Delia's Residential Community 1

§1569.153 (k) A copy of this section and Sections 1569.152 and 1569.154 is provided by a facility to all of the residents and their responsible parties, and... to all of the facility's prospective residents and their responsible parties. This requirement was not met as evidenced by: Based on review of resident R1's file, R1 did not have a signed document stated they received the Theft & Loss Policy and the sections 1569.152 and 1569.154 was provided to the resident and/or resident's responsible party which poses/posed a potential health, safety or

Report suspected non-serious physical abuse within 24 hours

87211 (c) Any suspected physical abuse that does not result in serious bodily injury of an elder or dependent adult shall be reported to the local ombudsman, the corresponding licensing agency, and the local law enforcement agency within twenty-four (24) hours... This requirement was not met as evidenced by: Based on review of staff S1's file, S1 did not have a signed SOC341A statement acknowledging requirement to report suspected abuse of dependent adult and elders which poses/posed a potential health, safety or personal rights risk to persons

Health screening and fitness requirements

87411 Personnel Requirements - General All personnel, including the licensee and administrator, shall be in good health, and physically and mentally capable of performing assigned tasks. This requirement is not met as evidenced by: Based on review of S1's file, S1 did not have a Health Screening Report on file which poses/posed a potential health, safety or personal rights risk to persons in care.

87457 Pre-Admission Appraisal (c)(3) The prospective resident, or his/her responsible person, if any, shall be involved in the development of the appraisal.This requirement was not met as evidenced by: Based on review of resident records, resident R1's Appraisal/ Needs and Services Plan dated 04/2025 was created but it was not signed by the resident or his/her responsible party which poses/posed a potential health, safety or personal rights risk to persons in care.

Record centrally stored prescriptions and refill data

87465 Incidental Medical and Dental Care (h) (6) The licensee shall be responsible for assuring that a record of centrally stored prescription medications for each resident is maintained for at least one year...This requirement is not met as evidenced by: Based on interview and record review, resident R2's 1 out of 6 medications was not logged on the Centrally Stored Medication Log which poses/posed a potential health, safety or personal rights risk to persons in care.

Passageways and stairways kept clear

87307 Personal Accommodations and Services (d) The following space and safety provisions shall apply to all facilities: (6) All outdoor and indoor passageways and stairways shall be kept free of obstruction. This requirement is not met as evidenced by: Based on observation, interview and record review, the licensee did not ensure that sliding exit doors tracks were free of obstruction. LPA observed a wooden block obstructing the sliding exit door tracks which poses an immediate health, safety or personal rights risk to persons in care.

Record centrally stored prescriptions and refill data

87465 Incidental Medical and Dental Care (h) (6) The licensee shall be responsible for assuring that a record of centrally stored prescription medications for each resident is maintained for at least one year...This requirement is not met as evidenced by: Based on interview and record review, 4 out of 7 medications were not logged on the Centrally Stored Medication Log which poses/posed a potential health, safety or personal rights risk to persons in care.

Must complete individual written admission agreements

87507 Admission Agreements(a) The licensee shall complete an individual written admission agreement, as defined in Section 87101(a), with each resident or the resident's representative, if any.This requirement is not met as evidenced by: Based on interview and record review, 1 out of 2 resident files did not contain Admission Agreement which poses/posed a potential health, safety or personal rights risk to persons 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. This requirement was not met as evidenced by: Based on observation, one of the ramp railings located on the left side of the backyard is wobbly. This poses a potential health risk to residents in care.