Greenhaven Place Independent Lvg and Assisted Lvg

Engaged in conduct which is inimical to the health, morals, welfare, or safety of either an individual in or receiving services from the facility, or the people of the State of California as evidenced by S1 documenting a narcotic medication was administered to a resident not at the facility at the time of administration and conducting mediation administration while under the influence of a narcotic which poses an immediate health, safety and personal rights risk to residents in care.

Give PRN medication by physician order

Incidental Medical and Dental CareIf 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 requirement is not met as evidenced by: Medication was not administered as prescribed to R1 Based on documentation and interviews which confirmed the medication error occurred.This violation poses a potential health and safety risk to residents in care.

Modified diets for medical necessity

Food Service: "(b) The following food service requirements shall apply:(7) Modified diets prescribed by a resident's physician as a medical necessity shall be provided."This requirement was not met as evidenced by: Based on record review and interviews, R1 was provided food contrary to doctor's orders, which poses a potential health and safety risk.

Reporting Requirements: "(a) Each licensee shall furnish to the licensing agency such reports as the Department may require, including, but not limited to, the following:(1) 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. This report shall include the resident's name, age, sex and date of admission; date and nature of event; attending physician's name, findings, and treatment, if any; and disposition of the case.(B) Any serious injury as determined by the attending physician and occurring while the resident is under facility supervision."This requirement was not met as evidenced by: Based on interviews and record review, R1's POA was not notified after R1 suffered a serious injury at this facility, which poses a potential health and safety risk.

Incidental Medical and Dental CareIn all facilities licensed for sixteen (16) persons or more, one or more employees shall be designated as having primary responsibility for assuring ... assisting residents as needed with self-administration of medications... This requirement is not met as evidenced by: medication that belonged to R2 was administered to R1 and there was no adverse reaction Based on documentation which confirmed the medication error occurredThis violation poses an potential health, and safety risk to residents in care.

Regular observation and documentation of resident changes

Observation of the ResidentThe licensee shall ensure that residents are regularly observed for changes in physical, mental, emotional and social functioning and that appropriate assistance is provided when such observation reveals unmet needs...deterioration of mental ability...the licensee shall ensure that such changes are documented and brought to the attention of the resident's physician and the resident's responsible person, if any. This requirement is not met as evidenced by: R1 having a car accident while driving alone.Based on interviews confirming R1 was driving alone facility did not ensure supervision as stated on LIC602.This violation poses an immediate health, and safety risk to residents in care.

Regular observation and documentation of resident changes

Observation of the ResidentThe licensee shall ensure that residents are regularly observed for changes in physical, mental, emotional and social functioning and that appropriate assistance is provided when such observation reveals unmet needs. When changes such as unusual weight gains or losses or deterioration of mental ability or a physical health condition are observed, the licensee shall ensure that such changes are documented and brought to the attention of the resident's physician and the resident's responsible person, if any. This requirement is not met as evidenced by: Facility documentation, R1 was absent without leave (AWOL). The Licensee failed to adequately supervise R1 which allowed for R1’s elopement from the facility.This possess an immediate health and safety risk to residents in care.

Regular representative updates on care

Personal Rights of Residents in All FacilitiesResidents in all residential care facilities for the elderly shall have all of the following personal rights: To have their representatives regularly informed by the licensee of activities related to care or services, including ongoing evaluations, as appropriate to their needs. This requirement is not met as evidenced by: R1's representative did not receive requested records. The Licensee failed to provide records for R1 as requested by representative.This possess an immediate health and safety risk to residents in care.

Incidental Medical and Dental CareIf 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: Facility staff shall contact the resident's physician prior to each dose, describe the resident's symptoms, and receive direction to assist the resident in self-administration of that dose of medication. The date and time of each contact with the physician, and the physician's directions, shall be documented and maintained in the resident's facility record. 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: Facility documentation, R1 did not receive medication (s). timely. The Licensee did not refill medication or administer medications as prescribed. This possess an immediate health and safety risk to residents in care.

Give PRN medication by physician order

Incidental Medical and Dental CareOnce ordered by the physician the medication is given according to the physician's directions. This requirement is not met as evidenced by: LPA observed that R1 missed a dose of insulin. Based on confirmation from S1 who stated the insulin was not able to be located until the next morning.This violation poses an immediate health, and safety risk to residents in care.

Right to freedom from abuse and neglect

Additional Personal Rights of Residents in Privately Operated FacilitiesIn 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: To be free from neglect, financial exploitation, involuntary seclusion, punishment, humiliation, intimidation, and verbal, mental, physical, or sexual abuse. This requirement is not met as evidenced by: LPA observed that S1 used R1's funds for personal use. Based on confirmation from police report S1 used R1's funds for personal use.This violation poses an immediate health, and safety risk to residents in care.

Persons prohibited from being a licensee, owning beneficial interest in licensed facility, or holding certain positions or employment; grounds; notice; removal; appeal; petition for reinstatement The department may prohibit any person ... who has done any of the following: Engaged in acts of financial malfeasance concerning... but not limited to, improper use or embezzlement of client moneys... This requirement is not met as evidenced by: LPA observed that Administrator allowed S1 to gain access to R1's personal finances. Based on confirmation from police report Administrator allowed S1 access to R1's finances.This violation poses an immediate health, and safety risk to residents in care.

87405(b)The administrator of a facility or facilities shall have the responsibility and authority to carry out the policies of the licensee. (d) The 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. This requirement is not met as evidenced by: LPA observed that Administrator allowed S1 to gain access to R1's personal finances. Based on confirmation from police report Administrator allowed S1 access to R1's finances.This violation poses an immediate health, and safety risk to residents in care.

Exclusions(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. This requirement is not met as evidenced by: LPA observed that Administrator requested to remove S1 from the facility roster. Based on confirmation the Administrator S1 has been removed from the facility roster.This violation poses an immediate health, and safety risk to residents in care.