Tlc Home Care V

Record centrally stored prescriptions and refill data

INCIDENTAL MEDICAL CAREA record of centrally stored Rx medications for each resident shall be maintained and include... pharmacist, drug name, strength and quantity, dates filled, started & expiration, prescription number and instructions. This requirement is not met, as Centrally Stored Medication Records reflect incorrect dates filled, expiration dates, quantities, Rx numbers, and some meds are not recorded on CSMR. Licensee failed to maintain accurate CSMRs, which poses a potential health, safety or personal rights risk to clients in care.

Signed rights acknowledgement in resident record

PERSONAL RIGHTSThe licensee shall have each resident and the resident's representative sign a copy of these rights, and the signed copy shall be included in the resident's record.This requirement is not met, as Personal Rights forms are incomplete or missing for 3 out of 6 clients. Licensee failed to ensure that complete Personal Rights forms are maintained for all clients, which poses a potential health, safety or personal rights risk. Clients #3 and #4, have incomplete Personal Rights forms, and there is no Personal Rights form for client #5.

HEALTH AND SAFETY CODE... the employee shall complete 10 hours of initial training. This training shall consist of 6 hours of hands-on shadowing training, which shall be completed prior to assisting with the self-administration of medications, & 4 hrs of other training or instruction, as described in subdivision (f), which shall be completed within the first two weeks of employment.This requirement is not met, as staff #2 has not received required 10 hours of medications training, which poses a potential health, safety or presonal rights risk.

HEALTH AND SAFETY CODEEach employee who received training and passed the examination required in paragraph (5) of subdivision (a), and who continues to assist with the self-administration of medicines, shall also complete 8 hours of in-service training on medication-related issues each...12 month period. This requirement is not met, as staff #3 has received only 4 hours of annual medication training. Licensee failed to ensure that staff receive required 8 hours of annual medication training, which poses a potential health, safety or personal rights risk.

Ensure hazardous items are locked and not unattended

STORAGE SPACE & ACCESS...the licensee shall ensure that disinfectants, cleaning solutions, poisonous substances... 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 is not met. as paint is stored in unlocked storage shed in backyard. Licensee failed to ensure that toxics are inaccessible to clients, which poses an immediate health and safety risk to clients in care.

HOSPICE CARE OF TERMINALLY ILLThe licensee shall be permitted to accept or retain residents who have been diagnosed as terminally ill ... and who may or may not have restrictive and/or prohibited health conditions, to reside in the facility and receive hospice services from a hospice agency in the facility when all of the following conditions are met:The licensee remains in substantial compliance with the requirements of this section, with the provisions of the RCFE Act (HSC 1569 et seq.), all other requirements of Chapter 8 of Title 22...CCR governing RCFEs, and with all terms and conditions of the waiver.

Dignity in personal relationships

Based on observation, the licensee did not comply with the section cited above in 1 out of 6 client rooms, which poses an immediate health, safety or personal rights risk to persons in care.There is a video "nanny cam" in room #2 so staff can monitor client. Device also allows for audio monitoring.

Signed rights acknowledgement in resident record

Based on clients' record review, the licensee did not comply with the section cited above in 4 out of 6 client records reviewed, which poses a potential health, safety or personal rights risk to persons in care.Personal Rights froms are missing or incomplete for clients #1, #3, #4, #5.

Maintain physician order documentation in resident record

Based on clients' record review, the licensee did not comply with the section cited above, as there are no MD orders for half bed rails for client #2 and #3. This poses a potential health, safety or personal rights risk to persons in care.

Health screening and fitness requirements

Based on staff record review, the licensee did not comply with the section cited above in 3 out of 5 staff files reviewed, which poses a potential health, safety or personal rights risk to persons in care.- Health screenings and/or TB test results are not maintained for staff #2, #3, #4.

Based on absence of staff training records, the licensee did not comply with the section cited above, as there is no documentation that 3 out of 4 staff have received required 40 hours of initial training, which poses a potential health, safety or personal rights risk to persons in care.

Based on staff record review, the licensee did not comply with the section cited above, as there is no evidence that Staff #5 has received at least 20 hours of annual training. This poses a potential health, safety or personal rights risk to persons in care.

Based on clients record review, the licensee did not comply with the section cited above, as there is no hospice care plan for client #5, which poses a potential health, safety or personal rights risk to persons in care.

Based on staff record review, the licensee did not comply with the section cited above, as there is no evidence that staff received medications training. This poses a potential health, safety or personal rights risk to persons in care.

Complete admission suitability appraisal

Based on record review of clients, the licensee did not comply with the section cited above in 3 out of 6 client files reviewed, which poses a potential health, safety or personal rights risk to persons in care.- Appraisals are incomplete or not maintained for clients #3, #5, #6.

Ensure hazardous items are locked and not unattended

Based on observation, the licensee did not comply with the section cited above, as spray bottle of Mold and Mildew cleaner stored in common bath/shower room, accessible to clients. This poses an immediate health, safety or personal rights risk to persons in care.

No stage 3 or 4 pressure injuries

PROHIBITED HEALTH CONDITIONSPersons who require health services for or have a health condition including, but not limited to, those specified below shall not be admitted or retained in a RCFE:Stage 3 and 4 pressure injuries.This requirement was not met, as former client was assessed to have stage III pressure injury on 3/27/24, which was being treated by home health. Licensee failed to relocate client to higher level of care or request exception from CCLD, which posed an immediate health, safety or personal rights risk to clients in care.

Maintain cleanliness and prevent incontinence odors

MANAGED INCONTINENCEIn addition to Section 87611, General Requirements for Allowable Health Conditions, the licensee shall be responsible for...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 client #1 was observed on at least 4 occasions within a 30-day period to be in a soiled diaper. Licensee failed to ensure that client who needed incontinent care as clean and dry, which posed a potential health, safety or personal rights risk to clients in care.

ALLOWABLE HEALTH CONDITIONS & USE OF HOME HEALTH AGENCIESIncidental medical care may be provided to residents through a licensed HH agency provided...the licensee informs the HH agency of any duties the regulations prohibit facility staff from performing, and of any regulations that address the resident’s specific condition(s). This requirement was not met, as staff did not inform HH that they were not qualified to perform wound care nor that stage III pressure ulcers were prohibited, which posed a potential health, safety, or personal rights risk to clients in care.

ALLOWABLE HEALTH CONDITIONS & USE OF HOME HEALTH AGENCIESThe licensee & HH agency agree in writing on the responsibilities of the HH agency, & ...of the licensee in caring for the resident’s medical condition(s)... shall include day & evening contact information for the HH agency, & the method of communication between the agency & the facility, which may include ... logbook. This requirement was not met, as facility failed to maintain written record from HH of client's condition, which posed a potential health, safety or personal rights risk to clients in care.

PERSONNEL REQUIREMENTSAll services requiring specialized skills shall be performed by personnel qualified by training or experience in accordance with recognized professional standards.This requirement was not met, as non-medical staff provided wound care on C1 pressure ulcer on days when visiting LVNs and RNs did not visit client. Licensee failed to ensure that client received medical care from qualified personnel, which posed a potential health, safety or personal rights risk to clients in care.