Follow-up·November 6, 2024

Citations

19 citations recorded^*CCLD

• 87411(g)(2)Type B

  General (g) Prior to employment or initial presence in the facility, all employees and volunteers subject to a criminal record review shall (2) Request a transfer of a criminal record clearance as specified in Section 87355(c)...This requirement was not met as evidenced by: Based on interview with Staff #2 (S2), LPAs Brown and Allen determined that the Licensee did not ensure that Staff #3 (S3) criminal background clearance was transferred to the facility prior to employment which poses a potential and personal rights risks to residents in care.

• 87412(a)(11)Type A

  87412 Personnel Records (a) The licensee shall ensure that personnel records are maintained on the licensee, administrator and each employee. Each personnel record shall contain the following information: (11) A health screening as specified in Section 87411, Personnel Requirements - General.this requirement is not met as evidenced by... Based on observation interview and record review the licessee did not comply with the cited section above by not ensuring that staff 4,3,and 5 have the required health screening report maintained in s3,s4 and s5 files which poses an immediate health,saftey ,and personal rights risk to residents in care.

• 87412(a)(12)Type A

  87412 Personnel Records (a) The licensee shall ensure that personnel records are maintained on the licensee, administrator and each employee. Each personnel record shall contain the following information: (12) Hazardous health conditions documents as specified in Section 87411, Personnel Requirements - General .this requirement is not met as evidenced by Based on observation interview and record review the licessee did not comply with the cited section above by not ensuring that staff 4,3,and 5 have the required Tuberculousis (TB) test and TB test results maintained in s3,s4 and s5 files which poses an immediate health,saftey ,and personal rights risk to residents in care.

• 87457(a)(1)Type B

  (a) Prior to admission, the prospective resident and his/her responsible person, if any, shall be interviewed by the licensee or the employee responsible for facility admissions. (1) Sufficient information about the facility and its services shall be provided to enable all persons involved in the placement to make an informed decision regarding admission. LPAs Brown and Allen observed that R3 does not have the required Preplacement Appraisal as evidenced of incomplete Preplacement Appraisal (LIC603) in R3 file.

• 87468.2(20)Type B

  (a) In addition to the rights listed in Section 87468.1, Personal Rights of Residents in All Facilities, residents in privately operated residential care facilities for the elderly shall have all of the following personal rights:(20) To be protected from involuntary transfers, discharges, and evictions. A licensee shall not involuntarily transfer .... This requirement was not met as evidenced by: Per Licensee/Administrator Armstrong and Resident #5 (R5) responsible party stated written notice of transfer was not given to them only verbal notification which poses a potential health, safety or personal rights risk to persons in care.

• 87705(c)(4)(A)Type A

  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. (A) In addition to requirements specified in Section 87415,..This requirement was not met as evidenced by: LPAs Brown and Allen observed that the facility does not have a staff scheduled to work the night shift, awake and on duty as required for facility with dementia residentswhich poses an immediate health, safety or personal rights risk to persons in care

• 1569.695(c)Type B

  HSC 1569.695 Other Provisions (c) A facility shall conduct a drill at least quarterly for each shift. The type of emergency covered in a drill shall vary from quarter to quarter, taking into account different emergency scenarios...This requirement is not met as evidenced by: Based on observation, interview and record review, the licensee did not comply with the section cited above by not conducting the required fire and eathquake drill at least quarterly which poses a potential health, safety or personal rights risk to persons in care

• 1569.695(d)Type B

  HSC 1569.695 Other Provisions (d) A facility shall review the plan annually and make updates as necessary, including changes in floor plans and the population served. The licensee or administrator shall sign and date documentation ....This requirement is not met as evidenced by: Based on observation, interview and record review, the licensee did not comply with the section cited above by not ensuring that the emergency disaster plan was reviewed annually and signed by the Administrator or Licensee which poses a potential health, safety or personal rights risk to persons in care.

• 1569.695(e)(2)Type B

  HSC 1569.695 Other Provisions (e) A facility shall have all of the following information readily available to facility staff during an emergency: (2) An appraisal of resident needs and services plan for each resident.This requirement was not met as evidenced by: LPAs Brown and Allen observed that Resident #3 (R3) does not have the required Needs and Services Plan maintained in R3 file.

• 87219(a)(1)Type B

  CCR 87219 Planned Activities (a) Residents shall be encouraged to maintain and develop their fullest potential for independent living through participa-tion in planned activities. The activities made available shall include: (1) Socialization...This requirement is not met as evidenced by: Based on observation, interview and record review, the licensee did not comply with the section cited above by not ensuring that there's planned activities at the facility for the socialization of residents and not just watching television at the living room which poses a potential health, safety or personal rights risk to persons in care.

