Oakmont of Brookside

(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, residents, and other persons. This requirement is not met as evidenced by R1 not granted permission for staff to open pharmacy deliveries on his behalf. This is a personal right violation.

87465 Incidental Medical and Dental 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. This requirement was not met as evidenced by records reviewed and interviews with staff. The facility is not following the Doctor's orders as requested in the current and outdated PRN letters for R1 through R7

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:(2) To be accorded safe, healthful and comfortable accommodations, furnishings and equipment. This requirement was not met as evidenced by based on the repair and auditory frequency of the alarm going off the residents in care with or without hearing impairments were subjected to the loud noise and as a result were exposed to a uncomfortable environment.

87303 Maintenance and Operation(a) The facility shall be clean, safe, sanitary and in good repair at all times. Maintenance shall include provision of maintenance services and procedures for the safety and well-being of residents, employees and visitors.This requirement was not met as evidenced by records reviewed The alarm system was triggering more frequently than usual from 9/24/2024 through 10/232024. The facility did not have a Maintenance Director at the time of the incidents and the staff or Administrator would have to call Phillips lifeline systems to have the system reset after putting a code in to stop the alarm.

Based on observation; the facility did not comply with the regulations adopted by the State Fire Marshal. The "Fixed System" or "Ansul System" in the kitchen is scheduled for a semi-annual maintenance and was last serviced on 9/27/2023. This poses an immediate health, safety or personal rights risk to persons in care.

87464 (f)(1) Basic services care and supervision as defined in Section 87101(c)(3) and Health and Safety Code section 1569.2(c).This requirement is not met as evidence by: Based on the department's findings, the facility did not provide adequate care and supervision including a two person assist which resulted in R1 sustaining a fracture from a fall while transferring. This posed an immediate health and safety risk to R1.

87705(c)(5)Care of Persons with DementiaLicensees who accept and retain residents with dementia shall ensure that each resident with dementia has an annual medical assessment and a reappraisal done at least annually This requirement was not met based on records reviewed, The department observed R3 with an outdated LIC 602/ Physician report expired. This poses a potential health and safety risk to residents in care.

87464 Basic Services (f) Basic services shall at a minimum include: (6) Arrangements to meet health needs, including arranging transportation, as specified in Section 87465, Incidental Medical and Dental Care Services. This requirement was not met as evidenced by The facility not following the doctors orders and not taking R1 to be checked after the fall on 12/3/23 at the request of the PCP. R1 had another fall at approximately 3 pm and was told by POA not to transport R1 via ambulance. Later in the evening R1 requested to go to the ER and was diagnosed with fractured ribs.

(a) Facility personnel shall at all times be sufficient in numbers, and competent to provide the services necessary to meet resident needs. In facilities licensed for sixteen or more, sufficient support staff shall be employed to ensure provision of personal assistance and care as required in Section 87608, Postural Supports. Additional staff shall be employed as necessary to perform office work, cooking This requirement was not met as evidenced by R1 being without medication for seven days. This is a potential health and safety risk to resident in care

Incidental Medical and Dental Care. (a) plan for incidental medical and dental care shall be developed by each facility (1)The licensee shall arrange, or assist in arranging, for medical and dental care appropriate to the conditions and needs of residents. This requirement is not met as evidenced by: Based on record reviews and interviews, licensee did not ensure physician was efficiently notified for medication order clarification for R1. This poses an immediate health and safety risk to residents in care.

(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: (2) Request a transfer of a criminal record clearance as specified in Section 87355(c) or... Based on observation, the Licensee did not ensure all staff were associated to the facility. The LPA observed that S1 was not associated to the facility. This poses an immediate health and safety risk to residents in care.

87405(a-d) All Facilities shall have a qualified and currently certified administrator.... This requirement was not met as evidenced by records reviewed and interviews with staff. This is an immediate risk to operations and care of residents.

87465(c)(2) Incidental Medical and Dental Care. Once ordered by the physician the medication is given according to the physician's directions. This requirement is not met as evidenced by: Based on observation and records review, the Licensee did not ensure medications ordered for residents are given as prescribed which poses an immediate health and safety risk to residents in care.

(b) The following food service requirements shall apply:.....(9) Procedures which protect the safety, acceptability and nutritive values of food shall be observed in food storage, preparation and service.This requirement was not met as evidenced by: LPA, Administrator and kitchen staff observed expired food in the main kitchen area, uncovered food, missing temperature checks for foods served, and no labels on prepared food

Basic Services (c) "Care and supervision" means the facility assumes responsibility for, or provides... assistance with activities of daily living without which the resident’s physical health, mental health, safety, or welfare would be endangered. Assistance includes ...personal care and supervision. This requirement was not met as evidenced by R1's Companion was not around or failed to report that they were leaving the facility. As a result, R1 was unaccounted for and was in the community without supervision. This poses an immediate health and safety risk and hazard.

(b) In addition to subsection (a), when one or more residents in the facility are diagnosed with a communicable disease, the following shall apply: (1) In addition to the requirements of subsection (a)(2), assigned staff and volunteers, regardless of having direct contact with clients, shall be required to perform enhanced environmental cleaning and disinfection to maintain a safe and sanitary environment and to prevent, contain, and mitigate the transmission of the communicable disease. Enhanced environmental cleaning and disinfection shall be of:(A) all frequently touched surfaces such as doorknobs, handles, and shared items, as well as, (B) when one or more client(s) has a communicable disease, in any impacted areas, and immediately after contact with a client who has a communicable disease. (2) All staff and volunteers providing direct care to a resident who has a communicable disease shall wear appropriate Personal Protective Equipment (PPE) to prevent exposure to infectious agents or chemicals through the respiratory system, skin, or mucous membranes of the eyes, nose, or mouth. PPE may include gloves, gowns, masks, respirators, shoe coverings and eye protection..... This requirement was not met as evidenced by records reviewed and interviews conducted. The facility failed to address the infection response protocols. This is an immediate health and safety risk to residents in care.

87458(b)(1) Medical Assessment. The medical assessment, at a minimum, shall include: A physical exam of the resident containing a primary and secondary diagnosis, if any, results of a test for tuberculosis and any medical conditions which would preclude care of the person in an RCFE. R1 does not have a current TB test. This poses a potential health and safety risk to residents in care.