal Rights of Residents in Privately Operated Facilities (2) To have their records and personal information remain confidential and to approve their release, except as authorized by law. This requirement was not met as evidenced by R1's POA receiving paperwork for other residents (5). This poses an indirect threat to the health and safety of residents 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 R1's soiled incontinence products being left throughout the room. This poses an indirect threat to the health and safety of residents in care.

87466 Observation of the Resident The licensee shall ensure that residents are regularly observed for changes in physical, mental, emotional and social functioning and that appropriate assistance is provided when such observation reveals unmet needs. . . . This requirement was not met as evidenced by the facility not providing R1 with appropriate safety measures as a fall risk. This poses an immediate threat to the health and safety to residents in care.

87705 Care of Persons with Dementia(c) Licensees who accept and retain residents with dementia shall be responsible for ensuring the following:(4) There is an adequate number of direct care staff to support each resident’s physical, social, emotional, safety and health care needs as identified in his/her. . current appraisal. This requirement was not met as evidenced by R1's safety needs not being met which allowed them to sustain an unwitnessed falls with fractures. This poses an immediate threat to the health and safety to residents in care.

Based on observation, the licensee did not comply with the section cited above in 3 out of 6 water temperatures measuring above 120 degrees which poses an immediate health, safety or personal rights risk to persons in care.

87465(g) - Incidental medical and dental care services - The licensee shall immediately telephone 9-1-1 if an injury or other circumstance has resulted in an imminent threat to a resident’s health... This requirement is not met as evidenced by: Based on interviews and records review it was determined that R1 fell on 3/18/2022 and EMS was not contacted. R1 was not taken to the ER until 3/22/2022. R1 sustained bruising which poses an immediate health and safety risk to residents in care.

87705(c)(4) - Care of Persons with Dementia (c) Licensees who accept and retain residents with dementia shall be responsible for ensuring the following: (4) There is an adequate number of direct care staff to support each resident’s physical, social, emotional, safety and health care needs as identified in his/her current appraisal. This requirement is not met as evidenced by: Based on interviews conducted and record reviewed, the Licensee did not ensure that resident (R1) was supervised according to the care plan which posed an immediate health and safety risk to residents in care.

The licensee shall assist residents with self-administered medications as needed. This requirement is not met as evidence by: thru review of records and observation, it was learned that the facility did not have 2 medications for a resident that were ordered as a PRN (as needed) medication. If needed, they would not have been available

Facility personnel shall at all times be sufficient in numbers, and competent to provide the services necessary to meet resident needs...This requirement is not met as evidenced by:On 12/15/21 CCL staff witnessed 2 residents alone in the second floor dining area with no staff nearby. Both residents had food on the table. One resident was standing bent over the table and could potentially have fallen or choked on food with no staff nearby; the other could have potentially choked.

87465(a)(5)- Incidental Medical and Dental Care-The licensee shall assist residents with self-administered medications as needed. This requirement is not met as evidenced by: Based on observation and record review the licensee did not provide medication prescribed by physician which poses an immediate health and safety risk to residents in care.