Belmont Village Sunnyvale

POSTURAL SUPPORTSA written order from a physician indicating the need for the postural support shall be maintained in the resident’s record. This requirement is not met, as MD orders are not maintained for half bed rails for clients #1, #2, #5, #7, and residents in rooms #408, #342, #223, #203, #207, #125, #102. Licensee failed to ensure that MD orders are maintained for residents who use half bed rails, which poses a potential health, safety or personal rights risk to clients in care.

PERSONAL RIGHTSResidents in all residential care facilities for the elderly shall have ... the following personal rights...To have access to individual storage space for private use. This requirement is not met, as closets and/or storage spaces of residents #12 and #13--in rooms 203 and 207 respectively--are locked and not accessible to residents as requested by clients' powers of attorney. Licensee failed to ensure that residents have access to their individual storage spaces, which poses a potential health, safety or personal rights violation.

INCIDENTAL MEDICAL CARECentrally 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 is not met, as client #8 is not able to self store/admin medications, per MD, but Ibuprophen (2), Tylenol and Tumms are stored in bathroom. Licensee failed to ensure that medications are inaccessible to clients who cannot self store/admin meds, which poses an immediate health or safety risk to clients in care.

(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 of any of the events specified in (A) through (D) below. ... This requirement is not met as evidenced by: Based on interview, record review, and observation the licensee did not ensure to report incidents and death reports to the Department within 7 days of the occurrence which poses a potential health, safety, and personal rights risk to persons in care.

87464 Basic Services. (f) Basic services shall at a minimum include: (1) Care and supervision ... means the facility assumes responsibility for, or provides or promises to provide in the future, ongoing assistance with activities of daily living ... taking medications, money management, or personal care. This requirement was not met as evidenced by:Based on the interviews and record reviewed, the facility did not provide care and supervision for R1. R1 had a change of condition and was not reported, and the facility did not take action on R1's change of condition, which led to R1's hospitalization.

87465 Incidental Medical and Dental Care. (a) A plan for incidental medical and dental care shall be developed by each facility... shall arrange, or assist in arranging, for medical and dental care appropriate to the conditions and needs of residents. This requirement was not met as evidenced by: Based on the interviews and records reviewed, the facility did not assist or arrange medical care appropriately to the resident condition and needs when R1 had a change of condition, this poses/posed a immediate health and safety risk to persons in care.

Based on observation, interview, and record review the licensee did not comply with the section cited above in 2 out of 6 counts wherein LPA did not observed 2 staff members file contained at least 20 hours of annual training which poses/posed a potential health, safety or personal rights risk to persons in care.

Based on observation, interview, and record review the licensee did not comply with the section cited above in 1 out of 6 counts wherein LPA was unable to review a staff member's health screeing and TB result which poses/posed a potential health, safety or personal rights risk to persons in care.

Based on observation, interview, and record review the licensee did not comply with the section cited above in 5 out of 11 counts wherein 5 residents PRN medications were not properly documented in the centrally stored medication record which poses/posed a potential health, safety or personal rights risk to persons in care.

Incidental Medical and Dental Care(a) A plan for incidental medical and dental care shall be developed by each facility. ... and provide for assistance in obtaining such care, by compliance with the following: (1) The licensee shall arrange, or assist in arranging, for medical and dental care appropriate to the conditions and needs of residents. This was not met as evidenced by: Based in interviews & record reviews, no calls were made to 911 to send R1 to emergency room for further assessment when R1 fell during outing which poses an immediate health, safety, and personal rights risk to persons in care.

During record review, 5 out of 6 residents with dementia whose records were reviewed did not have a physician's report that was updated annually, which poses a potential safety risk to residents in care.

Based on review of staff records, 2 out of 5 reviewed staff did not have current First Aid Certifications, which poses a potential safety risk to residents in care.

(a) (4) 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 the following personal rights: 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. Facility did not discuss plan of care instruction with staff to ensure R1 receive the care and supervision as a result R1 had 3rd fall sustained a right hip fracture. This poses an immediate risk to the health of the resident.This requirement was not met as evidence by: Based on investigation record review and interview, the facility did not update the care plan for R1 to ensure that resident received care, supervision and services that meet resident’s needs.

(a) 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. Significant changes shall include but not be limited to. This requirement was not met as evidence by: Based on document review and investigation, there was no evidence that the facility reassessed R1 after the fall. R1’s Reappraisal was not updated for the facility to develop the care plan to meet resident’s needs. This poses an immediate risk to the health of the resident.

1568.082(3) Conduct which is inimical to the health, welfare, or safety of either an individual in or receiving services from the facility or the people of the State of California. Licensee/administrator failed to comply and cooperate with technical assistance recommendations provided by local public health and CCL on 25% surveillance testing of staff regardless of vaccination status weekly. This poses an immediate risk to the health of the residents in care.