Ehimas Residential Care

87465 Incidental Medical and Dental Care (e)For every prescription and nonprescription PRN medication...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 not met as evidenced by: Based on records review, the licensee did not ensure 1 out of 6 resident files reviewed had a written order for a PRN located in the CSML and the MAR.

87506 Resident Records (a)The licensee shall ensure that a separate, complete, and current record is maintained for each resident in the facility... This requirement was not met as evidenced by: Based on observations and records review, 2 out of 3 resident files were observed to be missing documentation. This poses a potential health, safety, and personal rights risk to residents in care.

87468.2 Additional Personal Rights of Residents ...(a) In addition to the rights Section 87468.1,...:(4)To care, supervision, ... and are delivered by staff that are sufficient in numbers, qualifications, and competency to meet their needs. This requirement was not met as evidenced by: Based on observation and records review, LPA observed 1 staff on shift for 13 residents when two staff are scheduled to work for AM shift, which poses an immediate health and safety risk to residents in care.

87555General 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 was not met as evidenced by: Based on observations, the facility did not have a food supply of fruits and vegetables that met the above requirements during LPA's visit, which poses an immediate health and safety risk to residents in care.

87213 Finances The licensee shall have a financial plan that conforms to the requirements of Section 87155... and that assures sufficient resources to meet operating costs for care of residents... This requirement was not met as evidenced by: Based on audit report findings, the licensee did not maintain sufficient cash reserves to ensure providision of care and supervision to residents in care.

87755 Inspection Authority of the Licensing Agency (b) The licensee shall ensure that provisions are made for private interviews with any resident or any staff member; and for the examination of all records relating to the operation of the facility. This requirement was not met as evidenced by: Based on audit report findings, the licensee did not respond to Auditor's request for documentation, which poses a potential health, safety, and personal rights risk to resident in care.

87405 Administrator - Qualifications and Duties (b) The administrator of a facility or facilities shall have the responsibility and authority to carry out the policies of the licensee. This requirement was not met as evidenced by: Based on audit report findings, the licensee did not ensure administrator followed their policies of the facility, which poses a potential health, safety, and personal rights risk to residents in care.

87218 Theft and Loss (a) The licensee shall ensure an adequate theft and loss program as specified in Health and Safety Code Section 1569.153. This requirement was not met as evidenced by: Based on audit report findings, the licensee did not ensure to have a theft and loss program in plan, which poses a potential health, safety, and personal rights risk to residents in care.

87217 Safeguards for Resident Cash, Personal Property, and Valuables (a)...if a resident incapable of handling his own cash resources...cash resource shall be safeguarded in accordance with the regulations in this section. This requirement was not met as evidenced by: Based on audit findings, the licensee did not ensure to make reasonable efforts to safeguard resident property, which poses a potential health, safety, and personal rights risk to residents in care.

87216 Bonding(a) Each licensee, other than a county, who is entrusted to safeguard resident cash resources, shall file or have on file with the licensing agency a copy of a bond issued by a surety company to the State of California as principal... This requirement was not met as evidenced by: Based on audit report findings, the licensee did not ensure 3 residents' monies were not handled by staff and when done so licensee did not obtain Surety Bond, which poses a potential health, safety, and personal rights risk to residents in care.

Limitations - Capacity and Ambulatory Status (b) Resident rooms approved for 24-hour care of ambulatory residents only shall not accommodate nonambulatory residents. Residents whose condition becomes nonambulatory shall not remain in rooms restricted to ambulatory residents. This requirement is not met as evidenced by: Based on observation, interview, and record review, the licensee did not ensure nonambulatory residents were housed in nonambulatory rooms which poses an immediate Health, Safety, and Personal Rights risk to persons in care.

Care of Persons with Dementia (5) Each resident with dementia shall have an annual medical assessment as specified in Section 87458, Medical Assessment, and a reappraisal done at least annually, both of which shall include a reassessment of the resident’s dementia care needs. This requirement is not met as evidenced by: Based on record review of the 602s provided, the licensee did not ensure residents’ health records were up to date which poses a potential Health, Safety, and Personal Rights risk to persons in care.

(a) … residents in privately operated residential care facilities for the elderly shall have all of the following personal rights:(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 is not met as evidenced by:Based on interviews conducted and records reviewed, and the resident’s return by police officer, the licensee did not ensure the resident’s supervision needs were met, which poses an immediate Health, Safety and Personal Rights risk to persons in care.

