Cloisters of the Valley, Llc

Maintain facility in clean, safe, sanitary condition

Reappraisal identifies facility is not appropriate

(4)"The licensee may evict a resident for one or more of the reasons listed in…Thirty (30) days written notice to the resident is required…the reappraisal believe that the facility is not appropriate for the resident." This requirement was not met, as evidenced by: Based on records and interviews: Licensee evicted 1 out of 63 residents(R1) based on inability to meet their needs, without issuing them 30 days written notice. This posed a potential personal rights risk to persons in care.

Right to sufficient care and qualified staff

(a) (1)A written report shall be submitted to the licensing agency..within seven days of the occurrence..(D) Any incident which threatens the welfare, safety or health.. any residentThis requirement was not met, as evidenced by: Based on records review and interviews, licensee did not follow the facility Reporting requirements for 1 out of 66 residents. This posed a potential health and personal rights risks to persons in care.

Facility personnel sufficiency and competence

(a)Facility personnel shall at all times be sufficient in numbers and competent to provide the services necessary to meet resident needs. This requirement was not met as evidenced by: Based on interviews and records review, the facility did not provide sufficient staff to meet resident’s care needs. This posed a potential personal rights risk to 65 residents in care.

(a) (1) A written report shall be submitted to the licensing agency..within seven days of the occurrence..(D) Any incident which threatens the welfare, safety or health.. any residentThis requirement was not met, as evidenced by: Based on records review and interviews, licensee did not follow the facility Reporting requirements for 1 out of 63 residents. This posed a potential health and personal rights risks to persons in care.

Give PRN medication by physician order

(c)(2) If the..licensee shall be permitted to assist the resident with self-administration..requirements are met: (2)Once ordered.. medication is given according to.. directions.This requirement was not met, as evidenced by: Based on interviews the licensee did not administer R1 with PRN medication as prescribed which posed a potential Safety risk to persons in care.

87465 Incidental Medical and Dental Care (a) A plan for incidental medical and dental care shall be developed by each facility...(1)The licensee shall arrange.. care appropriate to the conditions and needs of residents. This requirement was not met, as evidenced by: Based on interviews and records review, the licensee did not provide medical care to 1 out of 63 residents in care. This posed an immediate personal rights risk to persons in care.

Store centrally held medications in locked secure place

Incidental Medical and Dental Care. Centrally stored medicines shall be kept in a safe and locked place that is not accessible to persons other than employees responsible for the supervision of the centrally stored medication. This requirement is not met as evidenced by: Based on interviews and record review, the licensee did not ensure medications were locked and inaccessible to 62 out of 62 [R1-R62] residents which posed an immediate 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 ensure residents received their prescribed medications for 27 out 62 [R1-R27] residents which posed an immediate health and safety risk to residents in care.

Facility personnel sufficiency and competence

87411 Personnel Requirements – General (a)Facility...shall at all times be sufficient in numbers...provide the services necessary to meet resident needs...services. This was not met as evidenced by: Based on interviews and records review, R1 sustained an injury due to R1 being left on the toilet with no supervision which poses an immediate Health, Safety, or Personal Rights risk to persons in care.

Comply with all admission agreement terms

Admission Agreements. The licensee shall comply with all applicable terms and conditions set forth in the admission agreement, including all modifications and attachments. This requirement is not met as evidenced by: Based on interviews and record review, the licensee did not provide a refund to 1 out of 64 [R1] residents, which posed a potential personal rights risk to residents in care.

Provide resident hot water for personal care

87303 Maintenance and Operation:"(e)(2) Faucets used by residents for personal care such as shaving and grooming shall deliver hot water..."This requirement was not met, as evidenced by: Based on interview and record review, the licensee did not comply with the section cited above as the facility did not have hot water for multiple days which posed a potential health and safety risk to sixety-eight (68) of sixety-eight (68) residents in care.

Maintenance and operation requirements for facilities

87303(a) Maintenance and Operation The facility shall be clean, safe, ......afety and well-being of residents, employees and visitors. The licensee did not ensure the floors of residents’ rooms were free from slip hazards to ensure the health and safety of the residents while in care. This requirement was not met as evidenced by: Based on observations, records review, and interviews the licensee did not address slipping hazard, to ensure the health and safety of the residents resulting in a resident (R1) falling and sustaining a fracture. This posed an immediate health and safety risk to one (1) of (59) residents in care.

887466 Observation of the ResidentThe licensee shall ensure that residents are regularly observed ... such observation reveals unmet needs. ...resident's physician ..... Licensee did not seek timely medical attention when a change in condition was observed. This requirement was not met as evidenced by: Based on observations, records review, and interviews with staff and outside sources, the licensee did not seek timely medical care for resident (R1) when a change in condition was observed. This posed an immediate health and safety risk for one (1) of (59) residents in care.

