Lo-har Senior Living

87307(3)(A) …. Each bed shall be equipped with good springs, a clean and comfortable mattress, available pillow(s) and lightweight warm bedding.This requirement was not met as in evidence: Based on observations, the licensee did not provide 3 of 68 residents in care clean and comfortable mattresses that pose a possible health risk to persons in care.

87465 (a):(4) The licensee shall assist residents with self-administered medications as needed.This requirement was not met as in evidence: Based on interviews the licensee did not assist resident with self-administratrion of medication in 1 of 66 persons in care R1 which posed a potential Safety, risk to persons in care.”

87468.2 a)... 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 verbal, mental, physical, or sexual abuse.This requirement was not met as in evidence: Based on interviews and records collected the licensee did not protect R1 from physical abused in 1 of 57 residents in care which posed an immediate Safety risk to persons in care

87468.2 Additional Personal Rights of Residents in Privately Operated Facilities (a) ...residents in privately operated residential care facilities for the elderly shall have ...the following personal rights:(8) To be free from neglect. This requirement was not met as evidence by: Based on interviews and record reviews the licensee did not protect resident from neglect in 1 of 67 persons in care (R1) which posed an immediate safety risk to persons in care.

87625 Managed Incontinence (a)The licensee shall be permitted to accept or retain a resident who has a manageable bowel and/or bladder incontinence condition under the following....: (1).... managed with any of the following: (C) A program of scheduled toileting at regular intervals. Based on interviews and record reviews the licensee did not provide resident with managed incontince program in 1 of 67 persons in care (R1) which posed an potential health risk to persons in care.

Based on observations, the licensee did not comply with the section cited above in 64 out of 64 residents in care which poses/posed a potential health risk to persons in care.

(c) Any suspected physical abuse that does not result in serious bodily injury of an elder or dependent adult shall be reported to the local ombudsman, the corresponding licensing agency, and the local law enforcement agency within twenty-four (24) hours as required by Welfare and Institutions Code Section 15630(b)(1). This requirement was not met as in evidence in: Based on interviews and records reviewed the licensee did not report abuse to R1 which posed a Safety risk to persons in care.

1569.312 Basic Service Requirement Every facility required to be licensed under this chapter shall provide at least the following basic services: (d) Being aware of the resident's general whereabouts, although the resident may travel independently in the community. This requirement was not met as in evidence in: Based on interviews and records reviewed the licensee did not know the whereabouts of R1 which posed a potential Safety risk to persons in care.

87411 Personnel Requirements(c) All RCFE staff who assist residents with personal activities of daily living ..(1) Staff providing care shall receive appropriate training in first aid from persons qualified by such agencies as the American Red Cross.This requirement is not met as evidenced by: Based on records reviewed the licensee did not provide first aid training to 13 of 16 staff which poses a potential health and safety risk to 56 persons in care.

87468.1 Personal Rights of Residents in All Facilities (a) Residents...shall have... the following personal rights:(9) To have communications to the licensee from their representatives answered promptly and appropriately. This requirement was not met as evidence in; Based on observations and interviews the licensee did not communicate with representatives promptly and appropriately in 1 of 65 persons in care [R1] which posed a potential Personal Rights risk to persons in care.

87625 Managed Incontinence (b)… the licensee shall be responsible for… (3) ensuring that incontinent residents are kept clean and dry. This requirement has not been met as evidenced by: Based on interviews and records review, the licensee did not comply with the section above as R1 was not assisted with incontinence services to remain clean and dry. This poses a potential health risk to 64 of 64 residents in care.

87464 Basic Services (f)(4) Personal assistance and care as needed by the resident… with those activities of daily living such as… bathing…This requirement has not been met as evidenced by: Based on interviews and records review, the licensee did not comply with the above section as R1 was not assisted with bathing services as needed. This poses a potential personal rights risk to 64 of 64 residents in care.

87303(f)(5) Maintenance and Operation (f)(5) Solid waste… shall be maintained in a clean and sanitary condition. This requirement has not been met as evidenced by: Based on observation and interviews, the licensee did not comply with the above section as soiled incontinence briefs were not emptied frequently enough to prevent odors. This poses a potential health risk to 64 of 64 residents in care.

87303 Maintenance and Operation (a) the facility shall be clean, safe, sanitary, and in good repair at all times… This requirement has not been met as evidenced by: Based on observation and interviews, the licensee did not comply with the section above as the facility was observed to be cluttered and dirty on multiple occasions. This poses a potential health risk to 64 of 64 residents 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. This requirement has not been met as evidenced by: Based on interviews and records reviewed, the licensee did not comply with the above section as staff were not able to meet resident care needs. This poses a potential health risk to 64 of 64 residents in care.

87611 General Requirements for Allowable Health Conditions (e) … the licensee shall ensure that the resident is cared for in accordance with the physician’s orders and that the resident’s medical needs are met. This requirement has not been met as evidenced by: Based on interviews and records review, the licensee did not ensure that R1’s physician’s order for assistance with feeding and oxygen use was followed, resulting in hospitalization for R1. This posed an immediate health risk to R1.

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. These requirements were not met as evidence by:Based on interviews and observations the licensee did not provide basic services in 3 of 62 persons in care ([R1/R2/R3]) which posed a potential Health risk to persons in care.

