Rose Garden Residential Care

(c) “Care and supervision” means the facility assumes responsibility for, or provides or promises to provide in the future, ongoing assistance with activities of daily living without which the resident’s physical health, mental health, safety, or welfare would be endangered. This requirement was not met with evidence by: (1) one out of (1) one resident eloped from the facility without staff knowledge resulting to Resident #1 (R1) sustaining multiple injuries.

(7) Dementia care, including the use and misuse of antipsychotics, the interaction of drugs commonly used by the elderly, and the adverse effects of psychotropic drugs for use in controlling the behavior of persons with dementia. This requirement is not met as evidenced by: Based on LPA's record review and interviews, staff 7 was observed having and using canabis susbtance while working at facility which poses an immediate health and safety risk to residents in care.

87555General FoodServiceRequirements (b)(8)All food shall be of good quality. Commercial foods shall be approved by appropriate federal, state and local authorities. Food in damaged...shall not be accepted, used or retained. This requirement is not met as evidenced by: staff did not inspect the food to ensure the food service was in a quality condition for the client/resident in care which poses a potential health, safety and personnal rights risk to persons in care.

80092.1 General Requirements for Restricted Health Conditions (n)The licensee shall ensure that the client’s health-related service needs are met and shall follow the approved plan for each client. This requirement is not met as evidenced by: Staff did not seek medical attention for resident in care after an unwitnessed fall which poses a potential health, safety and personnal rights risk to persons in care.

87465 Incidental Medical and Dental Care(g) (g) The licensee shall immediately telephone ...a resident’s health including, but not limited to, an apparent life-threatening medical crisis except as specified in Sections 87469(c)(2), (c)(3), or (c)(4).This requirement is not met as evidenced by: Based on interviews, the licensee did not comply with the section cite above by not calling 911 after falls with suspected head injury for R1 which poses an immediatel health, safety and personnal rights risk to persons in care.

87555General Food Service Requirements(a)The total daily diet shall be of the quality and in the quantity necessary to meet the needs and... shall be selected, stored, prepared and served in a safe and healthful manner. This requirement is not met as evidenced by: Based on interviews, the licensee did not comply with the section cite above by not serving mold to a resident. Which poses an potential health, safety and personnal rights risk to persons in care.

Based on observation, interview, and record review, the licensee did not comply with the section cited above which poses an immediate health, safety or personal rights risk to persons in care.

Based on observation and interview, the licensee did not comply with the section cited above which poses/posed a potential health, safety or personal rights risk to persons in care.

87470 Infection Control Requirements (c) An Infection Control Plan shall be developed by the licensee and shall be included in the Plan of Operation required by Section 87208.This requirement is not met as evidenced by: Based on LPAs record review, observation and interviews Licesnee did not have an updated Infection control plan nor an infection control training completed on Covid -19 use of Personal Protective equiptment (PPE). This poses a potential risk to the health safety and personal rights of residents in care.

Theft and Loss 87218.... (a) The licensee shall ensure an adequate theft and loss program as specified in Health and Safety Code Section 1569.153.... (1) The initial personal property inventory shall be completed by the licensee, and the resident, or the resident’s representative.... (2) A licensee who fails to make reasonable efforts to safeguard resident property, shall reimburse a resident for or replace stolen or lost resident property at its current value. The licensee shall be presumed to have made reasonable efforts to safeguard resident property if there is clear and convincing evidence of efforts to meet each requirement specified in Section 1569.153.This requirement is not met as evidence by: Based on record review, facility did not follow theft & loss regulation for Resident#1 leading to R#1 loss and mismanagement of R#1 personal belongings, which poses a potential health, safety, or Personal Rights risk to persons 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 is not met as evidence by: Based on observation, facility did not follow maintenance and operation regulation to keep facility clean, sanitary and in good repair for 1 out of 4 units, which poses a potential health, safety, or Personal Rights risk to persons in care.

