Grateful Heart Home Care Inc

(a) The use of alternate concepts, programs, services, procedures, techniques, equipment, space....(2) A written request for a waiver or exception and substantiating evidence supporting the request shall be submitted in advance to the licensing agency... Based on observation, the licensee did not comply with the section cited above by not ensuring a waiver request for video survelliance in private resident rooms was submitted to licensing department, which poses an immediate health, safety, and personal rights risk to persons in care.

Based on observation and record review, the licensee did not comply with the section cited above by not ensuring residents Medication Administration Record (MAR) are dated and signed, 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 by not ensuring residents medication are stored in original container and not transferred to different containers, which poses an immediate health, safety or personal rights risk to persons in care.

Based on observation and record review, the licensee did not comply with the section cited above in 5 out of the 5 residents medications were transferred between containers which poses an immediate health, safety or personal rights risk to persons in care.

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... The facility failed to meet the reporting requirement regarding R1's fall on 10/14/2021 and subsequent death within the regulatory time frame.

To be free from neglect, financial exploitation, involuntary seclusion, punishment, humiliation, intimidation, and verbal, mental, physical, or sexual abuse. The facility did not meet this requirement as evidenced by facility staff failing to seek immediate medical treatment by calling 911 for R1’s head injury from an unwitnessed fall on 10/21/2021. This poses a risk to the health and safety of residents in care.

Based on LPA tour of the facility, the licensee did not comply with the section cited above. LPA Is unable to access a portioned off locked space of the garage which poses an immediate health, safety or personal rights risk to persons in care.

Based on review of associated criminal record clearancese licensee did not comply with the section cited above in 2 out of 2 staff working on this day do not have a criminal record clearance associated to this facility number. This poses an immediate health, safety or personal rights risk to persons in care.