Pacific Vista Senior Living

Maintain separate complete record for each resident

Based on record review, the licensee did not comply with the section cited above in 3 out of 6 residents which poses/posed a potential health, safety or personal rights risk to persons in care.

Document each PRN medication dose taken

Based on observation, record review, the licensee did not comply with the section cited above in 4 out of 4 MAR records which poses/posed a potential health, safety or personal rights risk to persons in care.

Maintain facilities for fire and panic safety

Fire Safety: All facilities shall be maintained in conformity with the regulations adopted by the State Fire Marshal for the protection of life and property against fire and panic. This requirement was not met as evidenced by: LPA observed Fire Extinguishers mounted on the wall were last serviced on 07/24/2017. This poses an immediate Health & Safety risk to the residents in care.

Postural Supports: (a) Based on the individual's preadmission appraisal, and subsequent changes...Postural supports may be used under the following conditions. (5) Under no circumstances shall postural supports...(A) A bed rail that extends from the head half the length of the bed and... (B) Bed rails that extend the entire length of the bed are prohibited except for residents who are currently receiving hospice care...This requirement was not met as evidenced by: Based on LPA’s observation, AD did not comply with the section cited in that R1’s bed has 3 half bed rails tied

Onsite food stock levels for nonperishables and perishables

General Food Service Requirements: Supplies of nonperishable foods for a minimum of one week and perishable foods for a minimum of two days shall be maintained on the premises. This requirement was not met at evidenced by: Based on LPA’s observation on 11/21/24 and 12/10/24, Licensee did not comply with the section cited in that there was not enough non-perishable and perishable food supply to sustain 7 days with 6 residents.

Store centrally held medications in locked secure place

Incidental Medical and Dental Care Services. Centrally stored medications shall be kept in a safe locked place that is not accessible to persons other than employees responsible for the supervision of the medication. This requirement is not being met as evidenced by: Licensee failed to ensure medications are inaccessible to residents in care. On 11/21/24 & 12/10/24 & 12/13/2024, LPA observed Ziploc bag with 6 bottles of vitamins in kitchen refrigerator. This poses an immediate health and safety risk to residents in care.

Infection control plan required in operations plan

Based on observation and interview, the licensee did not comply with the section cited above in 1 out of 1 time which poses/posed a potential health, safety or personal rights risk to persons in care.

Based on observation the licensee did not comply with the section cited above in 1 out of 1 times 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 3 out of 3 persons which poses an immediate health, safety or personal rights risk to persons in care.

Based on observation and interviews, the licensee did not comply with the section cited above in 1 out o 1 time which poses an immediate health, safety or personal rights risk to persons in care.

Based on observation and interview, the licensee did not comply with the section cited above in [1 out of 1 times which poses/posed a potential health, safety or personal rights risk to persons in care.

Address and clearance obligations before facility work

Based on observation, interview and record review, the licensee did not comply with the section cited above in 1 out of 1 time as S1 does not have proper fingerprint clearance, which poses an immediate health, safety or personal rights risk to persons in care.

Allow licensing inspection and controlled record removal

Based on observation and interview, the licensee did not comply with the section cited above in 6 out of 6 times as LPA requested to review a total of 6 files, which poses/posed a potential health, safety or personal rights risk to persons in care.

87456 Evaluation of Suitability for Admission (a)(1-3) Prior to accepting a resident for care and in order to evaluate his/her suitability, the facility shall, as specified in this article 8: (1) Conduct an interview with the applicant and his responsible person. (2) Perform a pre- admission appraisal. (3) Obtain and evaluate a recent medical assessment. This requirement is not met as evidenced by: The licensee failed to conduct an evaluation for R1, 1 time. This posed a potential health, safety and personal rights risk to persons in care.

Safe, healthful, comfortable accommodations

87468.1 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: (2) To be accorded safe, healthful and comfortable accommodations, furnishings and equipment. This requirement was not met as evidenced by: Based on interviews and record review, facility staff did not clear out dirty dishes and full trash bin after assistance was requested on 06/10/22. This posed a potential health, safety or personal rights risk to R1.

