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Inspection visit

Follow-up on corrections

PRESTIGE CARE HOMES IILicense 3427009853 citations on this visit
3 citations recorded

Inspector’s narrative

What the inspector wrote

Licensing Program Analyst (LPA) Vincent Moleski arrived unannounced to deliver findings on a complaint investigation. During the course of that investigation, LPA Moleski discovered other deficiencies unrelated to the complaint allegations, which will be addressed in this case management report. LPA Moleski met with facility administrator Vidan Barias and explained the purpose of the visit. LPA Moleski reviewed a resident’s (R1’s) medication administration records (MARs) as part of the previously mentioned complaint investigation. LPA Moleski observed that dosage amounts were not recorded for multiple doses of a PRN antipsychotic and a PRN opioid narcotic. Dosages are missing for one or more administrations of one or both of these medications on 10/26, 10/27, 10/28, 10/29, 10/30, and 10/31. Per 22 CCR Section 87465(b-d), PRN medications may only be given to a resident if their physician has stated in writing their ability to determine their need for PRN medications and communicate their symptoms. If that resident has deficits in either area, then a record including dosages must be maintained for all PRN medication administrations. LPA Moleski reviewed R1’s file and did not observe any documentation from R1’s physician regarding their ability to determine their need for PRN medications and communicate their symptoms. R1 was admitted to this facility as of 10/25/24, according to their admission agreement. However, R1’s LIC 602 examination was dated 10/31/24, after R1 was already admitted. The LIC 602 was not signed by R1’s physician until 11/1/24. Per 22 CCR Section 87458(a), medical assessments must be obtained “prior to a person’s acceptance as a resident.” [continued on 809-C] Based on multiple interviews with staff and other witnesses, and based on review of facility records, R1 suffered from restlessness and agitation between at least 10/31/24 and their death on 11/5/24. In an interview, a staff member (S3) admitted to moving a recliner up against R1’s bed in order to prevent R1 from slipping out. In an interview, R1’s responsible party said they had also observed a wheelchair moved up against R1’s bed, and additional lower railings in order to prevent R1 from getting up out of bed. 22 CCR Section 87608(a)(1) includes among postural supports devices which are used to prevent a resident from falling out of bed. Section 87608(a)(2) states that residents must be able to release any such device quickly, and Section 87608(a)(3) states that there must be written orders for the use of any such device from the resident’s physician. Section 87608(a)(5)(B) prohibits full-length bed rails, except for residents receiving hospice care, and when their hospice care plan specifies the need for full rails. LPA Moleski reviewed R1’s hospice care plan and did not observe any indication that R1 was approved to have full rails installed on their bed. This facility is hereby cited per 22 CCR Sections 87608(a), 87465(b), and 87458(a). An exit interview was held with Barias. Appeal rights and a copy of this report were left with Barias.

Citations

8 citations recorded*CCLD

What does Type A vs Type B mean?

Type A. Serious citation. Imminent or substantial risk to children. The regulator requires corrective action immediately and may impose a civil penalty.

Type B. Lower-severity citation. Corrective action required, no imminent risk. The regulator monitors compliance on the next visit.

  • 87458(a)Type B

    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.

  • 87465(b)Type B

    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.

  • 87608(a)Type A

    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.

  • 87211(a)(1)Type B

    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.

  • 87464(f)(1)Type A

    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.

  • 87465(a)(4)Type A

    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.

  • 87468.1(a)(1)Type A

    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.

  • 87633(a)(4)Type A

    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.

FAQ · About this visit

Common questions about this visit

What happened during the February 11, 2025 inspection of PRESTIGE CARE HOMES II?

This was an other inspection of PRESTIGE CARE HOMES II on February 11, 2025. 3 citations were issued: 1 Type A (serious) and 2 Type B.

Were any citations issued to PRESTIGE CARE HOMES II on February 11, 2025?

Yes, 3 citations were issued (1 Type A, 2 Type B). The first citation was for: "87458(a): “Prior to a person's acceptance as a resident, the licensee shall obtain documentation of a medical assessment..."

What type of inspection was this?

This was an other inspection. other inspections are conducted by CCLD as part of their licensing oversight.

SourceView on CCLDView original report

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Data from CCLD public records. Last updated . If you believe any information is inaccurate, report it here.