Golden Living Health Management, Inc.

Assist residents with self-administered medication

87465 Incidental Medical and Dental Care (a)A plan for incidental medical and dental care shall be developed by each facility. The plan shall encourage routine medical and dental care and provide for assistance in obtaining such care, by compliance with the following:(4)The licensee shall assist residents with self-administered medications as needed. The following requirement has not been met as evidenced by: Resident 1's medications were not given as prescribed, which poses an immediate health, safety, or personal rights risk to residents in care.

Arrange appropriate medical and dental care

87465 Incidental Medical and Dental Care (a) A plan for incidental medical and dental care shall be developed by each facility. The plan shall encourage routine medical and dental care and provide for assistance in obtaining such care, by compliance with the following:(1) The licensee shall arrange, or assist in arranging, for medical and dental care appropriate to the conditions and needs of residents.The following requirement has not beem met as evidenced by: Resident 1 was not provided timely medical care resulting in serious harm, which poses an immediate health, safety, or personal rights risk to residents in care.

Obtain required California clearance or exemption

Criminal Record Clearance. Obtain a California clearance or a criminal record exemption as required by the Department or. This requirement is not met as evidenced by: Based on record review, the licensee did not ensure 1 out of XX [S1] staff were fingerprint cleared and/or associated with the facility, which poses an immediate health and safety risk to residents in care.

Reporting Requirements. 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. Any incident which threatens the welfare, safety or health of any resident, such as psychological abuse of a resident by staff or other residents, or unexplained absence of any resident. This requirement was not met as evidenced by:Based on interviews and record review, the licensee did not report an incident involving 1 out of 84 [R1] residents, which posed a potential health and safety risk to residents.

Personal assistance and care for required daily activities

Basic Services. Basic services shall at a minimum include: Personal assistance and care as needed by the resident and as indicated in the pre-admission appraisal... and assistance with taking prescribed medications, as specified in Section 87608, Postural Supports. This requirement was not met as evidenced by: Based on interviews and records, the licensee did not ensure 1 out of 84 [R1] residents received assistance with bathing as documented, which posed a potential health, safety, and personal rights risk residents in care.

Regular observation and documentation of resident changes

Observation of the Resident. The licensee shall ensure that residents...observed for changes in physical, mental...assistance is provided when such observation reveals unmet needs. When changes...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 was not met as evidenced by:Based on interviews and records, the licensee did not observe a change in condition for 1 out of 84 [R1[ residents, which posed an immediate health and safety risk to residents in care.

Right to sufficient care and qualified staff

Additional Personal Rights ... (a)…residents… shall have... the following personal rights: (4) To care, supervision, and services that meet their... needs and are delivered by staff that are sufficient in...qualifications, and competency to meet their needs. This requirement was not met as evidenced by:Based on interviews and records review the licensee did not provide care and supervision to 1 out of 84 [R1] residents, which posed an immediate health, safety, and personal rights risk residents in care.

Maintain facility in clean, safe, sanitary condition

Maintenance and Operation. 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 evidenced by: Based on observations and interviews the licensee did not ensure the facility was in good repair for 1 out 87 [R1] residents, which posed a potential health and safety risk to residents in care.

Hold reappraisal meeting on changes

Reappraisals. When there is significant change in condition...or once every 12 months, whichever occurs first... share the reappraisal with the resident...and appropriate facility staff, as specified in Section 87467, Resident Participation in Decision Making. Based on record review the licensee did not ensure 1 out of 87 [R1] residents was assessed every 12 months, which posed a potential health and safety risk to resident in care.

Require physician order and label for PRN medication

Incidental Medical and Dental Care. For every prescription and nonprescription PRN medication...shall be a signed, dated written order from a physician...and a label on the medication. Both the physician's order and the label...of the following information. This requirement is not met as evidenced by: Based on record review the licensee did not ensure 1 out of 87 [R1] residents have current written orders on file, which posed a potential health and safety risk to resident in care.

Administrator – Qualifications and Duties. The administrator of a facility or facilities shall have the responsibility and authority to carry out the policies of the licensee. This requirement is not met as evidenced by: Based on interviews, the licensee did not ensure the administrator carried out the policies of the licensee for 4 out of 90 [R1-R4] residents, regarding illegal drug use in the facility, which poses an immediate health and safety risk to residents in care.

