Heritage Hills

Basic Services 87464(f) Basic services... include: (4) Personal assistance and care as needed by the resident and as indicated in the pre-admission appraisal, with those activities of daily living such as dressing, eating, bathing and assistance with taking prescribed medications... Based on observation, interview, and record review, the facility did not ensure that all resident toileting needs were met, which posed a potential Health, Safety, and Personal rights risks to 1 of 76 persons in care.

Basic Services 87464(f) Basic services... include: (1) Care and supervision as defined in Section 87101(c)(3) Health and Safety Code (c)"Care and supervision" means the facility assumes responsibility for... ongoing assistance with activities of daily living..." Based on observation, interview, and record review, the facility did not ensure that all resident signal alerts were answered in a timely manner, which posed a potential Health, Safety, and Personal rights risks to 1 of 76 persons in care.

Based on LPA observation, the licensee did not comply with the section cited above in that several items including dressings, sauces, and canned products were expired and in refridgerator/pantry which poses a potential health, safety or personal rights risk to 76 of 76 persons in care.

Based on LPA observation, the licensee did not comply with the section cited above in that vegetables (onions, lettuce, potatoes) and fruits (lemons, tomatoes) were left uncovered and had no labeled dates which poses a potential health, safety or personal rights risk to 76 of 76 persons in care.

87411 Personnel Requirements – General (a) Facility personnel shall at all times be sufficient in numbers, and competent to provide the services necessary to meet resident needs... Additional staff shall be employed as necessary to perform office work, cooking, house cleaning, laundering, and maintenance of buildings, equipment and grounds. The licensing agency may require any facility to provide additional staff whenever it determines through documentation that the needs of the particular residents... This was not met as evidenced by:Based on interviews and records review, R1 was able to ingest a chemical that was left unlocked/unsupervised by facility staff which poses an immediate Health, Safety, or Personal Rights risk to persons in care.

Reappraisals (c) If the licensee observes or is made aware of behavioral expression, as defined in Section 87101, that has caused or may cause harm to the resident or others, the licensee shall document all of the following in the resident’s reappraisal: (3) Interventions to be implemented to minimize the risks to the health and safety of the resident or others associated with the resident's behavioral expression. The licensee shall use the least restrictive intervention to manage the behavioral expression based on the individual needs of the resident. This requirement was not met as evidenced by: Based on record review and interviews, the licensee did not ensure that R2 received a reappraisal after a significant change in condition and behavioral expression to minimize risks to other residents in care. This posed an immediate safety risk to 70 of 70 residents in care.

87464 Basic Services(f) Basic services shall at a minimum include: (1) Care and supervision as defined in Section 87101(c)(3) and Health and Safety Code section 1569.2(c).This requirement was not met as evidenced by: Based on record review and interviews, the licensee did not ensure that R1 was provided care and supervision, which posed an immediate health, safety, and personal rights risk to 1 (R1) of 64 residents in care.

1569.312 Basic services requirements: "(e) Monitoring the activities of the residents while they are under the supervision of the facility to ensure their general health, safety, and well-being." This requirement was not met as evidence by: Based on interview, the licensee did not comply with the section cited above in one (1) out of sixety-nine (69) residents which posed a potential health and safety risk to persons in care.

87468.1(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 interviews, Licensee did not accord 1 of 70 residents (R1) dignity in their personal relationships with staff. This posed a potential personal rights risk to persons in care.

87625(b)..."Licensee shall be responsible for ensuring (2)...that incontinent residents are checked... when they are known to be incontinent...(3) incontinent residents are kept clean and dry and that the facility remains free of odors from incontinence. This requirement was not met, evidenced by: Based on interviews and observations, Licensee did not: check residents when known to be incontinent, ensure residents' were clean/dry, or ensure the facility remained free of odors of incontinence. This posed a potential health risk to 70 of 70 residents in care.

1569.317 Absentee Notification Plan for Missing Residents: “Every residential care facility for the elderly…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 records and interviews, licensee’s staff did not develop an absentee notification plan for 71 of 71 residents (R1 through R71), which posed a potential safety risk to persons 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, within the context of effective searching following a delayed-egress door alarm, the licensee did not ensure facility personnel were competent to provide the services necessary to meet the needs of 1 of 71 residents (R1), which posed a potential safety risk to persons in care.

87303 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 as evidence by: Based on interviews and observations, the Licensee did not ensure the facility was clean and sanitary, whcih posed a potential health, safety, and personal rights risk to 69 of 69 persons in care.

87411 Personnel Requirements - General (a) Facility personnel shall at all times be sufficient in numbers, and competent to provide the services necessary to meet resident needs. In facilities licensed for sixteen or more, sufficient support staff shall be employed to ensure provision of personal assistance and care as required in Section 87608, Postural Supports. Additional staff shall be employed as necessary to perform office work, cooking, house cleaning, laundering, and maintenance of buildings, equipment and grounds. The licensing agency may require any facility to provide additional staff whenever it determines through documentation that the needs of the particular residents, the extent of services provided, or the physical arrangements of the facility require such additional staff for the provision of adequate services. This requirement was not met as evidence by: Based on interviews and review of records, the Licensee did not ensure staff were competent to provide services necessary, which posed a potential health, safety, and personal rights risk to 69 of 69 persons in care.

87464 Basic Services (f) Basic services shall at a minimum include:(4) Personal assistance and care as needed by the resident and as indicated in the pre-admission appraisal, with those activities of daily living such as dressing, eating, bathing and assistance with taking prescribed medications, as specified in Section 87608, Postural Supports. This requirement was not met as evidence by: Based on interviews, the Licensee did not ensure staff assisted residents with activities of daily living such as dressing, which posed a potential health, safety and personal rights risk to 69 of 69 person in care.

87211 Reporting Requirements (a)(1) A written report shall be submitted to the licensing agency and to the person responsible for the resident within seven days of the occurrence... This requirement has not been met as evidenced by: Based on interviews and records review, the Licensee did not submit an incident report to the Department regarding R1's fall. This poses an potential safety risk to 68 of 68 residents in care.

1569.699 Exit doors; egress-control devices of time-delay type; fences: (a)(7)(A) A sign shall be provided on the door located above and within 12 inches (305mm) of the panic bar or other door-latching hardware…” This requirement was not met, as evidenced by: Based on LPA observation, licensee did not place the required sign within 12 inches of the panic bar or other door-latching hardware for 2 of 6 delayed-egress exit doors, which posed a potential safety risk to persons in care.

The licensee may evict a resident for one or more of the reasons listed in Section 87224(a)(1)...Thirty (30) days written notice to the resident is required...Nonpayment of the rate for basic services within ten days of the due date.This requirement has not been met as evidenced by: Based on interviews and records review, Thirty (30) days written notice to the resident was not issued for Nonpayment of the rate for basic services...for 1 in 1 of 64 persons in care [R1] which posed an immediate safety and personal rights risk to persons in care.

87464 Basic Services (f)(1)(c)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…on going assistance with activities of daily living without which the resident’s physical health, mental health, safety, or welfare would be endangered.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 72 residents, by not providing the required supervision which poses an immediate health and safety risk to residents in care.

Based on observation, the licensee did not comply with the section cited above for all residents which poses a potential personal rights risk to persons in care.

Based on observation the licensee did not comply with the section cited above in which poses a potential safety risk to all persons in care.