Spring Glen Elderly Care Villa

87555 General Food Service Requirements (b) The following food service requirements shall apply: (26) 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 is not met as evidenced by: Based on LPAs' observations, facility did not ensure to have a seven (7) day nonperishable food supply on cite, which poses a potential health, safety or personal rights risk to persons in care.

(4) The licensee shall assist residents with self-administered medications as needed. This requirement is not met as evidenced by: Based on LPAs' observations and records reviewed, facility did not ensure to document medications on Centrally Stored Medication Forms for all residents with some medications having no identifiable start date, which poses an immediate health, safety or personal rights risk to persons in care.

(1) The department shall adopt regulations to require staff members of residential care facilities for the elderly who assist residents with personal activities of daily living to receive appropriate training. This training shall consist of 40 hours of training. A staff member shall complete 20 hours, including six hours specific to dementia care, as required by subdivision (a) of Section 1569.626 and four hours specific to postural supports, restricted health conditions, and hospice care, as required by subdivision (a) of Section 1569.696, before working independently with residents. The remaining 20 hours shall include six hours specific to dementia care and shall be completed within the first four weeks of employment. The training coursework may utilize various methods of instruction, including, but not limited to, lectures, instructional videos, and interactive online courses. The additional 16 hours shall be hands-on training. This requirement is not met as evidenced by: Based on LPAs' observations and records reviewed, facility did not ensure that staff received initial training and documentation for initial training was maintained at the facility, which poses/posed a potential health, safety or personal rights risk to persons in care.

(a) Disinfectants, cleaning solutions, poisons, firearms and other items which could pose a danger if readily available to clients shall be stored where inaccessible to clients. This requirement is not met as evidenced by: Based on LPAs' observations, the facility did not ensure that storages for disinfectants, cleaning solutions, and knives were locked and inaccessible to the residents at all times, which poses an immediate health, safety or personal rights risk to persons in care.

Based on LPA's observation and records reviewed, facility did not ensure that all care staff received first aid training, which poses/posed a potential health, safety or personal rights risk to persons in care.

Based on LPA's observations and records reviewed, facility did not ensure that health screenings were completed for all staff, which poses/posed a potential health, safety or personal rights risk to persons in care.

Based on LPA's observations and records reviewed, facility did not ensure that staff received initial training and documentation for initial training was maintained at the facility, which poses/posed a potential health, safety or personal rights risk to persons in care.

Based on LPA's observations, three fire exits (exits 3, 4, and 6) were obstructed, smoke alarm in room #3 was inoperable, and fire extinguisher wasn't serviced, which poses an immediate health, safety or personal rights risk to persons in care.

Based on LPA's observation, facility did not ensure that debris was cleared from backyard area, which poses/posed a potential health, safety or personal rights risk to persons in care.

Based on LPA's observations, the facility did not ensure that storage for disinfectants, cleaning solutions, knives, and other hazardous items were locked and inaccessible to the residents at all times, including shed in backyard area, storage in kitchen area, and storage in laundry room, which poses an immediate health, safety or personal rights risk to persons in care.

Based on LPA's observations and records reviewed, facility did not ensure that an individual who can act as the Administrator or house manager was present at the facility during business hours, which poses/posed a potential health, safety or personal rights risk to persons in care.

Based on LPA's observation and records reviewed, facility did not ensure that there was a staff member with CPR training at the facility at all times, which poses/posed a potential health, safety or personal rights risk to persons in care.

Based on LPA's observations and records reviewed, facility did not ensure to document medications on Centrally Stored Medication Forms for all residents with some medications having no identifiable start date, which poses an immediate health, safety or personal rights risk to persons in care.

Based on LPA's observations, facility did not ensure that medication room was locked and inaccessible to the residents at all times, and medications stored in refrigerator were accessible to the residents, which poses an immediate health, safety or personal rights risk to persons in care.

Based on LPA's observations and records reviewed, facility did not ensure that all residents in care had a safeguard for personal property and valuables, which poses/posed a potential health, safety or personal rights risk to persons in care.

Based on records reviewed, facility did not ensure that they had a fire clearance for bedridden persons before accepting and retaining a resident who was considered bedridden according to their LIC 602A, which poses an immediate health, safety, and personal rights risk to the residents in care.

87506 Resident Records (e) Original records or photographic reproductions shall be retained for a minimum of three (3) years following termination of service to the resident.This requirement is not met as evidenced by: Based on interview conducted with Administrator, records for resident (R1) were not maintained at the facility following resident moving out on 1/24/22, which posed a potential health and safety risk to residents in care.

87465 Incidental Medical and Dental Care(d) If the resident is unable to determine his/her own need for a prescription or nonprescription PRN medication, and is unable to 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:(3) The date and time the PRN medication was taken, the dosage taken, and the resident's response shall be documented and maintained in the resident's facility record. This requirement is not met as evidenced by: Based on record review and interviews conducted, the Licensee did not ensure that the facility maintained a record of PRN medications administered for Alpharazolam 0.5mg for resident (R3), which poses a potential health and safety risk to residents in care.

(c) Prior to admission a determination of the prospective resident's suitability for admission shall be completed and shall include an appraisal of his/her individual service needs in comparison with the admission criteria specified in Section 87455, Acceptance and Retention Limitations.(1) The appraisal shall include, at a minimum, an evaluation of the prospective resident's functional capabilities, mental condition and an evaluation of social factors as specified in Sections 87459, Functional Capabilities and 87462 Social Factors.This requirement is not met as evidenced by: Based on interview with Administrator, the Licensee did not ensure that resident (R1) was evaluated in person prior to admission on 1/22/22, which posed a potential health and safety risk to residents in care. ,

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 requirement is not met as evidenced by: Based on documentation review, medications were not administered for residents, R2 and R3, per physician's orders, as medication exhausted before a refill was obtained. Additionally, MAR does not document that R3 received Atorvastatin-Calcium 40 mg, or Melatonin 10mg as ordered, which poses a potential health and safety risk to residents in care.

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 requirement is not met as evidenced by: Based on interviews conducted and documentation reviewed, the Licensee did not ensure that staff (S1/S2) obtained a criminal record clearance prior to working, residing, volunteering at the facility, which posed an immediate health and safety risk to residents in care.