Incidental Medical and Care...The licensee shall arrange, or assist in arranging, for medical and dental care appropriate to the conditions and needs of residents. This requirement was not as evidenced by: Based on the Consumnes Fire Department, Prehospital Care Report #F22234263, S1 signed an order for R1 not to be transported to the Emergency Department against medical advice. This poses an immediate risk to the health, safety and personal rights of residents in care.

Additional Personal Rights of Residents in Privately Operated Facilities...residents in privately operated residential care facilities for the elderly shall have all of the following personal rights:...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 as evidenced by: Based on records reviewed and interviews conducted staff did not adequately supervise R1 resulting in multiple falls with serious bodily injury. This poses an immediate risk to the health, safety and personal rights of residents in care.

ReappraisalsThe pre-admission appraisal shall be updated, in writing as frequently as necessary to note significant changes and to keep the appraisal accurate. This requirement was not met as evidenced by: Based on records reviewed the resident appraisal was not updated after R1 sustained multiple signficant falls. This poses an immediate risk to health safety and personal rights of residents in care.

Additional Personal Rights of Residents in Privately Operated Facilities...residents in privately operated residential care facilities for the elderly shall have all of the following personal rights:...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 as evidenced by: Based on LPA Jensen's and Fain's observations of residents during the course of a site visit on 3/20/23 as described in the LIC 9099A. This poses an potential risk to the health, safety and personal rights of residents in care

Personal Rights of Residents in All FacilitiesResidents in all residential care facilities for the elderly shall have all of the following personal rights:(1) To be accorded dignity in their personal relationships with staff, residents, and other persons. This requirement was not met as evidenced by: Based on the Department investigator's observation of a R1 going about his daily routine with visibily soiled clothing. This poses a potential threat to health, safety and personal rights of residents in care.

Basic services requirementsEvery facility required to be licensed under this chapter shall provide at least the following basic services: ...Being aware of the resident's general whereabouts, although the resident may travel independently in the community. This requirement was not met as evidenced by: Based on LPA Jensen's review of an incident report and the written account received by email from local law enforcement officer, resident R5 was outside of the facility and reported as missing from the afternoon of 4/20/23 to the morning of 4/21/23. This poses an immediate threat to the health, safety and personal rights of resident in care.

...the licensee shall be responsible for the following:...Ensuring that incontinent residents are kept clean and dry and that the facility remains free of odors from incontinence. Based on LPA Jensen's detection of an odor related to urine or feces on 3 separate occasions. This poses a potential risk to the health, safety and personal rights to residents in care.

The 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 requirement was not met as evidenced by: Based on LPA Jensen's observation of chewed sunflower seed shells on floor, stains on walls, stains on floor, broken bedroom door and discarded mattress and chairs in backyard. This poses a potential risk to the health, safety and personal rights of residents in care.

1569.312(d) - Basic Service Requirements. Every facility...shall provide at least the following basic services:(d) Being aware of the resident's general whereabouts…This requirement was not met as evidenced by Based on review of police documentation for a found person(A missing person / found person on 01/10/23) This poses an immediate health and safety risk.

All facilities licensed for 16 or more and all residential facilities having separate floors or buildings shall have a signal system which shall:(A) Operate from each resident's living unit.(B) Transmit a visual and/or auditory signal to a central staffed location or produce an auditory signal at the living unit loud enough to summon staff.(C) Identify the specific resident living unit.This requirement was not met as evidenced by: LPA's observation of the facility call system being inoperable and interview with Licensee who confirmed that the facility does not currently have a working signal system. This poses a potential risk to teh health, safety and personal rights of residents in care.

Personal Rights:(a) Residents in all residential care facilities for the elderly shall have all of the following personal rights:(2) To be accorded safe, healthful and comfortable accommodations, furnishings and equipment.The facility failed to meet this as evidenced by:A fly trap full of dead flies was hanging from the ceiling in the middle of a resident room.

Maintenance and Operation:(g) Facilities which have machines and do their own laundry shall:(1) Have adequate supplies available and equipment maintained in good repair.This was not met as evidenced by an inoperable washing machine.

87555 general food services Procedures which protect ... food shall be observed in food storage, preparation and service.This requirement is not met as evidenced by Based on observation, interviews and record review freezer burned food, opened packages of frozen meat and unlabeled food item were found in the refrigerator and freezer.

