Creston Village Assisted Living and Memory Care

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: Based on observation and interview, the licensee did not ensure the facility was clean and sanitary which poses a potential Health, Safety, and Personal Rights risk to persons in care.

Personal Rights 87468.2....residents in privately operated residential care facilities for the elderly shall have all of the following personal rights: To protection of their property from theft or loss... This requirement was not met as evidenced by: Based on interview and record review, the licensee did not comply with the section cited when S1 stole R1’s medications, which posed an immediate health and safety risk to residents in care.

87465 Incidental Medical and Dental Care (a) A plan for incidental medical … provide for assistance in obtaining such care, by compliance with the following: (5) … Assistance with self-administered medications shall be limited to the following: (A) Medications usually prescribed for self-administration which have been authorized by the person's physician. This requirement was not met by evidence of MARs indicating medication not provided in accordance to Physicians order in February of 2024. Which poses an imminent risk to Residents in care.

87555 General Food Service Requirements (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 by evidence of Resident and Staff interviews verifying cold meals were served on serval occasions, which poses a potential risk to residents in care.

87411 Personnel Requirements - General (a) Facility personnel shall at all times be sufficient in numbers, and competent to provide the services necessary to meet residents’ needs. … This requirement was not met by the number of call response times with R1 that exceeded 10 minutes which poses a potential risk to residents in care.

87507(g) Admission agreements shall specify ...:(G) A comprehensive description of billing and payment procedures.(H) A provision indicating that an itemized monthly statement that lists all separate charges incurred by the resident that are collected by the facility shall be provided to the resident or the resident’s representative, if any. This requirement was not met by evidence of monthly over billing of reporting parties and poses a potential danger to residents in care.

87468.2(a)In addition to the rights listed in Section 87468.1, Personal Rights of Residents in All Facilities, residents ... shall have all of the following personal rights: (2) To have their records and personal information remain confidential and to approve their release, except as authorized by law. This requirement was not met by evidence of photographs posted on Social Media (Facebook) of R1 and R2, where R1 and R2 both signed facility's likeness of release, not to release form which poses a potential risk to residents in care.

(a)...following personal rights:(1)To be accorded dignity in their personal relationships with staff, residents, and other persons. This requirement was not met as evidenced by: Based on interviews and documentation the licensee did not comply with the regulation above, residents were not being accorded dignity from a few staff at the facility which poses a potential Personal rights risk to residents in care.

(a)... (1) To be accorded dignity in their personal relationships with staff, residents, and other persons. This requirement was not met as evidenced by: Based on interviews the licensee did not comply with regulation above, residents that were pressing pendants for help often were being told not to do that which poses a potential personal rights risk to residents in care.

(f) Basic services shall at a minimum include:(1) Care and supervision as defined in Section 87101(c)(3) and Health and Safety Code section 1569.2(c). This requirement was not met as evidneced by: Based on documentation the licensee did not comply R1 was able to elope undected and wander away from facility which poses an immediate safety risk to reisdents in care.

(32) Equipment or appropriate size and type shall be provided for the storage, preparation and service of food and for sanitizing utensils and tableware, and shall be well maintained. This requirement was not met as evidenced by: Based on interviews the licensee did not comply with the above regulation as food was not being served hot which poses a potential health and personal rights risk to residents in care.

(a)...(3)...(A)A bed for each resident… Each bed shall be equipped with good springs, a clean and comfortable mattress…This requirement is not met as evidenced by: Based on interviews, staff admitted moving R1’s mattress to the floor to prevent injury to R1 falling out of bed, which posed an immediate health and safety risk to residents in care.

Based on LPA observation the licensee did not comply with the section cited above stairwell by door 7 did not have the required evacuation chair which poses an immediate health, safety or personal rights risk to persons in care.

(a)The facility shall be clean, safe, sanitary and in good repair at all times. ...safety and well-being of residents, employees and visitors. This requirement was not met as evidenced by: Based on Observation and photographs the licensee did not comply with the regulation above R1’s room was found with bugs and dead bugs all over the floors, cobwebs in the windows and curtains and dirt in window seals which poses a potential Health, Safety and Personal rights risk to residents in care

Based on LPA observation, the licensee did not comply with the section cited above by having memory care cabinets unlocked with cleaning supplies and a staff bathroom that was unlocked which had acrylic paint in the cabinets, which poses an immediate health and safety risk to persons in care.

(i)…(1) shall have a signal system which shall…(B)…produce an auditory signal at the living unit loud enough to summon staff.This requirement is not met as evidenced by: Based on review of call log 09/04/2020 to 09/06/2020, staff response time to R1’s call button was from 9 minutes to 25 minutes, which posed an immediate health and safety risk to residents in care.

(b)...(3)Ensuring that incontinent residents are kept clean and dry and that the facility remains free of odors from incontinence. This requirement was not met as evidenced by: Based on medical reports and interviews the Licensee did not ensure the R1’s diapering needs we are being met which poses an immediate health and safety risk to residents in care.

The pre-admission appraisal shall be updated, in writing as frequently as necessary to note significant changes and to keep the appraisal accurate. The reappraisals shall document changes in the resident's physical, medical, mental, and social condition….This requirement was not met as evidenced by: Based on interviews and documentation review, R1’s Resident Evaluation was not updated to reflect R1’s change of condition, which posed a potential health and safety risk to residents in care.

MedicalAssessment,...reappraisal done at least annually, both of which shall include a reassessment of the resident’s dementia care needs. This requirement is not met as evidenced by: Based on Record Review the licensee did not comply R1 had a change of condition, No annual medical assessment and was diagnosed with “Baseline Dementia” during a 09/05/2020 ER visit, which posed an immediate health and safety risk to residents in care.

...residents are regularly observed for changes in physical, mental, emotional and social functioning and that appropriate assistance is provided...This requirement is not met as evidenced by: Based on medical reports and interviews, R1 had multiple pressure injuries observed but not reported by the Licensee, which posed an immediate health and safety risk to residents in care.

87468.1 Personal Rights of Residents in All Facilities...To be accorded safe, healthful and comfortable accommodations, furnishings and equipment. This requirement was not met as evidenced by: Based on observations, the facility failed to ensure S1 and S2 were wearing face coverings which poses an immediate health, safety and personal rights risk to residents in care.