Tender Home Senior Care

Based on observation and records review the licensee/admin did not comply with the section cited above. 5 of 5 of the resident's medications in the Medication Administration Records were not recorded and given per physician's orders according the facility's Plan of Operation which poses an immediate health, safety or personal rights risk to persons in care.

Personal Rights of Residents in All Facilities(a) Residents in all residential care facilities for the elderly shall have all of the following personal rights:To be free from...humiliation...or other actions of a punitive nature... This requirement is not met as evidenced by: Based on R1 was demanded to lie down by S1.This violation poses an immediate health, and safety risk to residents in care.

Reporting RequirementsEach licensee shall furnish to the licensing agency such reports as the Department may require, including, but not limited to, the following: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 report shall include the resident's name, age, sex and date of admission; date and nature of event; attending physician's name, findings, and treatment, if any; and disposition of the case. This requirement is not met as evidenced by: Based on Licensee admittance that the reporting requirements has not been met. This violation poses an immediate health, and safety risk to residents in care.

Resident RecordsThe licensee shall ensure that a separate, complete, and current record is maintained for each resident in the facility or in a central administrative location readily available to facility staff and to licensing agency staff This requirement is not met as evidenced by: Based on LPA observation R1's records were not made available for review during this visit. This violation poses an immediate health, and safety risk to residents in care.

Personal Rights of Residents in All Facilities(a) 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 is not met as evidenced by: Based on S1 did not allow R1 to sit rather than lie on bed.This violation poses an immediate health, and safety risk to residents in care.

Personnel Requirements - General: Skill and knowledge required to provide necessary resident care and supervision, including the ability to communicate with residents. This requirement was not met as evidenced by observations by LPA who observed a staff member alone at the facility who could not speak english and would not be able to communicate effectively with residents to meet their needs and communicate with emergency responders in the case of an emergency at the facilty which poses a potential health, safety and personal rights risk to residents in care. The department emphasizes that we are not prohibiting non-english speakers from working in a licensed facility, but one staff member must be present who can effectively communicate with residents to meet their needs at all times a resident is present in the facility.

To complete the training requirements set forth in this subdivision, each employee shall pass an examination that tests the employee’s comprehension of, and competency in, the subjects listed in paragraph (4). This requirement was not met as evidenced by LPA review of staff file which and statements from the licensee that the staff member did not complete an examination regarding medication administration and was not aware of the requirement which poses a potential health, safety and personal rights risk to residents in care.

Employees assisting residents with self-administration of medication; training requirements: Each employee who received training and passed the examination required in paragraph (5) of subdivision (a), and who continues to assist with the self-administration of medicines, shall also complete eight hours of in-service training on medication-related issues in each succeeding 12-month period. This requirement was not met as evidenced by training records for S2 only contained 5 hours of annual training instead of the required 8 which poses an immediate health, safety and personal rights risk to residents in care.

Observation of the Resident: The licensee shall ensure that residents are regularly observed for changes in physical, mental, emotional and social functioning and that appropriate assistance is provided when such observation reveals unmet needs. When changes such as unusual weight gains or losses or deterioration of mental ability or a physical health condition are observed, the licensee shall ensure that such changes are documented and brought to the attention of the resident's physician and the resident's responsible person, if any. This requirement was not met as evidenced by the injury sustained and bruising observed by home health aid after the date of the reported fall by R1 and the injury was not reported or observed prior to Home health aid which poses an immediate health, safety and personal rights risk to reidents in care.

Based on review of 5 residednt records, the licensee did not comply with the section cited above in 3 out of 5 resident records which poses a potential health, safety or personal rights risk to persons in care.

Administrator - Qualifications and Duties: The administrator shall have the qualifications specified in Sections 87405(d)(1) through (7). If the licensee is also the administrator, all requirements for an administrator shall apply: (2) Knowledge of and ability to conform to the applicable laws, rules and regulations. This requirement was not met as evidenced by LPAs observations that staff continue to not wear masks when inside the facility as required by the Order of the State Public Health Officer dated June 11, 2021 requiring compliance with CDPH Guidance for the Use of Face Coverings, and as required by COVID-19 Prevention Emergency Temporary Standards (ETS) at Title 8, CCR section 3205, and an individual mask

Plan of Operation: (a) Each facility shall have and maintain a current, written definitive plan of operation. The plan and related materials shall be on file in the facility and shall be submitted to the licensing agency with the license application. Any significant changes in the plan of operation which would affect the services to residents shall be submitted to the licensing agency for approval. This requirement was not met as evidenced by LPA review of facility plan of operation which included language that all medications administered would be recorded and documented. LPA observed the facility had not been following the plan of operation and recently reinstituted documenting medication administration.

Personal Rights of Residents in All Facilities: To be accorded safe, healthful and comfortable accommodations, furnishings and equipment. This requirement was not met as evidenced by, on 5/4/22 licensee did not ensure the personal rights of persons in care to safe and healthful accommodations and engaged in conduct inimical to the health, welfare, and safety of persons in care, in that facility staff Tamaka Holder and three visitors did not wear face coverings while in the facility, as required by the Order of the State Public Health Officer dated June 11, 2021 requiring compliance with CDPH Guidance for the Use of Face Coverings, and as required by COVID-19 Prevention Emergency Temporary Standards (ETS) at Title 8, CCR section 3205, and an individual mask exemption did not apply.

Personal Rights of Residents in All Facilities: To be accorded safe, healthful and comfortable accommodations, furnishings and equipment. This requirement was not met as evidenced by, on 4/6/22 licensee did not ensure the personal rights of persons in care to safe and healthful accommodations and engaged in conduct inimical to the health, welfare, and safety of persons in care, in that facility staff Tamaka Holder did not wear face coverings while in the facility, as required by the Order of the State Public Health Officer dated June 11, 2021 requiring compliance with CDPH Guidance for the Use of Face Coverings, and as required by COVID-19 Prevention Emergency Temporary Standards (ETS) at Title 8, CCR section 3205, and an individual mask exemption did not apply.

Based on LPAs testing of water temperature the licensee did not comply with the section cited above as the water temperature recorded was 122 degrees F which poses an immediate health, safety or personal rights risk to persons in care.