Brookdale Folsom

87465 Incidental Medical and Dental Care (a) A plan for incidental medical and dental care shall be developed by each facility...by compliance with the following: (4) The licensee shall assist residents with self-administered medications as needed.This requirement is not met as evidenced by: Based on medication counts and records reviewed, the facility did not ensure that residents (R2 and R3) were receiving medications as prescribed, which poses an immediate health, safety, and personal rights risk to residents in care.

87464 Basic Services (f) Basic services shall at a minimum include:(1) Care and supervision as defined in Section 87101(c)(3) and Health and Safety Code section 1569.2(c).This requirement is not met as evidenced by: Based on documentation reviewed, the facility did not ensure resident (R1) was maintaining proper hydration, which poses an immediate health, safety, and personal rights risk to residents in care.

87466 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 is not met as evidenced by: Based on documentation reviewed, the facility did not ensure R1 was observed for symptoms of possible changes in blood pressure, which poses an immediate health, safety, and personal rights risk to residents in care.

87625 Managed Incontinence- (b) In addition to Section 87611, General Requirements for Allowable Health Conditions, the licensee shall be responsible for the following: (3) Ensuring that incontinent residents are kept clean and dry and that the facility remains free of odors from incontinence. This requirement is not met as evidenced by: Based on hospice records reviewed, the Licensee did not ensure that resident (R1) was kept clean and dry, on 2/2/24, 3/19/24, 4/5/24, and on 4/26/24, when hospice was at the facility to see (R1), which posed an immediate health and safety risk to residents in care.

87464 Basic Services (f) Basic services shall at a minimum include: (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 requirement is not met as evidenced by: Based on interviews conducted and documentation reviewed, the Licensee did not ensure that resident (R1) was provided with the personal assistance and care in ensuring her compression socks were worn as ordered, shoes and feet were kept clean on 4/5/24 and 4/6/24, and Seroquel medication was given as ordered, which posed an immediate health and safety risk to residents in care.

§1569.625 Staff training; legislative findings; contents (b)(2) (2) In addition to paragraph (1), training requirements shall also include an additional 20 hours annually, eight hours of which shall be dementia care training, as required by subdivision (a) of Section 1569.626, and four hours of which shall be specific to postural supports, restricted health conditions, and hospice care, as required by subdivision (a) of Section 1569.696. This training shall be administered on the job, or in a classroom setting, or both, and may include online training. This requirement is not met as evidenced by: Based on review of (14) staff training records, provided in April 2024, many of the staff, including (S1), did not complete the required annual training, specifically to Dementia care, following the initial year of employment, which poses a potential health and safety risk to residents in care.

87464 Basic Services (f) Basic services shall at a minimum include: (1) Care and supervision as defined in Section 87101(c)(3) and Health and Safety Code section 1569.2(c).This requirement is not met as evidenced by: Based on records reviewed and interviews conducted, the facility did not ensure that residents R1 was properly supervised, resulting in AWOL, which poses an immediate health, safety, and personal rights risk to residents in care.

87465 Incidental Medical and Dental Care (a) A plan for incidental medical and dental care shall be developed by each facility (...) by compliance with the following: (4) The licensee shall assist residents with self-administered medications as needed. This requirement is not met as evidenced by: Based on medication count and records reviewed, the facility did not ensure that residents (R1, R2, & R3) were receiving medications as prescribed, which poses an immediate health, safety, and personal rights 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 have all of the following personal rights: (3) To be free from punishment, humiliation, intimidation, abuse, or other actions of a punitive nature, such as withholding residents’ money or interfering with daily living functions such as eating, sleeping, or elimination. This requirement is not met as evidenced by: Based on interview the licensee did not ensure that resident was afforded their personal rights which poses 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 have all of the following personal rights: (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 interview the licensee did not ensure residents were treated with dignity which poses an immediate health and safety risk to residents in care.

Rate increase due to change in level of resident care; notice: For any rate increase due to a change in the level of care of the resident, the licensee shall provide the resident and the resident’s representative, if any, written notice of the rate increase within two business days after initially providing services at the new level of care. This requirement has not been met as evidenced by: Based on interviews conducted and records obtained, R1 was moved to memory care unit on 10/7/20, the addendum to the resident agreement was provided to the responsible party on 10/14/20. This poses a potential health and safety risk to the residents in care.

Personnel Requirements - GeneralFacility personnel shall at all times be sufficient in numbers, and competent to provide the services necessary to meet resident needs. This requirement has not been met as evidenced by: Based on observation and interviews conducted the facility did not address resident's (R2) aggressive behavior on the unit resulting in injury to R1. This poses an immediate risk to the resident's health and safety.

Reappraisals - The pre-admission appraisal shall be updated, in writing as frequently as necessary to note significant changes and to keep the appraisal accurate. The reappraisals shall document changes in the resident's physical, medical, mental, and social condition. This requirement has not been met as evidenced by: Based on interviews conducted and records reviewed, the administrator failed to conduct a reappraisal or implement a needs and services plan after behaviors were observed in R1. This resulted in the facility taking the residents personal phone away.