Westmont at San Miguel Ranch

87465(a)(1) Incidental Medical and Dental Care. A plan for incidental medical and dental care shall be developed by each facility.....The licensee shall arrange, or assist in arranging, for medical and dental care appropriate to the conditions and needs of residents. This was not met as evidenced by: Based on interviews and records review, the facility did not meet the needs of R1 as R1s condition had changed due to the abscess having some kind of discharge. Even though staff did provide the required care the facility should have sent R1 out of the facility immediately, as the discharge from the open wound was now a portal for an infection as R1 had sepsis, which poses an immediate health and safety risk to residents in care.

87468.2 Additional Personal Rights of Residents in Privately Operated Facilities (a) In addition to the rights listed in Section 87468.1, Personal Rights of Residents in All Facilities, residents in privately operated residential care facilities for the elderly shall have all of the following personal rights: (8) To be free from neglect, financial exploitation, involuntary seclusion, punishment, humiliation, intimidation, and verbal, mental, physical, or sexual abuse.This requirement was not met as evidenced by: Based on review of records, and interviews, the licensee did not ensure R1 was free of neglect, which resulted in R1 sustaining injuries, this posed an immediate health, safety, and personal rights risk to 1 of 89 residents in care.

87464 Basic Services(to include) (4) Personal assistance and care as needed by the resident …with those activities of daily living ... Based on interviews and record review 1 of 63 residents did not receive basic services when care was not delivered to R1 for six hours which posed a potential risk to the health of persons in care.

This requirement was not met, as evidenced by: Based on observation and record review, in an area of the facility where 1 of 71 residents (R1 through R24) resided, licensee utilized delayed egress devices on exterior doors but did not ensure that its fire clearance included approval of delayed egress devices. This posed a potential safety risk to persons in care.

87458 Medical Assessment … Prior to a person's acceptance as a resident, the licensee shall obtain and keep on file, documentation of 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 was not met as evidence by: Based on records review, staff did not obtain residents Physician’s Report (LIC602) prior to admission. This posed a potential health risk to two of 78 [R1 & R2] residents in care.

87411 Personnel Requirements – General: “(a) Facility personnel shall at all times be…competent to provide the services necessary to meet resident needs.” This requirement was not met, as evidenced by: Based on interviews, the licensee did not ensure facility personnel (S2) was competent to provide the services necessary to meet the needs of 1 of 81 residents (R1), which posed a potential safety risk to persons in care.

1569.317 Absentee notification plan for missing residents Every residential care facility for the elderly, as defined in Section 1569.2, shall, for the purpose of addressing issues that arise when a resident is missing from the facility, develop and comply with an absentee notification plan… this requirement was not met as evidenced by: Based on interviews and records reviewed Licensee did not ensure staff complied with the facility’s absentee notification plan. Staff 1 (S1) did not complete an immediate systematic search of the property after an exit door alarm went off. This posed a potential safety risk to 1 out of 68 residents in care.