• 87307(a)(2)(B)Type A

  (a) Living accommodations and grounds shall be related to the facility's function. The facility shall be large enough to provide comfortable living accommodations and privacy for the residents, staff, and others who may...This requirement was not met as evidenced by: Based on observation, interview and record review, the licensee did not comply with the section cited above by using the family room area as the sleeping area for Resident #3 (R3) and the staff, which poses an immediate health, safety or personal rights risk to persons in care.

• 87411(c)Type A

  87411 Personnel Requirements – General (c) All RCFE staff who assist residents with personal activities of daily living shall receive initial and annual training as specified in Health and Safety Code sections 1569.625 and 1569.69 (1) Staff providing care shall receive appropriate training in first aid from persons qualified by such agencies as the American Red Cross. This requirement is not met as evidence by.. Based on observations and record review the licensee didn't comply with the section above by not ensuring that staff 1, 3, 4.and 5 did not have appropriate training in first aid from persons qualified by such agencies as the American Red Cross.

• 87411(g)(1)Type A

  (g) Prior to employment or initial presence in the facility, all employees and volunteers subject to a criminal record review shall (1) Obtain a California clearance or a criminal record exemption as required by law or Department regulations or..This requirement was not met as evidenced by: Based on interview with Staff #2 (S2) and Staff #4 (S4), LPAs Brown and Allen determined that the Licensee did not obtain S4 criminal background clearance prior to employment which poses an immediate health, safety and personal rights risk to residents in care. Deficiency will be issued

• 87465(6)Type A

  87465 Incidental Medical and Dental Care (6) When requested by the prescribing physician or the Department, a record of dosages of medications which are centrally stored shall be maintained by the facility...This requirement was not met as evidenced by: LPAs Brown and Allen observed that R3 does not have the required record of dosages of medications that are centrally stored which poses a potential health, safety or personal rights risk to persons in care.

• 87705(c)(3)(A)Type A

  87705 Care of Persons with Dementia (c) Licensees who accept and retain residents with dementia shall be responsible for ensuring the following: (3) In addition to the on-the-job trainingrequirements in Section 87411(d), staff who provide direct care to residents with dementia .... This requirement was not met as evidenced by:PAs Brown and Allen observed that Staff #2 (S2), Staff #3 (S3), Staff #4 (S4) and Staff #5 (S5) do not have the required dementia care training in hydration, skin care, communication, therapeutic activities, behavioral challenges, the environment, and assisting with activities of daily living. which poses an immediate health, safety or personal rights risk to persons in care.

• 87705(c)(3)(b)Type A

  87705 Care of Persons with Dementia (c) Licensees who accept and retain residents with dementia shall be responsible for ensuring the following: (3) In addition to the on-the-job trainingrequirements in Section 87411(d), staff....This requirement was not met as evidenced by: LPAs Brown and Allen observed that Staff #2 (S2), Staff #3 (S3), Staff #4 (S4) and Staff #5 (S5) do nothave the required dementia care training in Recognizing the effects of medications commonly used to treat the symptoms of dementia.which poses an immediate health, safety or personal rights risk to persons in care

• 87777(a)(1)(g)Type A

  (a) The Department may prohibit an individual from serving as a board of directors, executive director, or officer; being employed or allowed in a licensed facility as specified in Health and Safety Code Sections 1569.58 and 1569.59. Health and Safety Code Section 1569.58 reads in part:.. (g) A licensee's failure to comply with the department's exclusion order after being notified of the order shall be grounds for disciplining the licensee pursuant to Section 1569.50.This requirement was not met as evidenced by: Based on LPAs and interviews with Caroline Armstrong and resident S1 has been allowed at the facility on 11/3/2024 after receiving an exclusion letter.

• 87465(a)(4)Type A

  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...:This requirement was not met as evidenced by: LPAs Brown and Allen observed that staffs at the facility are not assisting R1, Resident #2 (R2) and R3 with their self-administered medications per their physician’s order as there’s no record at the facility that indicated they are assisting R1. R2 and R3 which poses an immediate health, safety or personal rights risk to persons in care.

• 87507(c)Type B

  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. Attachments to the agreement may be utilized as long as they are also signed and dated as prescribed above. LPAs Brown and Allen observed Resident #1 (R1) and Resident #3 (R3) Admission Agreement do not have the required signature and signature date of R1 and R3 or their Representative.

FAQ · About this visit

Common questions about this visit

Next steps