Fountain Square of Lompoc

Based on observation of facility kitchen door that leads to resident hallway and disrepair of fountain in in-closed courtyard with rocks on pathway, the licensee did not comply with the section cited above in 2 out of 2 observations of disrepair, which poses a potential health, safety or personal rights risk to persons in care.

87468.2 Additional Personal Rights of Residents in Privately Operated Facilities(a)… Personal Rights of Residents in All Facilities, residents… shall have all of the following personal rights: (14) To reasonable accommodation of their individual needs and preferences in all the health or aspects of life in the facility, except when accommodation would endanger safety of the individual resident or other residents. This requirement was not met by evidence of multipal prolonged times staff answering R1’s call buttons, which poses an imminent risk to residents in care.

Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above in [count] out of [total count] [(objects) (persons)] [identifiers] which poses/posed a potential health, safety or personal rights risk to persons in care.

Based on observation the licensee did not comply with the section cited above in that the water temperature in residetn room exceeded 120*(f), which poses/posed a potential health, safety or personal rights risk to persons 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 that resulting in call button times exceeding 41 minutes, which poses a potential risk to residents in care.

87309 Storage Space and Access (a) Except as specified in subsection (b), the licensee shall ensure that ... knives, matches, tools, sharp objects, and 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 was not met by evidence of: The licensee did not follow the section cited above when S1 brought a loaded gun into the facility and left it accessible, which posed an immediate health and safety risk to residents in care.

87211 Reporting Requirements (a) Each licensee shall furnish to the licensing agency such reports as the Department may require, including, but not limited to, the following:(1) A written report shall be submitted to the licensing agency and to the person responsible for the resident within seven days of the occurrence ...This report shall include...attending physician's name, findings, and treatment, if any; and disposition of the case. This requirement was not met was not met in 18 of 105 and 7 of 105 SIRs submitted in March through June of 2025, which poses a potential risk to Residents.

87465 Incidental Medical and Dental Care (h) The following requirements shall apply to medications which are centrally stored:(2) Centrally stored medicines shall be kept in a safe and locked place that is not accessible to persons other than employees responsible for the supervision of the centrally stored medication. This requirement was not met by observation of LPA discovering open and unsecured medication room with no staff present. This poses an eminent danger to residents in care.

87218 Theft and Loss (a) The licensee shall ensure an adequate theft and loss program...(2) A licensee who fails to make reasonable efforts to safeguard resident property,... The licensee shall be presumed to have made reasonable efforts to safeguard resident property if there is clear and convincing evidence of efforts to meet each requirement specified in Section 1569.153. This requirement was not met by evidence of lack of screening of uncleared staff and vendors, which puts residents in potential danger.

Basic Services (d)...if a facility chooses to accept a particular resident for care, the facility shall be responsible for meeting the resident's needs as identified in the pre-admission appraisal…and providing the other basic services…either directly or through outside resources. This requirement is not met as evidenced by: Based on interviews and records review, the licensee did not comply with the section cited above. Staff did not provide adequate care and supervision, residents sustaining falls resulting in injuries...

Additional Personal Rights of Residents in Privately Operated Facilities (a) .., residents... 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...to meet their needs. This requirement is not met as evidenced by: Based on interviews and records review, the licensee did not comply with the section cited above when they did not provide adequate staffing which resulted in residents needs not being met, including residents being left soiled for an extended period of time.

Reporting Requirements(a) ... (1) A written report shall be submitted to the licensing agency…within seven days of the occurrence of any of the events specified in (A) through (D) below.... (B) Any serious injury as determined by the attending physician and occurring while... the resident is under facility supervision.This requirement is not met as evidenced by: Based on interviews and records review, the licensee did not comply with the section cited above. The Licensee did not submit incident reports for numerous falls for R1 and R4,...

87468.2 Additional Personal Rights of Residents in Privately Operated Facilities(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: (25) To protection of their property from theft or loss according to Health and Safety Code ... This requirement was not met by evidence of several missing property items of Resident 1, which poses a potential risk to residents in care.

87303(i)(1)(C)Facilities shall have signal systems which shall meet the following criteria:(1)All facilities licensed for 16 ...shall have a signal system which shall:(C)Identify the specific resident living unit..This requirement was not met by evidence of Administrator admitting and reporting signal system malfunction. Which poses a potential risk to resident in care

87468.2(a)(4) Add’tl Personal Rights of Residents…(a) …residents in...RCFE shall have all following personal rights: (4) To care, supervision, and services that meet individual needs delivered by staff sufficient in numbers, qualifications, and competency to meet needs. This requirement is not met based on interviews and record review, licensee did not comply with the section cited above when staff failed to provide appropriate supervision to Resident #1 resulting in multiple incidents which posed an immediate health and safety risk to residents in care.

87211 Reporting Requirements (a) Each licensee shall furnish to the licensing agency such reports as the Department may require…(1) A written report submitted to licensing agency…within seven days...(D) Any incident that threatens welfare, safety or health of any resident This requirement was not met based on interviews and record review; licensee did not comply with section cited above when Licensing Department did not receive incident reports regarding a resident fall and physical altercation which posed a potential health and safety risk to residents in care.

87411(a) Personnel Requirements-General. (a) Facility personnel shall at all times be sufficient in numbers, and competent to provide the services necessary to meet resident needs... to ensure provision of personal assistance and care This requirement is not met as evidenced by: Based on interviews and records review, licensee did not comply with section cited above by failing to have sufficient staff to meet the needs of residents, which posed a potential health and safety risk to residents in care.

87211(a)(1)(D) Reporting Reqs. Licensee shall furnish to licensing agency...including...(1) Written report submitted to licensing agency and to person responsible for resident within 7 days… (D) Any incident which threatens the welfare, safety or health of any resident… This requirement is not met as evidenced by: Based on interviews and records review, licensee did not comply with section cited above by failing to report an incident and change of condition in R1 to licensing and responsible pary, which posed a potential health and safety risk to residents in care.

87211a(1)(A),(B) Reporting Reqs. Licensee shall furnish to licensing agency...including...(1) Written report to licensing agency…within 7 days…(A) Death of resident...regardless where death occurred...(B) Any serious injury determined by attending physician..occurring to resident under facility supervision This requirement is not met as evidenced by: Based on interviews and records review, licensee did not comply with the section cited above. Licensee did not submit incident reports for R1's hospitalizations or death report for R1, which posed a potential health and safety risk to residents in care.