Ivy Park at Otay Ranch

87466 Observation of the Resident: “The licensee shall ensure that residents are regularly observed for changes in physical, mental, emotional and social functioning…” This requirement was not met, as evidenced by: Based on records and interviews, Licensee did not ensure that 1 of 113 residents (R1) was regularly observed for changes in physical, mental, emotional and social functioning following their fall. This posed a potential health risk to persons in care.

87755 Inspection Authority of the Licensing Agency: “(c) The licensing agency shall have the authority to inspect, audit, and copy resident or facility records upon demand during normal business hours.” This requirement was not met, as evidenced by: Based on records and interviews, Licensee did not cooperate with the licensing agency’s authority to receive a copy of a facility recording pertaining to an investigation involving 1 of 113 residents (R1). This posed a potential health and safety risk to persons in care.

87464 Basic Services (f)(1).... “Care and Supervision” means the facility assumes responsibility for…on going assistance with activities of daily living and the assumption of varying degrees of responsibility for the safety and well-being of residents.This requirement was not met as evidenced by: Based on LPA interviews and records review the licensee did not provide R1 supervision. 1 in 1 of 126 persons in care [R1] which posed a potential health and safety risk to persons in care.·

1569.652 Termination of admission agreement upon death of resident; removal of resident’s property; refund of fees paid; notice of contract termination and refunds: “(a) A residential care facility for the elderly shall not require advance notice for terminating an admission agreement upon the death of a resident. No fees shall accrue once all personal property belonging to the deceased resident is removed from the living unit.” This requirement was not met, as evidenced by: Upon the death of 1 of 113 residents (R1), Licensee continued to allow fees to accrue after the deceased resident’s personal property was removed from the living unit. This posed a potential personal rights risk to persons in care.

87303 Maintenance and Operation: “(a) The facility shall be clean, safe, sanitary…at all times.” This requirement was not met, as evidenced by: Based on records and interviews, Licensee did not ensure the facility was clean and sanitary at all times. This posed a potential health and safety risk to persons in care.

87507 Admission Agreements: “(c) Admission agreements shall be signed and dated, acknowledging the contents of the document, by the resident or the resident’s representative, if any, and the licensee or the licensee’s designated representative no later than seven days following admission. 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 evidenced by: Based on records and interviews, Licensee or their designated representative did not sign the admissions agreement for 1 of 113 residents (R1) within seven (7) days after the resident’s admission. This posed a potential personal rights violation to persons 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 of any of the events specified in (A) through (D) below…(D) Any incident which threatens the welfare, safety or health of any resident…” This requirement was not met, as evidenced by: Based on records and interviews, Licensee did not submit a written report to the licensing agency and to the person responsible for 1 of 113 residents (R1) who had an incident which threatened their welfare, safety, or health. This posed a potential personal rights risk to persons in care.

87507 Admission Agreements: “(e) The licensee shall provide a copy of the signed and dated current admission agreement, and all subsequent signed and dated modifications, to the resident or the resident's representative, if any, immediately upon signing the admission agreement or modification. The licensee shall provide additional copies to the resident or resident’s representative upon request.” This requirement was not met, as evidenced by: Based on records and interviews, Licensee did not provide copy of the signed and dated current admission agreement to the representative of 1 of 113 residents (R1) immediately upon singing the admission agreement and upon request. This posed a potential personal rights violation to persons in care.

87464 Basic Services (f)(1).... “Care and Supervision” means the facility assumes responsibility for…on going assistance with activities of daily living and the assumption of varying degrees of responsibility for the safety and well-being of residents.This requirement was not met as evidenced by: Based on LPA interviews and records review the licensee did not provide R1 and R2 supervision. 2 in 2 of 109 persons in care [R1-R2] which posed a potential health and safety risk to persons in care.·

REPORTING REQUIREMENTSAny 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 failed to report R2's elopement to law enforcement and the licensing agency. 1 in 1 of 109 persons in care [R2] This posed a potential health and safety risk to R2.

87464 Basic Services(f) (4) Basic services shall at a minimum include, personal assistance and care as needed by the resident and as indicated in the pre-admission appraisal, with those activities of daily living. This requirement was not met as evidence by: Based on interviews and records review, the licensee did not ensure that residents received personal assistance and care as needed on a timely basis to meet the residents’ needs. This posed a potential health risk to residents in care.

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 114 residents (R1) was protected from theft of loss, which posed an immediate personal rights risk to persons in care.

Personnel RequirementsFacility personnel shall at all times be sufficient in numbers, and competent to provide the services necessary to meet resident needs… Based on interviews and review of records the licensee did not have personnel sufficient in numbers…to provide the services necessary to meet the needs 104 of the 104 persons in care which posed a potential risk to the health and safety of persons in care.

“ … (a) If a licensee ...facility for the elderly increases the rates of fees for residents ... the licensee shall provide no less than 60 days' prior written notice to the residents or the residents' representatives …” Based on records review and staff interview the licensee did not ensure that R1 was provided a 60-day prior notice to monthly rent increase. 1 in 4 of 92 persons in care. which posed a potential personal rights risk to persons in care.

87468.1 Personal Rights of Residents in All FacilitiesResidents shall be accorded dignity in his/her personal relationships with staff, residents, and other persons. This requirement was not met as evidenced by: Interviews with staff and residents and records review revealed the licensee did not ensure staff spoke inappropriately to residents in care. This posed potential personal rights risks to residents in care.

87464 Basic Services(f) (4) Basic services shall at a minimum include, personal assistance and care as needed by the resident and as indicated in the pre-admission appraisal, with those activities of daily living. This requirement was not met as evidence by: Based on observations, interviews, and records review, the licensee did not ensure that residents received personal assistance and care as needed on a timely basis to meet the residents’ needs. This posed a potential health risk to residents in care.

Incidental Medical and Dental Care Services. Once ordered by the physician...medications shall be given in accordance with the physician’s directions. This requirement was not met as evidenced by: Based on staff interview the licensee did not give medications in accordance with the physician's directions.1 in 1 of [85] persons in care (R1) which posed a potential health risk to persons in care.