87465 Incidental Medical and Dental Care (c)(2)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 observations licensee did not issue medication as prescribed in five of 65 persons in care which posed a potential health risk to persons in care.

Based on record review the licensee did not comply with the section cited above in 3 of 5 persons which poses/posed a potential health, safety or personal rights risk to persons in care.

Based on observations, the licensee did not comply with the section cited above in 2 of 6 showers which poses/posed a potential health, safety or personal rights risk to persons in care.

87219 Planned Activities (a)Residents shall be encouraged to maintain and develop their fullest potential for independent living through participation in planned activities. This requirement was not met as evidenced by: Based on observations and interviews the licensee did not provide planned activities to 65 of 65 persons in care which posed a potential health risk to persons in care.

87458 Medical Assessment: “(a) 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 evidenced by: Based on records and interviews, for 1 of 63 residents (R1), prior to their acceptance as a resident, licensee did not obtain and keep on file, documentation of a medical assessment, signed by a physician, which posed a potential health, safety, and personal rights risk to persons in care.

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...abuse. This requirement was not met as evidenced by: Based on interviews the licensee did not protect resident's personal right to be free from abuse in 1 of 57 persons in care ([R1]) which posed an immediate Safety risk to persons in care.

Personal Rights of Residents in All Facilities (a) Residents in all residential care facilities...shall have all of the following personal rights:(1)to be accorded dignity in their personal relationships with staff. This requirement was not met as evidenced by: Based on interviews the licensee did not accord resident dignity in their personal relationship with staff in 1 of 57 persons in care ([R1]) which posed a potential personal rights risk to persons in care.

87466 When changes such as..deterioration of mental ability or a physical health condition are observed... licensee shall ensure that changes are... brought to the attention of the resident's physician. This requirement was not met as evidenced by: Based on records reviewed and interviews, the licensee did not report metal or physical health conditions in 2 of 56 persons in care ([R1/R2]) which posed a potential Health risk to persons in care.

87705 Care of Persons with Dementia: “(c) Licensees who accept and retain residents with dementia shall be responsible for ensuring the following: (5) Each resident with dementia shall have an annual medical assessment as specified in Section 87458, Medical Assessment, and a reappraisal done at least annually, both of which shall include a reassessment of the resident’s dementia care needs.” This requirement was not met, as evidenced by: Based on records and interviews, licensee did not ensure that 1 of 55 residents (R1), who was diagnosed with a dementia, had a medical assessment performed within the last year, which posed a potential health, safety, and personal rights risk to persons in care.

87705 Care of Persons with Dementia: “(l) The following initial and continuing requirements shall be met for the licensee to lock exterior doors or perimeter fence gates: (2) The licensee shall ensure that the fire clearance includes approval of locked exterior doors or locked perimeter fence gates.” This requirement was not met, as evidenced by: Based on observation, in areas of the facility where 30 of 55 residents (R1 through R30) resided, licensee locked exterior doors and perimeter fence gates, but did not ensure that its fire clearance included approval of locked exterior doors or locked perimeter fence gates, which posed an immediate safety risk to persons in care.

87466 Observation of the Resident: “The licensee shall ensure that residents are regularly observed…” This requirement was not met, as evidenced by: Based on records and interviews, the licensee did not ensure that 1 of 55 residents (R1) was observed, which posed a potential safety risk to persons in care.

Clean linen, including blankets, bedspreads, top bed sheets, bottom bed sheets…The quantity shall be sufficient to permit changing at least once per week or more often when indicated to ensure that clean linen is in use by residents at all times. This requirement is not met as evidenced by: Based on observations and interviews, the licensee did not provide clean linen to residents on a weekly basis. This posed a potential health and personal rights risk to 56 of 56 residents in care.

87464 Basic Services (d)... if a facility chooses to accept a particular resident for care, the facility shall be responsible for meeting the resident's needs... providing the other basic services... either directly or through outside resources.This requirement was not met as evidence by; Based on interviews and records reviewed the licensee did not identify how facility would meet the resident's needs in 1 in 56 of persons in care which posed a potential Health, Safety, and Personal Rights risk to persons in care.

No licensee, officer or employee of a licensee shall make or disseminate any false or misleading statement regarding the facility or any of the services provided by the facility. This requirement was not met as evidenced by: Based upon LPA’s record review, licensee documented false information in records maintained for 1 of 55 residents in care. This posed a potential health and safety risk to residents in care.

87211(a)(1)(D)Reporting Requirements: (a)licensee shall furnish to the licensing agency (1)A written report shall be submitted..in any of the events specified... D)Any incident which threatens the welfare, safety or health of any resident... such as an unexplained absense.This requirement is not met as evidence by; Based on record reviews and interviews thelicensee did not report an unexplained absense of R1 to the Department which poses a potential Health and Safety risk to persons in care.

87303 Maintenance and Operation (f) (1) Solid waste shall be … disposed of in a manner that will not … provide a breeding place or food source for insects. This requirement was not net as evidenced by: Based on LPA observations food waste was in resident room with insects on/near the food waste posing a potential risk to 55 of 55 residents in care.

87303 Maintenance and Operation (a) The facility shall be clean, safe, sanitary and in good repair at all times. This requirement was not met as evidenced by: LPA observations revealed that the facility floors were soiled with liquid and solid waste, bathrooms had toilets with feces, posing a potential risk to the health and safety of 55 of 55 residents in care.