87506 Resident Records....(a) The 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.....(1) The licensee shall be responsible for storing active and inactive records and for safeguarding the confidentiality of their contents. The licensee and all employees shall reveal or make available confidential information only upon the resident's written consent or that of his designated representative.This requirement is not met as evidenced by: Based on interviews and record review, the licensee did not follow title 22 regulation pertaining to “resident records” by not storing active and inactive records and not safeguarding R#1 records, which poses a potential health, safety, or Personal Rights risk to persons in care.

‘residents in privately operated residential care facilities for the elderly shall have all .. personal rights:’ ... ‘(19) To have prompt access to review all of their records ... Photocopied records shall be provided within two (2) business days... This requirement is not met as evidenced by: Based on LPA observations and interviews, staff was not able to provide responsible party with resident's records in a timely manner which poses a personal rights risk to residents in care

87217 Safeguards for Resident Cash, Personal Property, and Valuables(j) Upon the death of a resident, all cash resources, personal property, and valuables of that resident shall immediately be safeguarded. This requirement was not met as evidenced by:Based on records reviewed and interviews conducted, neither staff nor R1's representative were able ro locate R1’s missing antenna.This poses a potential health and safety risk to residents in care.

87303 Maintenance and Operation (a) The facility shall be clean, safe and sanitary and in good repair at all times. Maintenance shall include ... This requirement is not met as evidenced by: Based on observations, the Licensee did not comply with the section cited above by having residents patio fence door in disrepair which poses an immediate health, safety and personal rights risks to residents in care.

1) Personal Rights 80072 (3) To be free from corporal or unusual punishment, infliction of pain, humiliation, intimidation, ridicule, coercion, threat, mental abuse, or other actions of punitive nature, including but not limited to: interference with the daily living function, including eating, sleeping, or toileting; or withholding of shelter, clothing, medication, or aids to physical functioning.This requirement is not met as evidence by: Based on interviews, record review, facility staff did not ensure Resident #1 to be free from corporal or unusual punishment, infliction of pain, humiliation, intimidation, ridicule, coercion, threat, mental abuse, or other actions of punitive nature. Which poses an immediate Health, Safety, or Personal Rights risk to persons in care.

Care of Persons with Dementia(4) There is an adequate number of direct care staff to support each resident’s physical, social, emotional, safety and health care needs as identified in his/her current appraisal. (A) In addition to requirements specified in Section 87415, Night Supervision, a facility with fewer than 16 residents shall have at least one night staff person awake and on duty if any resident with dementia is determined through a pre-admission appraisal, reappraisal.. This requirement is not met as evidenced by: Based on interviews & records review, it was found that R1 does have a history of leaving facilities unauthorized staff members did not ensure the saftey of the residents in care.Staff 1 found R1 30-45 minutes later outside of the facilty at Jack in the Box in the neighborhood. This pose immediate health, safety and personal rights risk to residents in care.

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 requirement is not met as evidenced by: The licensee did not report to R1's responsible party or ccl of R1's broken eye glases that are required

(a) The licensee shall ensure an adequate theft and loss program as specified in Health and Safety Code Section 1569.153. This requirement is not met as evidenced by: The licensee did not ensure that R1's personal belongings were returned to their responsible party upon their dischage from the facility and 1 item was located during LPA's visit.

87705 Care of Persons with Dementia The following initial and continuing requirements shall be met for the licensee to lock exterior doors or perimeter fence gates: available on the facility premises to permit residents with dementia to wander freely and safely. Interior and exterior space shall be... This requirement is not met as evidenced by: The staff did not esure the saftey of the resident while in care that resulted in unexplained brusing.

(B) In a residential facility, death of any client...regardless of where the death occurred. This includes a death that occurred outside the facility such as at a day program, workshop, job, hospital, en route to or from a hospital, or visiting away from the facility.This requirement was not met as evidenced by: LPA verified that an LIC 624A was not submitted to the Department.