Hopkins Manor

Safe, healthful, comfortable accommodations

87468.1(a)(2) Personal Rights of Residents in All Facilities: Residents in all residential care facilities for the elderly shall have all of the following personal rights....This requirement is not met as evidenced by: Based on observation and interview, the Licensee failed to ensure R1’s safety when S1 hit R1’s arm with S1’s fist 8 times attempting to release R1’s grasp of S1’s hair, which is an immediate health, safety, or personal rights risk to persons in care.

Facility personnel sufficiency and competence

87411(a) Personnel Requirements-General: Facility personnel shall at all times be sufficient in numbers, and competent to provide the services necessary to meet resident needs.This requirement is not met as evidenced by Based on observation, the Licensee failed to ensure that S1 was competent to follow the protocols they were trained on to meet resident needs, which is an immediate health and safety risk to persons in care.

Care and supervision as defined by statute and rules

87464(f)(1) Basic Services: 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 is not met as evidenced by: Based on record review and interviews, R1 fell in their bathroom and staff did not know R1 had fallen until four hours later. Per documents review, R1 was a fall risk. In addition based on staff interviewed, staff were to conduct hourly checks on R1 however, due to a lack of supervision, R1 fell and the facility did not know until four hours later. This is an immediate health, safety, or personal rights risk to persons in care.

Call 9-1-1 for imminent health threats

87465(g) Incidental Medical and Dental Care: The licensee shall immediately telephone 9-1-1 if an injury or other circumstance has resulted in an imminent threat....This requirement was not met as evidenced by: Based on interviews, R1 fell at the facility at 0500 hours but facility staff did not call 911 until R1’s family arrived at the facility 5-6 hours later. This is an immediate health, safety, or personal rights risk to persons in care.

Facility maintenance and healthful environment

87307(d)(2): Personal Accommodations and Services - The premises shall be maintained in a state of good repair and shall provide a safe and healthful environment.This requirement is not met as evidenced by: Based on record review, it was found that the facility’s pest control company was providing bed bug mitigation services indicating that the facility had a bed bug infestation from 3/1/2024 to 8/1/2024 which led to a resident being sent the hospital for the worst case of bed bugs. a resident (R1) went to the hospital with a nurse reporting that R1 was infested with bed bugs. This is an immediate health and safety hazard to residents in care.

Safe, healthful, comfortable accommodations

87468.1(a)(2): Personal Rights of Residents in All Facilities - To be accorded safe, healthful and comfortable accommodations, furnishings and equipment.This requirement is not met as evidenced by: Based on interview of Executive Director and staff, R2 was found in R2’s room with blood on R2’s face. 911 was called by the Executive Director to rule out possible further injuries and told the Paramedics and Police that R2 was attacked by R2’s roommate which shows that R2 was not afforded safe, healthful accommodations and is an immediate health, safety, or personal rights risk to persons in care.

Safe, healthful, comfortable accommodations

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 is not met as evidenced by: Based on interviews conducted and records obtained: R1 was transported to the hospital ER on 10/12/2024 where doctors determined he had been bitten by bed bugs at the facility. This is an immediate health and safety hazard to residents in care.

Licensee must supervise facility operations

87205 Accountability of Licensee Governing Body: (a)The licensee, whether an individual or other entity, shall exercise general supervision over the affairs of the licensed facility and establish policies concerning its operation in conformance with these regulations and the welfare of the individuals it serves.This regulation is not met as evidenced by: Based on information obtained, the facility having ongoing bed bug problems since March of 2024. The licensee did not exercise general supervision of the facility that resulted in ongoing issues of bed bugs wherein R1 was directly harmed and bitten by bed bugs. This resulted in R1 being transported to the hospital emergency room where a medical professional determined R1 had been bitten by bed bugs. This is an immediate health and safety hazard to residents in care.

87405 Administrator - Qualifications and Duties: (h) The administrator shall have the responsibility to: (1) Administer the facility in accordance with these regulations and established policy, program and budget.This regulation is not met as evidenced by: Based on LPAs review of records and interviews regarding the Administrator failing to take responsibility and administer facility operation in accordance with licensing regulations. It is noted that facility has exterminator monthly services, however upon review of this, the services do not address extermination of bed bugs for the entire facility. This resulted in at least one resident (R1) being harmed and bitten by bed bugs. This is an immediate health and safety hazard to residents in car. This poses an immediate health and safety risk to residents in care.

Maintain facility in clean, safe, sanitary condition

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 is not met as evidenced by: Based on obtained relevant records including: incident reports indicating bed bug issues (dated from March 2024 – current); medical documentation of R1 discharge notes that indicate R1 had bites due to bed bugs, and facility invoices for exterminator services. This resulted in a resident (R1) going to the hospital ER on 10/12/2024 with doctors determining the bites were caused by bed bugs. This is an immediate health and safety hazard to residents in care.

Safe, healthful, comfortable accommodations

87468.1(a)(2): 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 is not met as evidenced by interviews of staff in which the LPA learned that staff were on the other side of the facility, and unable to hear the attack occurring in the resident’s room therefore not being able to prevent it from occurring.

CCR 87211(a)(1)(D) Reporting Requirements: (a) Each licensee shall furnish to the licensing agency such reports as the Department..A written report shall be submitted to the licensing agency within seven days of the occurrence. This requirement is not met as evidenced by an interview with Ricardo Aban, Executive Director, in 2 out of 2 incidents, which was not reported to Licensing, which poses a potential health/safety risk to persons in care.

87469 Advanced Directives and Requests Regarding Resuscitative Measures:(c) If a resident who has an advance directive and/or request regarding resuscitative measures form on file experiences a medical emergency, facility staff shall do one of the following:(2) Immediately give the advance directive and/or request regarding resuscitative measures form to a physician, registered nurse or licensed vocational nurse if the physician or nurse is in the resident’s presence at the time of the emergency and assumes responsibility. This regulation has not been met as evidenced by: Based on the investigaton interviews it was discovered that the facility staff did not inform 911 of the advance directive for R1 and did not provide emergency services the advance directive information at time of arrival of medical services and the fire department at time of their arrival which caused confusion during an emergency situation. This poses an immediate health and safety risk to residents in care.

Right to sufficient care and qualified staff

87468.2 (a) In addition to the rights listed in Section 87468.1, Personal Rights of Residents in All Facilities, residents in privately operated residential care facilities for the elderly shall have all of the following personal rights:(4) To care, supervision, and services that meet their individual needs and are delivered by staff that are sufficient in numbers, qualifications, and competency to meet their needs. This regulation has not been met as evidenced by: This regulation has not been met as evidenced by: Per interviews and documentation reviewed, it was found that there were confirmed call button pushes between 630pm and 7pm at least 2 or 3 times indicating staff did not meet the calls for assistance of R1 to meet their needs.

Provide assistance for residents medical needs

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: (2) The licensee shall provide assistance in meeting necessary medical and dental needs. This includes transportation which may be limited to the nearest available medical or dental facility which will meet the resident's need. In providing transportation the licensee shall do so directly or make arrangements for this service. This requirement has not been met as evidenced by: Based on the investigation conducted, caregivers S1, S2, and S3 did not seek timely medical attention for R1. S1, S2, and S3 did not call 911 immediately but sought advice from S4 on what to do in this situation. 911 was alerted approximatley after 1 hour after R1 was found unresponsive. Timely medical attention was not sought in a timely manner.