Carlton Senior Living Sacramento

87355(b)(e) 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...This requirement was not met as evidence by: based on record review and interviews, the Licensee did not ensure that S1 was eligible to work in a licensed care facility and did not obtain criminal record clearance documentation prior to S1 working at the facility. This posed an immediate health and safety risk to residents in care.

87468.1 Personal Rights of Residents in All Facilities (a) Residents in all residential care facilities for the elderly shall ...(1) To be accorded dignity in their personal relationships with staff, residents, and other persons. This requirement is not met as evidenced by: Based on record review and interviews, it was found that Staff 3 (S3) did not treat R1 with dignity and respect, as they called R1 "stupid" and did not re-direct them using the training techniques received in "Dementia" Training. This poses an immediate risk to residents in care.

(a) 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 was not met as evidenced by: Based on observation, interview, and record review the licensee did not ensure that the residents room was kept in a clean and sanitary manner. It was learned that the facility did not obtain pest services or maintain the room in a sanitary manner. This poses a potential health,safety, and personal rights risks to persons in care.

(4) Personal assistance and care as needed by the resident and as indicated in the pre-admission appraisal, with those activities of daily living such as dressing, eating, bathing and assistance with taking prescribed medications, as specified in Section 87608, Postural Supports. This is not met as evidenced by: Based on interview and records review the licensee did not ensure that R1 was provided showering services. This poses an potential health, safety, and personal rights risks to persons in care.

(a) Residents in all residential care facilities...shall have all of the following personal rights: (1) To be accorded dignity in their personal relationships with staff, residents, and other persons. The licensee did not ensure the above re-quirement was enforced as evidenced by: Based on interviews and a review of documents, R1's personal rights were violated when R1 was not accorded dignity in their personal relationships. This posed an immediate risk to the health, safety and personal rights of residents in care.

87463 Reappraisals (g) The licensee shall ensure corresponding changes are made in the care and supervision provided to the resident.The licensee did not ensure the above regulation was met as evidenced by: Based on a records review, R1 had a total of 5 reported falls. Updated appraisals did not show changes to care and supervision. No strategic fall prevention plan was put into place. This posed(es) an immediate threat to the health safety and personal rights of residents in care.

87625 Managed Incontinence(b) In addition to Section 87611...the licensee shall be responsible for..:3) Ensuring that incontinent residents are kept clean and dry ... The Licensee did not ensure that the above regulation was enforced as evidenced by: Based on a review of records, as well as interviews with staff carestaff documented at least 3 incidents when R1 was not changed or could not be changed. This posed(es) an immediate threat to the health safety and personal rights of residents in care.

Basic Services CCR 8764(d)(d) A facility need not accept a particular resident for care. However, if a facility chooses to accept a particular resident for care, the facility shall be responsible for meeting the resident's needs.... The licensee did not ensure these needs were met as evidenced by: Based on a records review and information gathered from interviews, it was documented that R1 was a fall risk as far back as 3/28/29. A plan to mitigate these falls was not put into place.This posed an immediate threat to the health, safety and/or personal rights to residents in care.

Care of Persons with Dementia: Without violating Section 87468, Personal Rights, facility staff shall attempt to redirect a resident who attempts to leave the facility.This requirement was not met as evidenced by: Based on record reviews, Resident R1 who is identified as unable to leave the facility unassisted, eloped from the facility without staff knowledge which poses an immediate heath, safety and personal rights risk to residents in care.