Braswell's Mediterranean Gardens

87355 Criminal Record Clearance (e) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1569.17(b): shall prior to working... in a licensed facility: (2) obtain a California clearance... as required by the Department. The requirement is not met as evidence by Based on observation the license did not ensure staff properly obtained background check/ criminal record clearance prior to being hired at the facility which poses an immediate health and safety risk.

Based on LPA's observations the facility staff did not ensure medications were not transferred between containers which pose potential health, safety and personal rights risk to residents in care.

Based on LPA's observations the facility staff did not ensure MARS were siged at the time medications were given to the residents in care which pose potential health, safety and personal rights risks to resident 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:(1) To be accorded dignity in their personal relationships with staff, residents, and other persons. 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, R1's personal rights were violated when S1 did not accord them dignity in medication administration. This poses a potential health, safety, and personal rights 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:(1) To be accorded dignity in their personal relationships with staff, residents, and other persons. This regulation was not met as evidenced by: The licensee did not ensure the personal rights of all residents were maintained. Based on LPA's observation and statement of S1, S1 did not grant R1 and R2 dignity during S1's assistance with R1 and R2's toileting needs. This poses an immediate health, safety, and personal rights risk to residents in care.

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 was not met as evidenced by: The licensee did not comply with the terms in R1's admission agreement. R1's admission agreement indicated R1 paid a monthly fee to be provided assistance with ADLs which included bathing. Interview with AD revealed AD believed bathing assistance for R1 was not required, therefore would only get it when time permitted and free of charge. This poses a potential health, safety and personal rights risk to residents in care.

Incidental Medical and Dental Care- (a) A plan for incidental medical and dental care shall be developed... The plan shall ...provide for assistance...with the following:(1)The licensee shall arrange...for medical care... appropriate to the conditions and needs of residents. This requirement was not met as evidenced by: The licensee did not ensure medical care was arranged for the needs of R1. Based on interviews conducted, provisions for medical care were not made for R1 following their fall on 11/7/2020. The facility only made arrangements for such care two days later after being instructed to do so by R1's Conservator. This poses an immediate health,

Reporting Requirements- (a) Each licensee shall furnish...reports...including ...the following:(1)A written report shall be submitted to the licensing agency and to the person responsible for the resident... of the occurrence of...(D) Any incident which threatens the welfare, safety or health...of any resident. This requirement was not met as evidenced by: The licensee did not ensure a written report was submitted to R1's Conservator. Based on interviews conducted, the facility notified R1's foster mother of R1's fall but not their Conservator. This poses a potential health, safety, and personal rights risk to residents in care.

Maintenance and Operation-(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 requirement was not met as evidenced by: The licensee did not ensure the facility was safe and sanitary at all times. Based on interviews conducted and records reviewed, the facility has experienced an ongoing battle with bed bugs but did not take action to mitigate bed bugs until October 2022. This poses a potential health, safety, and personal rights risk to residents in care.

Observation of the ResidentThe 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... This requirement is not met as evidenced by: The licensee didn't ensure staff had proper training on observation of residents in care.

Reporting Requirements. The licensee shall send a written report, within seven days, to the licensing agency and the person responsible for the resident when any incident occurs which threatens the welfare, safety or health of any resident. This requirement is not met as evidenced by: Licensee to ensure that all unusual incidents are reported to CCL within 7 days as specified on code section 87211. hospitalization of R#1.

(e) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1569.17(b) shall prior to working, residing or volunteering in a licensed facility:Based on interview and record review, the licensee did not comply with the section cited above as LPA confirmed on Guardian that Staff 1 and Staff 2 did not have criminal clearance to work at the facility which poses an immediate health, safety or personal rights risk to persons in care.

Personal Rights: To be accorded safe, healthful and comfortable accommodations, furnishings and equipment to meet his/her needs... This requirement was not met by: Based on records review and interviews, the Licensee did not comply with the above regulation with at least two staff trained to use Hoyer Lift to assist Resident #1 with ADL's and the resident's care plan . This is an immediate Health and Safety risk to residents in care.

Records of licensed facilitiesEach residential care facility for the elderly required to be licensed pursuant to this chapter shall keep a current record of clients in the facility, including the client’s name and ambulatory status, and the name, address, and telephone number of the client’s physician and of any person or agency responsible for the care of the client. The facility shall protect the privacy and confidentiality of this information. This requirement was not met as evidenced by: Based on observation, interview and record review the licensee did not protect the privacy and confidentiality of client information on 4 different occasions. This poses a potential Health, Safety or Personal Rights risk to persons in care.

87468 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 was not met as evidenced by: Based on observation, interview and record review the licensee did not observe on more than one occasion the residents had not been afforded their privacy. This poses a potential Health, Safety or Personal Rights risk to persons in care.

87632 Hospice Care Waiver(a) In order accept or retain terminally ill residents and permit them to receive care from a hospice agency, the licensee shall have obtained a facility hospice care waiver from the Department. To obtain this waiver the licensee shall submit a written request for a waiver to the Department on behalf of any residents who may request retention, and any future residents who may request acceptance, along with the provision of hospice services in the facility. The request shall include, but not be limited to the following:(1)Specification of the maximum number of terminally ill residents which the facility wants to have at any one time. This requirement is not met as evidenced by: Based on observation, interview and record review the licensee did not operate within capacity limitations. The facility having 2 additional residents on hospice. When they are only approved for 5. This poses a potential Health, Safety, or Personal Rights risk to persons in care.