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, residing or volunteering in a licensed facility: (2) Request a transfer of a criminal record clearance as specified in Section 87355(c) or. This requirement was not met as evidenced by: Based on interviews and records reviewed the facility did not ensure Staff #1 (S1) had a transferred criminal record clearance or was associated to the facility which posed a potential health, safety and personal rights risk to 91 of 91 residents in care.

Basic services requirements. Being aware of the resident's general whereabouts, although the resident may travel independently in the community. This requirement is not met as evidenced by: Based on interviews and record review, the licensee did not ensure supervision was provided to 1 out of 92 residents [R1], which posed a potential health and safety risk to residents in care.

Assist residents with self-administered medication

Incidental Medical and Dental Care. The licensee shall assist residents with self-administered medications as needed. This requirement is not met as evidenced by: Based on interviews and record review, the licensee did not give medications as prescribed to 1 out of 91 residents [R1] in care, which posed an immediate Health and Safety risk to persons in care.

87465 (C)(2) Incidental Medical and Dental Care … Once ordered by the physician the medication is given according to the physician's directions… this requirement was not met as evidenced by: Based on interviews and record review, facility staff did not administer R1 their medications as prescribed. This posed a potential health risk to 1 of 89 residents in care.

Obtain required California clearance or exemption

87355 Criminal Record Clearance (e) All individuals subject to a criminal record review... shall prior to working, residing or volunteering in a licensed facility: (2) Request a transfer of a criminal record clearance. This requirement has not been met as evidenced by: Based on interviews and records review, the licensee did not ensure that S1's criminal background clearance was transferred to the facility prior to working. This poses an immediate safety risk to 97 of 97 residents.

Assist residents with self-administered medication

Incidental Medical and Dental Care. A plan for incidental medical...shall be developed by each facility. The plan shall encourage routine medical...such care, by compliance with the following: The licensee shall assist residents with self-administered medications as needed. This requirement is not met as evidenced by:Based on record review and interviews the licensee did not ensure medications were given as prescribed for 1 out of 79 residents in care [R2], which posed a potential health and safety risk.

Ensure hazardous items are locked and not unattended

Storage Space. Disinfectants, cleaning solutions, poisons, firearms and other items which could pose a danger if readily available to clients shall be stored where inaccessible to clients. This requirement is not met as evidenced by: Based on interviews the licensee did not items that pose a danger were inaccessible to 1 out of 79 residents in care [R1], which posed a potential health and safety risk.

Telephone service and directory listing requirements

Telephones. All facilities shall have telephone service on the premises. Facilities with a capacity of sixteen (16) or more persons shall be listed in the telephone directory under the name of the facility. This requirement is not met as evidenced by: Based on interviews the licensee did not ensure the facility had an operable telephone service at night for 91 out of 91 residents in care which posed a potential safety risk to residents in care.

Incidental medical and dental care services

Incidental Medical and Dental Care (h)(2) Centrally stored medicines shall be kept in a safe and locked place that is not accessible to persons... responsible for the supervision of the centrally stored medication. This requirement was not met as evidenced by: Based on interviews, record reviews and LPA observations, Licensee did not ensure independent resident medications, including controlled substances were secured. This posed a potential health risk to 1 out of 85 residents in care.

87507 Admissions 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: Based on interviews and records reviewed, Licensee did not notify R1 or amend the admission agreement when changing R1’s room. This posed a personal rights risk to 1 out of 75 residents in care.

Allowing diabetic residents based on self-management ability

Diabetes. The licensee shall be permitted to accept or retain...diabetes if the resident is able to perform his/her own glucose testing with blood...is able to administer his/her own medication...administered orally or through injection, or has it administered by an appropriately skilled professional. This requirement is not met as evidenced by: Based on interviews, the licensee retained (R1) 1 out of 83 resident’s that required assistance with diabetic medication management and no skilled professional on staff to assist with injections. This posed a potential health and safety risk to residents in care.

Assist residents with self-administered medication

Incidental Medical and Dental Care. The licensee shall assist residents with self-administered medications as needed. This requirement is not met as evidenced by: Based on interviews and record review the licensee did not assist with self-administered medications for (R1) 1 out of XXX residents in care. This posed an immediate health and safety risk to residents in care.

Maintain facility in clean, safe, sanitary condition

Maintenance and Operation. 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 evidenced by: Based on observations and interviews the licensee did not provide a safe and sanitary environment for (R1) 1 out of XXX residents in care. This posed a potential health and safety risk to residents in care.

