Peace and Joy Rcfe

Based on record review, 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.

Maintenance and OperationThe facility shall be clean, safe, sanitary and in good repair at all times. Maintenance shall include provision of maintenance services and procedures for the safety and well-being of residents, employees and visitors. This was not met because, LPA observed several tiles that were broken near the kitchen.

Alterations to Existing Building or New Facilities. Prior to construction or alterations, all facilities shall obtain a building permit. LPA observed additional rooms in the garage being used as living quarters.

Administrator - Qualifications and DutiesThe administrator shall have the qualifications specified in Sections 87405(d)(1) through (7). If the licensee is also the administrator, all requirements for an administrator shall apply.(1) Knowledge of the requirements for providing care and supervision appropriate to the residents. The LPA observed that the facility was using a hoyer lift without proper documented training or without proper instuction from a licensed proessional.

Administrator - Qualifications and Duties.All facilities shall have a qualified and currently certified administrator. The licensee and the administrator may be one and the same person. The administrator shall have sufficient freedom from other responsibilities and shall be on the premises a sufficient number of hours to permit adequate attention to the management and administration of the facility as specified in this section. When the administrator is not in the facility, there shall be coverage by a designated substitute who shall have qualifications adequate to be responsible and accountable for management and administration of the facility as specified in this section. The Department may require that the administrator devote additional hours in the facility to fulfill his/her responsibilities when the need for such additional hours is substantiated by written documentation. This was not because LPA observed that the administrators certificate was expired during visit.

Incidental Medical & DentalAssistance with self-administration does not include forcing a resident to take medication, hiding or camouflaging medications in other substances without the resident's knowledge and consent, or otherwise infringing upon a resident's right to refuse to take a medication.The licensee shall be responsible for assuring that a record of centrally stored prescription medications for each resident is maintained for at least one year and includes: The LPA observed a pill crusher inservices without perscription or authorization for use.

Incidental Medical and Dental Care.The following requirements shall apply to medications which are centrally stored:Centrally stored medicines shall be kept in a safe and locked place that is not accessible to persons other than employees responsible for the supervision of the centrally stored medication. This was not met because medication were left unatended/ not locked on main floor accessible to dementia residents.

87203 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 was not met because the smoke alarm was missing from the a residents room #2.

If the resident's physician has stated in writing that the resident is unable to determine his/her own need for nonprescription PRN medication but can communicate his/her symptoms clearly, facility staff designated by the licensee shall be permitted to assist the resident with self-administration, provided all of the following requirements are met:Once ordered by the physician the medication is given according to the physician's directions. This was not met because the facility could not prove that the medication was dispensed as per physicans instructions.

Care of Persons with Dementia.The licensee shall have an auditory device or other staff alert feature to monitor exits, if exiting presents a hazard to any resident. This was not met by; the facility failed to use the auditory alarm as designed. All auditory alarms had been turned off and doors were left ajar during visit.