Appearance Quality Home

Based on LPA observations, the licensee did not comply with the section cited above by R1's prescribed medication from 9/7 was still in the medication packet and staff logged medication as given on that day; which poses an immediate health, safety or personal rights risk to persons in care.

Based on LPA record review, the licensee did not comply with the section cited above by not maintaining cleaning solutions inaccessible to residents in care; which poses an immediate health, safety or personal rights risk to persons in care.

Based on LPA observations, the licensee did not comply with the section cited above by PA observed that resident #1 (R1) medication log was not up-to-date. Staff did not log when resident's pm medication were given on several days; which poses an immediate health, safety or personal rights risk to persons in care.

Based on observation and record review, the administrator did not comply with the section cited above in providing an Infection Control Plan in the facility file which poses a potential health, safety or personal rights risk to persons in care.

Based on observation, interview and record review, the administrator did not comply with the section cited above in notifying the licensing agency of their intention to lock the exterior door/gate which poses a potential health, safety or personal rights risk to persons in care.

Based on observation, interview and record review, the administrator did not comply with the section cited above in not providing criminal record clearance of (S2) which poses an immediate health, safety or personal rights risk to persons in care.

Based on observation and record review, administrator did not comply with the section cited above in maintaining complete personnel records for (S1) and (S2) which poses a potential health, safety or personal rights risk to persons in care.

Based on observation and record review, the administrator did not comply with the section cited above in reviewing annually the emergency disaster plan which poses a potential health, safety or personal rights risk to persons in care.

Based on observation and record review, the administrator did not comply with the section cited above in providing proof of training, first aid/cpr certification, and medication training for staff which poses a potential health, safety or personal rights risk to persons in care.

Based on observation and record review, the administrator did not comply with the section cited above in maintaining complete resident records for (R1) like the physician's report and appraisal/needs & services which poses a potential health, safety or personal rights risk to persons in care.

Based on observation and interview, the administrator did not comply with the section cited above in maintaining one week of nonperishable and two days of perishable foods for residenst in care after disposing the expired nonperishable and perishable food which poses an immediate health, safety or personal rights risk to persons in care.

Based on observation the licensee did not comply with the section cited above by placing locks on the pantry and refrigerators without approved waiver. Which poses a potential health, safety or personal rights risk to persons 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, ... This requirement has not been met as evidenced by: Based on interviews, the Licensee did not ensure the personal rights of R1. This is an immediate personal rights risk to resident's in care.

87211 - Reporting Requirements(a) Each licensee shall furnish to the licensing agency such reports as the Department may require... (1)... (B) Any serious injury as determined by the attending physician and occurring while the resident is under facility supervision. This requirement has not been met as evidenced by: Based on interviews and observations, the Licensee did not ensure that serious injuries were reported to the Department in a timely manner. This is a potential health and safety risk to resident's 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: (16) To receive or reject medical care or other services. This requirement has not been met as evidenced by: Based on interviews, the Licensee did not seek timely medical attention for R1. This is a immediate health and safety risk to resident's in care.

87204 Limitation-Capacity and Ambulatory status (a) A licensee shall not operate a facility beyond the conditions and limitations specified on the license, including specification of the maximum number of persons who may receive services at any one time... This requirement is not met by: Based on observation, interview, and record review the licensee did not stay within capacity on 1 of 1 times.

80072 Personal Rights(a) Except for children’s residential facilities, each client shall have personal rights which include, but are not limited to, the following:(2) To be accorded safe, healthful and comfortable accommodations, furnishings and equipment to meet his/her needs. This requirement is not met as evidenced by:Based on observation, record review and interview the licensee did not ensure that 2 out of 6 residents had comfortable accommodations.

80022 Plan of Operation(a) Each licensee shall have and maintain on file a current, written, definitive plan of operation.Prior to the use of secured perimeters, applicants or licensees of Group Homes and Adult Residential Facilities seeking to utilize secured perimeters pursuant to Health and Safety Code section 1531.15 shall submit the Department of Developmental Service's written approval and the approved component of the applicant's or licensee's plan of operation to the Department as specified in the California Code of Regulations, Title 17, Chapter 3, Sub chapter 4, Article 12, Sections 56072(c). This requirement is not met as evidenced by: Based on observation the licensee did not obtain prior approval for a secured perimeter on 1 out of 1 times. This poses a potential health, safety, and personal rights risk to person's in care.

80019 Criminal Record Clearance80019 Criminal Record Clearance(e) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1522 shall prior to working, residing or volunteering in a licensed facility: (1)Obtain a California clearance or a criminal record exemption as required by the Department or.. This requirement is not met as evidenced by the licensee allowing for a family friend to utilize the amenities at the facility. This poses a potential health, safety or personal rights risk to person's in care.

80022 Plan of Operation(a) Each licensee shall have and maintain on file a current, written, definitive plan of operation.(7) A sketch of the building(s) to be occupied, including a floor plan which describes the capacity's of the buildings for the uses intended, room dimensions, and a designation of the rooms to be used for non ambulatory clients, if any. This requirement is not met as evidenced by:Based on observation the licensee did not follow the plan of operation on 1 out of 1 times

80026 Safeguards for Cash Resources, Personal Property, and Valuables of Residents(a) A licensee shall not be required to accept for admission or continue to care for any client whose incapacitates, as documented by the initial or subsequent needs appraisals, would require the licensee to handle such client's cash resources.(f) The licensee or employee of a licensee shall not make expenditures from clients' cash resources for any basic services in these regulations, or for any basic services identified in a contract/admission agreement between the client and the licensee. This requirement is not met as evidenced by:Based on observation, interview and record review the licensee did not ensure that the resident used their own resources for basic services. This poses a potential health, safety or personal rights risk to person's in care.

80034 Submission of a new application(a) A licensee shall file a new application as required by Section 80018 whenever there is a change in conditions or limitations described on the current license, or other changes including but not limited to the following:(4) Any increase in capacity.This requirement is not met as evidenced by:Based on observation, interview and record review the licensee did not submit a new application for an increase in capacity. This poses a potential health, safety or personal rights risk to person's in care.

80072 Personal Rights(a) Except for children’s residential facilities, each client shall have personal rights which include, but are not limited to, the following:(3) To be free from corporal or unusual punishment, infliction of pain, humiliation, intimidation, ridicule, coercion, threat, mental abuse, or other actions of a punitive nature, including but not limited to: interference with the daily living functions, including eating, sleeping, or toileting; or withholding of shelter, clothing, medication or aids to physical functioning. This requirement is not met as evidenced by: The licensee having the pantry and refrigerator locked.

80072 Personal Rights(a) Except for children’s residential facilities, each client shall have personal rights which include, but are not limited to, the following:(1) To be accorded dignity in his/her personal relationships with staff and other persons. This requirement is not met as evidenced by:Based on observation, and interviews the licensee did not ensure that the resident's were spoken to appropriately on at least 2 occasions. This poses a potential health, safety or personal rights risk to persons in care.