Document behavioral expression and related causes

Reappraisals. The licensee shall arrange a meeting with the resident, the resident’s representative, if any, appropriate facility staff...when there is significant change in the resident’s condition, or once every 12 months...Decision Making.This requirement is not met as evidenced by: Based on record review, the licensee did not ensure resident appraisals were on file for 3 out of 86 residents. This poses a health and safety risk to residents in care.

Maintain facility in clean, safe, sanitary condition

Maintenance and Operation. 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 evidenced by: Based on observations and interviews the licensee did not maintain the bathroom shower faucets in operating condition for 1 out of 84 residents. This posed a potential health and safety risk to residents in care.

Provide resident hot water for personal care

Maintenance and Operation.Water supplies and plumbing fixtures shall be maintained as follows:Faucets used by residents for personal care...shall deliver hot water. Hot water temperature controls shall be maintained...attain a temperature of not less than 105 degree F and not more than 120 degree F. This requirement is not met as evidenced by: Based on observations and interviews the licensee did not maintain faucets within regulation temperature for 1 out of 84 residents. This posed an immediate health and safety code risk

Acceptance obligations tied to pre-admission appraisal needs

87464(d) Basic Services: …if a facility chooses to accept a particular resident for care, the facility shall be responsible for meeting the resident's needs as identified in the pre-admission appraisal…This requirement was not met as evidenced by: Staff did not provide assistance with R1’s fall risk needs identified in pre-admission appraisal, resulting in bruising due to falls. This posed a potential safety risk to one of 82 residents in care.

Regular observation and documentation of resident changes

87466 Observation of the Resident: ...residents are...observed for changes in physical...functioning... When changes …are observed, ...changes are documented and brought to the attention of…responsible person. This requirement was not met as evidenced by: Based on interviews and records review, licensee did not notify R1’s responsible party after R1 incurred multiple falls. This posed a potential health risk to one of 82 residents in care.

Call 9-1-1 for imminent health threats

87465(g) Incidental Medical and Dental Care: The licensee shall immediately telephone 9-1-1 if an injury or other circumstance has resulted in an imminent threat to a resident’s health including, but not limited to, an apparent life-threatening medical crisis. This requirement was not met as evidenced by: Based on interviews and medical records review, licensee did not telephone 911 to obtain medical treatment for R1 after unwitnessed falls that resulted in serious bodily injury (hip fracture). This posed an immediate health risk to one of 82 residents in care.

Assist residents with self-administered medication

87465(a)(4) Incidental Medical and Dental Care: The licensee shall assist residents with self-administered medications as needed.This requirement was not met as evidenced by: Based on interviews and records review, licensee did not assist R1 with prescribed medications upon admission to the facility. This posed a potential safety risk to one of 82 residents in care.

Basic Services. Care and supervision as defined in Section 87101(c)(3) and Health and Safety Code section 1569.2(c). Care and supervision" means the facility assumes responsibility for..ongoing assistance with activities of daily living without which the resident’s...welfare would be endangered. Assistance includes assistance with taking medications, money management, or personal care. This requirement is not met as evidenced by:Based on record review and interviews, the licensee did not provide basic services for 1 out of 84 residents, by allowing R1 to leave the facility unassisted. This poses an immediately health and safety risk to residents in care.

Obtain baseline medical assessment before resident admission

Medical Assessment. Prior to a person's acceptance as a resident, the licensee shall obtain...a medical assessment, signed by a physician, made within the last year. The licensee shall be permitted to use the form LIC 602 (Rev. 9/89), Physician's Report, to obtain the medical assessment. This requirement is not met as evidenced by:Based on record review, the licensee did not ensure 1 out of 84 residents had a medical assessment within one year of admission. R1 was admitted in 2021 and their medical assessment was dated 2019. This poses a potential health and safety risk to residents.

Assist residents with self-administered medication

Incidental Medical and Dental Care - The licensee shall assist residents with self-administered medications as needed. This requirement is not met as evidenced by: Based on interviews and record review, the licensee did not ensure one (1) out of 84 residents received their medications timely. R1 went without medications for a total of 9 days. This poses an immediate health and safety risk to residents in care.

Document behavioral expression and related causes

Reappraisals. The licensee shall arrange a meeting with the resident, the resident’s representative, if any, appropriate facility staff...if any, when there is significant change in the resident’s condition, or once every 12 months, whichever occurs first...87467, Resident Participation in Decision Making.This requirement is not met as evidenced by: Based on record review, the licensee did not complete a Resident Appraisal for 1 out of 83 residents. This poses a potential health and safety risk to resident in care.