Prestige Care Homes Ii

Assist residents with self-administered medication

"(4) The licensee shall assist residents with self-administered medications as needed." This requirement was not met as evidenced by: Based on observation and record review, medications for R1 were mismanaged, which poses an immediate health, safety, and/or personal rights risk.

Develop required incidental medical care plan

Based on record review, start dates were not recorded for multiple medications for all residents in care, which means there is no plan in place to verify the accuracy of dosages given, which poses a potential health, safety, and/or personal rights risk.

Report specified resident events within seven days

Based on record review, at least two incidents which posed a risk to resident health and welfare were not reported to CCLD, which poses/posed a potential health, safety or personal rights risk to persons in care.

87608(a): “Postural supports may be used under the following conditions … [et seq.]” This requirement was not met as evidenced by: Based on interview and record review, R1 was restricted from leaving their bed with devices not approved for use by their physician or hospice agency, and which did not permit quick release by the resident, which poses an immediate health, safety, and/or personal rights risk.

Report specified resident events within seven days

87211(a)(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 requirement was not met as evidenced by: Based on interviews and record review, CCLD and R1’s RP were not notified of R1’s various injuries and other concerning behaviors, which poses a potential health, safety, and/or personal rights risk.

Care and supervision as defined by statute and rules

87464(f)(1): “Basic services shall at a minimum include: Care and supervision as defined in Section 87101(c)(3) and Health and Safety Code section 1569.2(c).” This requirement was not met as evidenced by: Based on interview and record review, a resident was not provided appropriate and/or effective assistance necessary to prevent self-inflicted injuries, which poses an immediate health, safety, and/or personal rights risk.

Assist residents with self-administered medication

“The licensee shall assist residents with self-administered medications as needed.” This requirement was not met as evidenced by: Based on interviews and record review, a resident was given more medication that permitted by their physician on 11/4/24, which poses an immediate health, safety, and/or personal rights risk.

Each terminal resident needs a written hospice care plan

87633(a)(4): “(a) The licensee shall be permitted to accept or retain residents who have been diagnosed as terminally ill … when all of the following conditions are met: … all hospice care plans are fully implemented by the licensee …” This requirement was not met as evidenced by: Based on interview and record review, fall assessments were not documented or provided to R1’s hospice agency, and other unusual behaviors requiring immediate attention were not reported immediately to the hospice agency, which poses an immediate health, safety, and/or personal rights risk.

Dignity in personal relationships

87468.1(a)(1): “Residents in all residential care facilities for the elderly shall have all of the following personal rights: To be accorded dignity in their personal relationships with staff, residents, and other persons.” This requirement was not met as evidenced by: Based on interviews and record review, a R2 was not accorded dignity in their relationships with staff, which poses an immediate health, safety, and/or personal rights risk.

Obtain baseline medical assessment before resident admission

87458(a): “Prior to a person's acceptance as a resident, the licensee shall obtain documentation of a medical assessment, signed by a licensed medical professional acting within the scope of their practice and made within the last year, to be kept in the resident's record.” This requirement was not met as evidenced by: Based on record review, R1 was examined for their medical assessment after already being admitted to this facility, which poses a potential health, safety, and/or personal rights risk.

Permit PRN self-administration with written ability

87465(b): “If the resident's physician has stated in writing that the resident is able to determine and communicate his/her need for a prescription or nonprescription PRN medication, facility staff shall be permitted to assist the resident with self-administration of his/her PRN medication.” This requirement was not met as evidenced by: Based on record review, R1 did not have the necessary physician’s authorization to receive assistance with PRN medications from facility staff, which poses a potential health, safety, and/or personal rights risk.

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 was not met as evidenced by: Based on observation, cleaning solutions, insecticide, and shears were left unlocked and accessible to residents in care, which poses an immediate health and safety risk.

Store centrally held medications in locked secure place

"(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 was not met as evidenced by: Based on observation, the licensee left medications out unlocked and accessible to residents in care, which poses an immediate health and safety risk.

Facility must clear fire safety for bedridden persons

"(a) All facilities shall maintain a fire clearance approved by the city, county, or city and county fire department, or district providing fire protection services, or the State Fire Marshal. Prior to accepting or retaining any of the following types of persons, the applicant or licensee shall notify the licensing agency and obtain an appropriate fire clearance ... (2) Bedridden persons." This requirement was not met as evidenced by: Based on record review, the licensee admitted and retained a bedridden resident, which poses an immediate health and safety risk.

Ensure hazardous items are locked and not unattended

Based on observation, cleaning solutions and detergents were left unlocked and unsecured, which poses an immediate health, safety or personal rights risk to persons in care.

Store centrally held medications in locked secure place

Based on observation, medications were not locked up and kept inaccessible to residents, which poses an immediate health, safety or personal rights risk to persons in care.

Based on record review, the licensee did not maintain a record of care with all required components for R2's foley catheter, which poses/posed a potential health, safety or personal rights risk to persons in care.

"Care and supervision" means the facility assumes responsibility for, or provides or promises to provide in the future, ongoing assistance with activities of daily living without which the resident’s physical health, mental health, safety, or welfare would be endangered. Assistance includes assistance with taking medications, money management, or personal care. This requirement was not met as evidenced by staff allowed resident to leave the facility in a taxi stating he was going to the hospital. Resident never arrived at the hospital and family reported him missing once it was discovered he was not at the hospital which poses an immediate health, safety and personal rights risk to residents in care.

Based on LPA review of resident records, the licensee did not comply with the section cited above as 1 resident with a diagnosis of dementia did not have an annuall medical assessment as required by regulations which poses a potential health, safety or personal rights risk to persons in care.

Obtain required California clearance or exemption

Criminal Record Clearance: 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: Request a transfer of a criminal record clearance as specified in Section 87355(c). This requirement was not met as evidenced by 2 of the 4 staff members present at the time of inspection were still associated to the old facility and the adminstrator thought they had to wait until licensed to associate. LPA confirmed that all staff present had criminal record clearances.