Braswells Yucaipa Leisure Manor

Admission Agreements(f)The licensee shall comply with all applicable terms and conditions set forth in the admission agreement, including all modifications and attachments. This requirement is not met as evidenced by: Staff received disciplinary action for not appropriately/immediately reporting falls and injuries (condition) to R1's authorized party and physician. Admissions agreement reveals basic services includes, "monitoring and appropriate reporting of resident needs and conditions to family and physician". This posed a potential health, safety, and personal rights risk to persons in care.

Observation of the Resident .The licensee shall ensure that residents are regularly observed for changes in physical, mental, emotional...functioning... appropriate assistance is provided when such observation reveals unmet needs. When changes such as...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: Staff observed R1 with skin tears, unable to sit up without pain and did not notify R1 physician regarding changes in the R1's condition. This posed an immediate health, safety, and personal risk to residents in care.

Additional Personal Rights of Residents in Privately Operated Facilities(a)In addition to the rights listed in Section 87468.1... residents...shall have all of the following personal rights: (4) To care, supervision, and services that meet their individual needs...delivered by staff that are sufficient in numbers, qualifications, and competency...This requirement is not met as evidenced by: R1 sustained an unwitnessed fall around 4:30pm on 8/13/22. It was not until around 11:30 am on 8/14/22, when R1 received medical care to meet R1 injuries (needs). Licensee did not ensure that R1 received care and supervision to meet R1 needs. On 8/13/2022, R1 was left unattended by staff in the dining room, for an unknown period of time. R1 sustained multiple fractures and skin tears. Medical records indicate the cause of the injuries was a fall. This posed an immediate health, safety and personal rights risk to residents in care.

87625 Managed Incontinence (b) In addition to Section 87611, 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 LPAs observations staff did not change resident's pull ups in a timely manner. LPAs observed resident soaked in adult pull up which poses a health and safety risk to residents in care

Based on observation, the licensee did not comply with the section cited above due to the assisted living wing rooms 21 and 28 hot water measured at 138.5 and 145.2, along with memory care shower hot water temperature measured at 145.9 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:(16)To receive or reject medical care or other services. This requirement was not met as evidenced by: The licensee did not ensure the personal rights of all residents were maintained. Based on interviews, ED confirmed she canceled R1's medical appointment because R1's family was going to accompany them to the appointment. This poses an immediate health, safety and personal rights risk to residents in care.

Personal Rights of Residents in All Facilities-(a) Residents...shall have all of the following personal rights: (11) To have their visitors...permitted to visit privately during reasonable hours... provided... rights of other residents are not infringed upon. This requirement was not met as evidenced by: The licensee did not ensure the personal rights of all residents were maintained. Based on interviews conducted, ED prohibited in person visits for R1. This poses an immediate personal rights risk to residents in care

Additional Personal Rights of Residents in Privately Operated Facilities- (a) In addition to...Section 87468.1... residents in...residential care facilities for the elderly shall have...the following personal rights:(4)To care, supervision...by staff ...to meet their needs. This requirement was not met as evidenced by: The licensee did not ensure the personal rights of all residents were maintained. Based record review, the supervision of R1 had been unverified as reported in an incident reported dated 2/28/20. This poses an immediate health, safety, and personal rights risk to residents

Reporting Requirements- (a) Each licensee shall furnish...reports...including the following:(1)A written report shall be submitted...to the person responsible for the resident within 7 days of..occurrence of any...events specified...below. (D)...unexplained absence of any resident. This requirement was not met as evidence by: The licensee did not ensure R1's responsible party was notified of an unexplained absence. Based on interviews and records reviewed, ED denied R1 had an unexplained absence yet records reviewed indicated R1 may have been unaccounted for. This poses a potential

87207 False ClaimsNo licensee, officer or employee of a licensee shall make or disseminate any false or misleading statement regarding the facility or any of the services provided by the facility.This requirement is not met as evidenced by: The licensee did not ensure that staff members understand that False Claims of any kind are not acceptable. The interviews conducted, and documents reviewed show that someone a (licensee, officer or employee of a licensee) falsified medical documents that were not signed by an licensed medical professional.

87411 Personnel Requirements - General (d) All personnel shall be given on the job training or have related experience in the ... (3) Skill and knowledge required to provide necessary resident care and supervision, including the ability to communicate with residents. This requirement is not met as evidenced by: Based on interviews with S1 & S3, the licensee did not ensure that R1 was provided adequate supervision. This is a potential health and safety risk to residents in care.