Bonnevie Residence and Care

87468.1 Personal Rights of Residents in All Facilities (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 conducted and observation, a metal latch was observed in the door exiting the living room. Staff interviewed stated they did this because a resident would try to exit. This poses an immediate health, safety, personal rights risks to residents in care.

Based on records reviewed, the licensee did not comply with the section cited above. LPA reviewed 3 resident medications and centrally stored medication records. Residents R1, R2 and R3 did not have multiple medications listed on the centrally stored medication record. Resident R1, R2 and R3's centrally stored medication record did not have any medications listed with a fill date of 2025. This poses/posed a potential health, safety or personal rights risk to persons in care.

Based on record review, the licensee did not comply with the section cited above. The facility conducted drills on the following dates: June 15, 2024, September 21, 2024, April 13, 2025, and July 10, 2025. This poses/posed a potential health, safety or personal rights risk to persons in care.

Based on observation and interview, the licensee did not comply with the section cited above. LPA noted there was "hook & eye", metal latch outside the living room door, leading towards the outside. S1 stated the latch was put there because there used to be a resident who wanted to go outside a lot. This poses an immediate health, safety or personal rights risk to persons in care.

HSC1569.269(29)... a licensee, or a spouse, domestic partner, relative, or employee of a licensee, shall not do any of the following:(E) Enter into a loan or promissory agreement or otherwise borrow money from a resident without outlining the terms of the repayment being given to the resident. This requirement is not met as evidenced by: Based on interview review, R1 and licensee does not have an written agreement regarding handling R1's finances and loaning money from residents which pose/poses an immediate health, safety, and personal right risks to persons in care.

Based on medication audit LPA observed R1,R2,and R3's Centrallly Stored Medicatiion Log (LIC622), all 3 residents medication refilled in September 2024 were not documented on log.

Based on observation and inspection during facility tour LPAs observed in pantry 20 cans of fruit and tomato soup and few vegetable and protein which poses/posed a potential health, safety or personal rights risk to persons in care.

Based on inspection of the facility (inside and out), LPA observed the following: #1. Loose floorboard in the main dining area. #2. Residents bedroom had cob webs in window panel bedroom #1. #3.bedroom # 3 window screen had holes. #4. Kitchen stove and oven, microwave and refrigerator were observed to have grease,crumbs and food residue, oil spills and stains #5. Residents bedrooms carpets were unvaccumed and had stains, and residents furnitures were dusty.

Based on inspection LPA measured the water temperature with a digital thermometer at 145.7 degrees F in bathroom #1, 130.1 in bathroom #2 and 141.1 in bathroom #3 (2nd Floor)

Based on observation the licensee did not comply with the section cited above. LPA observed the followiing toxic materials accessible to residents in care the following areas: #1. Car Wax and Curaid ointment unlocked hallway closet accross common area. #2. Comet, and cleaning supplies found in bathroom #3, #3 lighter fluid and bucket of laundry detergent was found in unlocked basement. #4 a garden potting soil/fertilizer was found outside the facility accesible.

Based on record review the licensee did not comply with the section cited above. LPA randomly reviewed resident file (R1,R2,R3,R4 R5). All 5 residents did not have appraisals needs and services plan in there files.

Based on inspection and observation LPAs observed bottles of pain reliever, allergy pills, antacid, osteo vitamin, herbal supplement, first aid anitbiotic ointment and 1 prescription ointment, and tube of pain releving cream in R1 unlocked closet. These medications belongs to R1 who is not able to store or administer own prescription/ OTC and store medication. R1s flonase was also found in kitchen. This poses/posed and immediate risk to resident in care.

Based on observation medication was found in hallway closet accross from the common area curaid ointment which belonged to previous unknown resident R6 who was on hospice which were not distructed properly upon death or resident is no longer at facility which poses an immediate health, safety or personal rights risk to persons in care.

Based on observation LPAs observed in Residents unlocked closet OTC medication. R1 buys OTC medication on their own.

87411 Personnel Requirement General (c) All RCFE staff who assist residents ... shall receive initial and annual training as specified in Health and Safety Code sections 1569.625 and 1569.69. This requirement is not met as evidenced by Based on interview, LIC stated that S1 does not have training since residing in the facility 7/1/2024, and is current assisting with resident's with personal activties of daily living, which pose/poses a potential health, safety & personal rights risk to persons in care.

87355 Criminal Record(e)All individuals...pursuant to Health and Safety Code Section 1569.17(b)... prior to working, residing ...in a licensed facility: (1)Obtain a California clearance ...as required by the Department. This requirement is not met as evidenced by: *deficiency stmnt did not print