Gardens at Escondido

87465 Incidental Medical and Dental Care (a) A plan for incidental medical and dental care shall be developed…(2) The licensee shall provide assistance in meeting necessary…transportation… available medical or dental facility… In providing transportation the licensee shall do so directly...arrangements for this service.This requirement is not met as evidenced by: Based on record reviews and interviews, the licensee failed to provide transportation for residents when the van was out of service, as agreed in the Residence and Care Agreement. DMV registration tags were expired. This poses a potential Health, Safety, or Personal Rights risk to persons in care.

87507 Admission Agreements(f) 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 evidence by: Based on record reviews and interviews, revealed that the licensee failed to comply with transportation service conditions and enforced a policy that contradicts the admissions agreement. This poses a potential Health, Safety, or Personal Rights risk to persons in care.

87465(c)(2) ...facility staff designated by the licensee shall be permitted to assist the resident with self-administration, provided all of the following requirements are met: Once ordered by the physician the medication is given according to the physician's directions. Based on interviews and records, Licensee did not ensure medication was given according to the physician's directions in 1 of 69 residents. This posed a potential health risk to persons in care.

...The following provisions shall apply:...(3) The resident may provide the following items; however, if the resident is unable or chooses not to provide them, the licensee shall assure provision of:...(D) Hygiene items of general use such as soap and toilet paper. Based on interviews and records, Licensee did not assure provision of hygiene items of general use such as toilet paper in 2 of 69 residents. This posed a potential health risk to persons in care.

Storage Space and Access... licensee shall ensure that disinfectants, cleaning solutions, poisonous substances, knives, matches, tools, sharp objects, and other similar items which could pose a danger to residents are in locked storage and are not left unattended if outside the locked storage. This requirement was not met, as evidenced by: Based on interviews and direct observations, Licensee did not ensure cleaning solutions and poisonous substances were locked in storage or attended while in use. This posed a health and safety risk to 68 of 68 residents.

87411(a)Personnel Requirements - GeneralFacility 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, Licensee did not ensure staffing was sufficient in numbers and competent to provide the services necessary to meet resident needs in 68 of 68 residents. This posed a potential health and safety risk to clients in care.

87468.2(a)...residents shall have all of the following personal rights: (16) To written notice of any room changes at least 30 days in advance unless a room change is agreed to by the resident, required to fill a vacant bed, or necessary due to an emergency. Based on records and interviews, Licensee did not provide written notice at least 30 days in advance to responsible parties regarding room changes. This posed a potential personal rights risk to 1 of 68 residents in care.

87468.1(a) Residents in all residential care facilities for the elderly shall have all of the following personal rights: (9) To have communications to the licensee from their representatives answered promptly and appropriately. Based on records and interviews, Licensee did not promptly respond to communications from a resident's representative. This posed a potential personal rights risk to 1 of 68 clients in care.

Based on observations, the licensee did not comply with the section cited above in 10 out of 10 food containers which poses a potential health, safety or personal rights risk to persons in care.