1569.321(e) Every facility...shall provide at least the following basic services: (e) Monitoring the activities of the residents while they are under the supervision of the facility to ensure their general health, safety and well-being. Based on interviews and record reviews, the license did not provide the 1:1 observation requirement per the needs and services plan. This poses a potential Health, Safety or Personal Rights risk to persons in care.

Reporting Requirements. (a) Each licensee shall furnish to the licensing agency...(1) A written report shall be submitted to the licensing agency...within seven days of the occurrence...(D)Any incident which threatens the welfare, safety or health of any resident...The requirement was not met as evidenced by: Based on record review and interview, licensee did not ensure reports were sent to licensing agency for multiple incidents occurring between 8-21-22 to 11-16-22 when there were 36 911 calls. This poses a potential health and safety risk to residents in care.

(3) Conduct that 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.. This requirement was not met as evidenced by: Based on record review, licensee did not ensure that reporting requirements were met with adequate supervision for the health and safety of residents in care based on 911 call logs obtained.

1569.312(d) - Basic Service Requirements. Every facility required to be licensed under this chapter shall provide at least the following basic services:(d) Being aware of the resident's general whereabouts…This requirement was not met as evidenced by Based on review of police documentation for a missing person report on 09/15/22.. This poses an immediate health and safety risk.

Personel Requirements - General: Facility personnel shall at all times be sufficient in numbers, and competent to provide the services necessary to meet resident needs...Additional staff shall be employed as necessary. This requirement was not met as evidenced by: Based on observation and interviews, there was not sufficient staff available for nght shift to meet the needs and supervise the residents concurrently. This poses a potential health and safety risk.

87303(a) Maintenance Operation. The facility shall be clean, safe, sanitary and in good repair at all times.This requirement is not met as evidenced by Based on observation and interviews, the licensee has not conducted basic maintenance for the bathrooms and dining room walls.

87411(a) Facility personnel shall all times be ... competent to provide the services necessary to meet resident needs...This requirement is not met as evidenced by Based on observation, interviews and record review, the licensee did not ensure adequate personnel provided incontinent care overnight. This poses a potential Health, Safety or Personal Rights risk to residents in care..

87625(b)(2) Ensuring that incontinent residents are checked during those periods of time when they are known to be incontinent, including during the night.This requirement is not met as evidenced by Based on observation and interviews, the licensee did not ensure overnight staff adequately checked and changed residents in care.

87625(b)(3) ... the licensee shall be responsible for ... Ensuring that incontinent residents are kept clean and dry and ... the facility remains free of odors from incontinence.This requrement is not met as evidenced by Based on observation and interviews, the licensee did not ensure residents were kept clean and dry resulting in a strong urine odor.

Reporting Requirements. (a) Each licensee shall furnish to the licensing agency...(1) A written report shall be submitted to the licensing agency...within seven days of the occurrence...(D)Any incident which threatens the welfare, safety or health of any resident...The requirement was not met as evidenced by: Based on record review and interview, licensee did not ensure reports sent to licensing agency for multiple incidents occurring between 5-20-22 and 8-19-22. This poses an immediate health and safety risk to residents in care.

General Food Service (b) The following food service requirements shall apply: (3)Between-meal nourishment or snacks shall be made available for all residents unless limited by dietary restrictions prescribed by a physician. This requirement was not met as evidenced by Based on observation, facility did not maintain adequate amounts of snacks for residents in care. This poses a potential health and safety risk for residents in care.

General Food Service (b)The following food service requirements shall apply: (31) Dishes and utensils shall be disinfected: (B) In facilities not using mechanical means,... the addition of a sanitation agent to the final rinse water. This requiremebnt was not met as evidenced by Based on observation and interview, Facility did not use a sanitation agent while hand washing dishes in the final rinse. This poses a potential health and safety risk for residents in care.

87211(a)(1)(D):Reporting requirements (a) Each licensee...(1)A written report shall be submitted to the licensing agency and to the person responsible...(D)Any incident which threatens the any resident, such as...unexplained absence... This requirement was not met as evidence by: Based on LPA documentation, facility did not comply with section 87211(a)(1)(D). Administrator stated the facility did not report incident to CCLD, which poses a potential health and safety risk to residents in care.