Dignity in personal relationships

87468.1 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: Based on interviews and records review, the licensee saved R1’s name as “evil” in their phone, & sent R1 text messages about being evil. This posed an immediate personal rights risk to R1.

Assist residents with self-administered medication

87465 Incidental Medical and Dental Care (a) A plan for incidental medical and dental care shall be developed by each facility. The plan shall encourage routine medical and dental care and provide for assistance in obtaining such care, by compliance with the following: (4) The licensee shall assist residents with self-administered medications as needed. This requirment was not met as evidenced by: Based on interviews and record review, facility staff did not assist R1 with two medications on 06/10/22. This poses an immediate health, saftey or personal rights risk to residents in care.

Protection from punishment and intimidation

87468.1 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: (3) To be free from punishment, humiliation, intimidation, abuse, or other actions of a punitive nature. This requirement was not met as evidenced by: Based on interviews and record review, facility staff refused to provide basic services to R1. Text messages also revealed R1 was sent texts threatening eviction and facility closure.This posed an immediate personal rights, health or saftey risk to R1.

87307 Personal Accommodations and Services (a) Living accommodations... The following provisions shall apply: (3) Equipment and supplies necessary for personal care and maintenance of adequate hygiene practice shall be readily available to each resident. This requirment was not met as evidenced by: Based on interviews and record review, the facility staff did not provide a clean commode and toilet paper/wipes on 06/10/22 to R1. This posed an immediate personal rights or health or safety risk to R1.

Admit resident care meeting requirements

87467 Resident Participation in Decisionmaking (a)... within two weeks of the resident’s admission, the licensee shall arrange a meeting with the resident, the resident’s representative... and any other appropriate parties, to prepare a written record of the care the resident... regarding the services provided at the facility. This requirement was not met as evidenced by: Based on interview and records review it was found that the licensee did not ensure a written record of care was completed. This poses a potential health, safety, or personal rights risk for residents in care.

Admission agreement signing and dating deadline

87507 Admission Agreements (c) Admission agreements shall be signed and dated, acknowledging the contents of the document, by the resident or the resident’s representative, if any, and the licensee or the licensee’s designated representative no later than seven days following admission. This requirement was not met as evidenced by: Based on interview and records review it was found that the licensee did not ensure the admission agreement signed within the required time frame. This poses a potential health, safety, or personal rights risk for residents in care.

87555 General Food Service Requirements (b) The following food service requirements shall apply: (1) Where all food is provided by the facility arrangements shall be made so that each resident has…daily food needs are met. Not more than fifteen (15) hours shall elapse between the third and first meal.” This requirement was not met as evidenced by: Based on interviews and records reviewed: facility staff did not provide food to a resident from 9pm on 6/9/2022 to 1pm on 06/10/22. This posed an immediate health and safety, or personal rights risk to R1.

Submit and maintain current mailing address

"87355 Criminal Record Clearance (e) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1569.17(b) shall prior to working, residing or volunteering in a licensed facility: (1) Obtain a California clearance or a criminal record exemption as required by the Department ..." This requirment was not met as evidenced by:Staff and resident interview confiming employee is working at the facility and is not fingerprinted. This is an immediate personal rights, health or safety risk.

(e) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1522 shall prior to working, residing or volunteering in a licensed facility:80019 Criminal Record Clearance (1) Obtain a California clearance or a criminal record exemption as required by the Department LPA conducted record review and found that S1 was not associated and did not possess a background clerance.

87224 Eviction Procedures(f) A written report of any eviction shall be sent to the licensing agency within five (5) days. Based on record review and interview, Licensee did not submit the 30-day evicit to the department.

Grounds for eviction listed for residents

87224 Eviction Procedures (a) The licensee may evict a resident for one or more of the reasons listed in Section 87224(a)(1) through (5). Thirty (30) days written notice to the resident is required except as otherwise specified in paragraph (5) LPA reviewed 30-day eviction given to resident and observed that the eviction did not cite a reasoing detailed in Title 22.

Store centrally held medications in locked secure place

Based on observation the licensee failed to maintain medicines in a locked place that is not accessible to persons other than employees. The medication closet was not locked at time of inspection. In addition, the LPA observed medications belonging to staff stored in the kitchen pantry, which was not locked.