South Pacific Villa

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 circumstances:(b) In addition to Section 87611, General Requirements for Allowable Health Conditions, the licensee shall be responsible for the following:(1) Ensuring that residents who can benefit from scheduled toileting are assisted or reminded to go to the bathroom at regular intervals rather than being diapered.(2) Ensuring that incontinent residents are checked during those periods of time when they are known to be incontinent, including during the night. The following requirement has not been met as evidenced by: Resident 1 was left soiled in urine and feces for extended periods of time contributing to a stage 1 pressure injury, which poses an immediate, heakth, safety, orpersonal rights risk to residents in care.

87464 Basic Services(f) Basic services shall at a minimuminclude:(1) Care and supervision asdefined in Section 87101(c)(3) and Health andSafety Code section 1569.2(c).The following requirement has not been met as evidenced by: The facility neglected to provide proper careand supervision of Resident 1 leading to stage 1 pressure injury, which poses an immediate health, safety, or personal rights risk to residents in care.

87465 Incidental Medical and Dental Care (a) A plan for incidental medical and dental care shall be developed by each facility. The plan shall encourage routine medical and dental care and provide for assistance in obtaining such care, by compliance with the following:(4) The licensee shall assist residents with self-administered medications as needed.The following requirement has not been met as evidenced by: Resident 1 was not given all prescribed medications, which poses an immediate health, safety, or personal rights 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: (3)…Residents shall be free from interference, coercion, discrimination, and retaliation in exercising their rights.” This requirement was not met, as evidenced by: Based on records and interview, Licensee did not ensure that 2 of 6 residents (R1 and R2) were free from interference and retaliation in exercising their rights. This posed a potential personal rights risk to persons in care.

87224 Eviction Procedures: “(d)(1) The notice to quit shall include the following information: (C) A statement informing residents of their right to file a complaint with the licensing agency, as specified in Section 87468, subsection (a)(4), including the name, address and telephone number of the licensing office with whom the licensee normally conducts business, and the State Long Term Care Ombudsman office.” Based on records and interview, for 1 of 6 residents (R1), Licensee did not ensure that their notice to quit included a statement informing them of their right to file a complaint with the licensing agency, including the name address and telephone number of the local licensing office and the State Long Term Care Ombudsman office. This posed a potential personal rights risk to persons in care.

87224 Eviction Procedures: “(d)(1) The notice to quit shall include the following information: (D) The following exact statement as specified in Health and Safety Code Section 1569.683(a)(4): "In order to evict a resident who remains in the facility after the effective date of the eviction, the residential care facility for the elderly must file an unlawful detainer action in superior court and receive a written judgment signed by a judge. If the facility pursues the unlawful detainer action, you must be served with a summons and complaint. You have the right to contest the eviction in writing and through a hearing." Based on records and interview, for 1 of 6 residents (R1), Licensee did not ensure that their notice to quit included the exact statement that is specified in California Health and Safety Code Section 1569.683(a)(4). This posed a potential personal rights risk to persons in care.

87465 Incidental Medical and Dental Care: “(h)(4) All centrally stored medications shall be…maintained in compliance with state and federal laws.” This requirement was not met, as evidenced by: Based on interview and LPA observation, Licensee did not ensure that all centrally stored medications were maintained in compliance with state and/or federal laws. This posed a potential health and safety risk to 2 of 6 residents (R1 and R2) in care.