Summerfield of Stockton

(e) 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: (1) Obtain a California clearance or a criminal record exemption as required by the Department or(2) Request a transfer of a criminal record clearance as specified in Section 87355(c) or(3) Request and be approved for a transfer of a criminal record exemption, as specified in Section 87356(r), unless, upon request for a transfer, the Department permits the individual to be employed, reside or be present at the facility.This requirement is not met as evidenced by: records reviewed The facility employed an individual that was excluded for life on or about June 5, 2018 and that individual has been working since October 21, 2022 to last day worked August 18, 2023.

Document behavioral expression and related causes

The licensee shall arrange a meeting with the resident, the resident’s representative, if any, appropriate facility staff, and a representative of the resident’s home health agency, if any, when there is significant change in the resident’s condition, or once every 12 months, whichever occurs first, as specified in Section 87467, Resident Participation in Decision Making. This requirement was not met as evidenced by review of current records for R1 and R4. also missing signatures for R5's assessment. This poses a potential safety risk to residents in care

(b) In addition to the requirements as specified in Section 87208, Plan of Operation, the plan of operation shall address the needs of residents with dementia, including: (1) Procedures for notifying the resident’s physician, family members and responsible persons who have requested notification, and conservator, if any, when a resident’s behavior or condition changes.(2) Safety measures to address behaviors such as wandering, aggressive behavior and ingestion of toxic materials.(c) Licensees who accept and retain residents with dementia shall be responsible for ensuring the following:(4)There is an adequate number of direct care staff to support each resident’s physical, social, emotional, safety and health care needs as identified in his/her current appraisal. This requirement is not met as evidenced by incidents of aggression resulting in death and injury and lack of updated service plans for R2 and R4. This poses an immediate health and safety risk to residents in care.

Document behavioral expression and related causes

The licensee shall arrange a meeting with the resident, the resident’s representative, if any, appropriate facility staff, and a representative of the resident’s home health agency, if any, when there is significant change in the resident’s condition, or once every 12 months, whichever occurs first, as specified in Section 87467, Resident Participation in Decision Making. This requirement was not met as evidenced by missing signatures on all (10 of 10) service plans for R1 thru R10 reviewed. This poses a potential safety risk to residents in care

(a) Each licensee shall furnish to the licensing agency such reports as the Department may require, including, but not limited to, the following:(h) Any change in the chief corporate officer of an organization, corporation or association shall be reported to the licensing agency in writing within fifteen (15) working days following such change. Such notification shall include the name, address, and the fingerprint card of the new chief executive officer, as required by Section 87355, Criminal Record Clearance. This requirements was not met based on lack of records to review and interviews conducted. This poses an immediate health and safety concern for residents in care.

(d) If the resident is unable to determine his/her own need for a prescription or nonprescription PRN medication, and is unable to communicate his/her symptoms clearly, facility staff designated by the licensee, shall be permitted to assist the resident with self-administration provided all of the following requirements are met:(1) Facility staff shall contact the resident's physician prior to each dose, describe the resident's symptoms, and receive direction to assist the resident in self-administration of that dose of medication.(2) The date and time of each contact with the physician, and the physician's directions, shall be documented and maintained in the resident's facility record. This requirement is not met as evidenced by lack of records for R1 and R2, as well as an interview with Med-Tech on duty. This poses an immediate health and safety risk to residents in care.

(a) Each licensee shall furnish to the licensing agency such reports as the Department may require, including, but not limited to, the following:(h) Any change in the chief corporate officer of an organization, corporation or association shall be reported to the licensing agency in writing within fifteen (15) working days following such change. Such notification shall include the name, address, and the fingerprint card of the new chief executive officer, as required by Section 87355, Criminal Record Clearance. This requirements was not met based on lack of records to review and interviews conducted.

(a) Any person seeking a license for a residential care facility for the elderly under this chapter shall file with the department, pursuant to regulations, an application on forms furnished by the department, that shall include, but not be limited to, all of the following:(3) If applicable, the following information: (F) The name and address of any management company serving the facility and the same information required of applicants in subparagraphs (C) and (D) for the management company. This requirement is not met based on observation and records reviewed.This poses an immediate risk to residents in care.