Northerncare Facility

Record centrally stored prescriptions and refill data

Incidental Medical and Dental Care (h)(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. There was not a recording of R1 skin treatment in the centrally stored medication record.

Licensee reports required by licensing agency

Reporting Requirements (a) Each licensee shall furnish to the licensing agency such reports as the Department may require. This requirement was not met based on interviews that Administrator failed to report incidents identified. This posed a potential risk to residents.

Criminal Record Clearance (c) A licensee or applicant for a license may request a transfer of a criminal record clearance from one state licensed facility to another, or from Trust Line to a state licensed facility… This requirement was not met based on records review and interview that found S1 and S2 did not have verified clearance prior to living and working at the home 5/27/25- 5/28-25.

Food quality controls and rejected damaged goods

General Food Service Requirements (b)(8) All food shall be of good quality… Food in damaged containers shall not be accepted, used or retained. This requirement was not met based on observation. This posed a potential risk to residents.

Conformance with applicable laws and regulations

Administrator - Qualifications and Duties (d) (2) Knowledge of and ability toconform to the applicable laws, rules and regulations. Administrator failed to hiring, train, seek criminal record clearance of S1 and S2, meet reporting requirements, ensure fire safety, create initiate resident behavior plans, ensure infection control and to have been arguing with family in the presence of residents. This posed a potential risk to residents.

Require physician order and label for PRN medication

Incidental Medical and Dental Care (e) For every prescription and nonprescription PRN medication for which the licensee provides assistance there shall be a signed, dated written order from a physician, on a prescription blank, maintained in the residents file, and a label on the medication. This requirement was not met based on records and statements that found R1's medications were not administered as ordered.This posed an immediate risk to resident.

Infection Control Requirements (a)(4)(C) Gloves shall be removed and discarded in the nearest appropriate waste receptacle with a tight-fitting cover immediately following the glove use as required.This requirement was not met based on observations and interviews. This posed an potential risk to residents health and safety.

Right to sufficient care and qualified staff

Additional Personal Rights of Residents in Privately Operated Facilities (a) (4) To care, supervision, and services that meet their individual needs and are delivered by staff that are sufficient in numbers, qualifications, and competency to meet their needs. This requirement was not met based on video and statements that found S1 did not provide appropriate transfer request to R1. This posed and immediate risk to R1.

Staff training in personal care activities

Personnel Requirements - General (c) All RCFE staff who assist residents with personal activities of daily living shall receive initial and annual training… This requirement was not met based on records review and interview finding no recorded training for S1 or S2. This posed a potential risk to residents.

87307 Personal Accommodations and Services (a)(3)(F) Basic laundry service… This requirement was not met based on statements that resident personal belongings were not kept separate from others and that R1’s personal linens were not properly laundered. This posed a potential risk to resident.

Store centrally held medications in locked secure place

(h) The following requirements shall apply to medications which are centrally stored: (2) 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 requirement is not met as evidenced by: Based on LPAs' observations, the facility did not ensure that medications were locked and inaccessible to the residents in care, which poses an immediate health, safety or personal rights risk to persons in care.

Ensure hazardous items are locked and not unattended

(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 tools and other items that could pose a danger to residents if readily available were locked and inaccessible to residents in the garage and backyard area, which poses an immediate health, safety or personal rights risk to persons in care.

Provide resident hot water for personal care

(e) Water supplies and plumbing fixtures shall be maintained as follows: (2) Faucets used by residents for personal care such as shaving and grooming shall deliver hot water. Hot water temperature controls shall be maintained to automatically regulate the temperature of hot water used by residents to attain a temperature of not less than 105 degree F (41 degrees C) and not more than 120 degree F (49 degrees C). This requirement is not met as evidenced by: Based on LPAs' observations, the facility did not ensure that water temperatures were controlled and maintained at not less than 105 degrees F and not more than 120 degrees F when hot water was measured at 123 degrees F, which poses an immediate health, safety or personal rights risk to persons in care. A civil penalty in the amount of $250 was assessed for repeat violation.

Obtain baseline medical assessment before resident admission

Based on LPA's observations and records reviewed, facility did not ensure that one (1) of six (6) residents had an LIC 602A on file, which poses/posed a potential health, safety or personal rights risk to persons in care. A civil penalty in the amount of $250 was assessed for repeat violation.

Maintain facility in clean, safe, sanitary condition

Based on LPA's observations, the facility did not ensure that the premises was clean, safe and sanitary in the garage, backyard area, living room area, and kitchen refrigerator, which poses/posed a potential health, safety or personal rights risk to persons in care.

Provide resident hot water for personal care

Based on LPA's observations, the facility did not ensure that water temperatures were controlled and maintained at not less than 105 degrees F and not more than 120 degrees F when hot water was measured at 127 degrees F, which poses an immediate health, safety or personal rights risk to persons in care. A civil penalty in the amount of $250 was assessed for repeat violation.

Ensure hazardous items are locked and not unattended

Based on LPA's observations, the facility did not ensure that chemical, tools, and other items that could pose a danger to residents if readily available were locked and inaccessible to residents in the kitchen, bathroom, garage, and backyard area, which poses an immediate health, safety or personal rights risk to persons in care.

Store centrally held medications in locked secure place

Based on LPA's observations, the facility did not ensure that medications were locked and inaccessible to the residents in care, which poses an immediate health, safety or personal rights risk to persons in care.

Maintain facilities for fire and panic safety

Based on LPA's observations, the facility did not ensure that fire extinguisher was serviced and fire exits were unobstructed, which poses an immediate health, safety or personal rights risk to persons in care.

§1569.625 Staff training; legislative findings; contents (b) (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 records reviewed, facility did not ensure that staff were acquiring all required trainings per Health and Safety Code, which poses a potential health, safety, and personal rights risk to residents in care.

Maintain facilities for fire and panic safety

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 requirement was is not met as evidenced by: Based on observation, facility didn't ensure fire exit was unobstructed by installing chain lock on front door out of reach of non-ambulatory residents, which poses an immediate health, safety, and personal rights risk to the residents in care.

Obtain baseline medical assessment before resident admission

Due to observation, facility did not ensure that one (1) resident had an LIC 602 on file, which poses/posed a potential health, safety or personal rights risk to persons in care.

Provide resident hot water for personal care

Due to observation, facility did not ensure that water temperatures were controlled and maintained at not less than 105 degrees F and not more than 120 degrees F, which poses an immediate health, safety or personal rights risk to persons in care.