Admission agreement signing and dating deadline

87507 (c) Admission agreements shall be signed and dated,...by the resident or the resident’s representative. Attachments to the agreement may be utilized as long as they are also signed and dated as prescribed above. This requirement was not met as evidence in: Based on records reviewed the licensee did not have Resident or responsible party sign admissions attachement in one of xxx persons in care (R1) which posed a potential Personal Rights risk to persons in care

Additional personal rights for private residential facilities

...Residents in Privately Operated Facilities...shall have...the following personal rights:(16) To written notice of any room changes at least 30 days in advance unless a room change...The requirement was not met as evidenced by: Based on interviews and record reviews, the facility did not provide Resident 1 written notice of a room change. This posed a potential Person Rights risk to 1 of 66 residents in care.

Additional personal rights for private residential facilities

87468.2 Additional Personal Rights of Residents in Privately Operated Facilities: “(a)…residents…shall have all of the following personal rights: “(25) To protection of their property from theft or loss…” This requirement was not met, as evidenced by: Based on records and interviews, licensee’s staff (S1) did not ensure that 1 of 62 residents (R1) had their personal property protected from loss of control, which posed an immediate personal rights 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, the licensee did not ensure facility personnel were competent to provide the services necessary to meet the needs of 2 of 63 residents (R1 and R2), which posed an immediate health and safety risk to persons in care.

Regular observation and documentation of resident changes

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 2 of 63 residents (R1 and R2) were regularly observed, which posed a potential safety risk to persons in care.

Dignity in personal relationships

87468.1 Personal Rights of Residents in All Facilities (a)(1) to be accorded dignity in their personal relationships with staff, residents, and other persons. This requirement has not been met as evidenced by: Based on interviews, the Licensee did not ensure that R1 was accorded dignity in their relationship with staff. This poses a potential personal rights risk to 62 of 62 residents in care.

Regular observation and documentation of resident changes

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 63 residents (R1) was observed, which posed a potential safety risk to persons in care.

Dignity in personal relationships

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: (1) To be accorded dignity in their personal relationships with staff…” This requirement was not met, as evidenced by: Based on interviews and records reviewed, licensee’s staff (S1) did not accord dignity to 1 of 58 residents (R1) in care, which posed a potential personal rights risk to persons in care.

Facility personnel sufficiency and competence

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 was not met, as evidenced by: Based on interviews and records reviewed, the licensee did not employ personnel in sufficient numbers to meet the personal care needs of 1 of 58 residents (R1) in care, which poses a potential health 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: (10) To have their visitors…permitted to visit privately during reasonable hours and without prior notice…” This requirement was not met, as evidenced by: Based on interviews and records reviewed, the licensee did not allow a resident to receive their visitor without prior notice for 1 of 58 residents (R1) in care, which poses a potential personal rights risk to persons in care.

Assist residents with self-administered medication

87465 Incidental Medical and Dental Care: “(a)(4) The licensee shall assist resident with self-administered medications as needed.” This requirement was not met, as evidenced by: Based on interviews and records reviewed, the licensee did not assist 4 of 58 residents in care (R1, R2, R3, and R4) with self-administered medications as needed, which posed a potential health risk to persons in care.

Submit and maintain current mailing address

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: Obtain a California clearance or a criminal record exemption as required by the Department. This requirement was not met as evidenced by: Based on interviews, and observations, 1 (S1) out of approximately 40 staff did not have a criminal record clearance, prior to beginning work. This posed an immediate health and safety risk to residents in care.

Basic Services: If the resident is an SSI/SSP recipient, then the basic services shall be provided and/or made available at the basic rate at no additional charge to the resident.This requirement was not met as evidenced by: Based on interviews and record reviews, the Licensee did not ensure 1 of 42 residents who are SSI/SSP recipients receive basic services at the rate determined by Title 22 California Code of Regulations. This poses a potential personal rights risk to residents in care.

Health Related Services. Medications shall be given according to physician's directions. This requirement is not met as evidenced by:This requirement was not met as evidenced by: Based on interviews and record reviews, the Licensee did not ensure 1 of 58 residents received their medication as prescribed. This poses a potential health risk to residents in care.

Advertisements and License Number: “…licensees shall reveal each facility license number in all public advertisements, including Internet…” This requirement is not met, as evidenced by: Based on LPA observation, licensee did not reveal the facility’s true license number in a public advertisement, specifically their Internet website, which posed a potential impact on the facility’s plan of operation.