Merrill Gardens at Gilroy

(f) The licensee shall comply with all applicable terms and conditions set forth in the admission agreement, including all modifications and attachments. This requirement is not met as evidenced by: Based on interview, record review and observation the licensee did not comply with the section cited above wherein the licensee did not comply with the terms and conditions set forth in resident (R1)’s admission agreement by not ensuring R1 was credited assisted living care services costs per the admission agreement timeframe which poses a potential health, safety, and personal rights risk to persons in care.

a) Facility personnel shall at all times be sufficient in numbers, and competent to provide the services necessary to meet resident needs. … This requirement is not met as evidenced by: Based on interview and record review, the licensee did not ensure that staff were competent to assist residents with medication administration in 2 counts wherein 2 resident’s were administered another resident’s medication on 02/25/25 and 07/17/25 which poses an immediate health, safety, and personal rights risk to persons in care.

(a) ... the licensee shall ensure that disinfectants, cleaning solutions, poisonous substances, ... 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 is not met as evidenced by: Based on record review, interview and observation the licensee did not ensure to keep toxic items inaccessible to resident (R1) who is diagnosed with dementia and should not have access to cleaning solutions and toxins per the physician, which posed an immediate health, safety, and personal rights risk to persons in care.

(a) In addition to the rights listed in Section 87468.1, Personal Rights of Residents in All Facilities, … (4) 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. This requirement is not met as evidenced by: Based on interview and record review, the licensee did not ensure there was enough staff scheduled in prom and plaza during the NOC shift in May 2024 and did not ensure staff responded to the resident’s call buttons within 15 minutes, which poses an immediate health, safety and personal rights risk to persons in care.

(a) Residents in all residential care facilities for the elderly shall have all of the following personal rights: (8) To have their representatives regularly informed by the licensee of activities related to care or services, including ongoing evaluations, as appropriate to their needs. This requirement is not met as evidenced by: Based on interview, record review and observation the licensee did ensure to comply with the section cited above by not informing R1 and R1’s authorized representatives of the need to remove R1’s medications from his/her room prior to removing the medications, despite R1’s care plan not requiring medication management which poses an immediate health, safety and personal rights risk to persons in care.

(a) Residents in all residential care facilities for the elderly shall have all of the following personal rights: (3) To be free from punishment, humiliation, intimidation, abuse, or other actions of a punitive nature,... This requirement is not met as evidenced by: Based on interview, record review and observation S1's aggressive actions towards R1, the night of 12/02/2024 violated R1's personal rights, which poses/posed an immediate health, safety, and personal rights risk to persons in care.

(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: (3) Any illness, injury, trauma, or change in the health care needs of the resident that results in a circumstance or condition specified in Sections 87455(c) … This requirement is not met as evidenced by: Based on interview, record review, and observation the licensee did not comply with the section cited above wherein the facility did not reassess R1 after 11/30/2023, even though R1 continued to be a fall risk and had multiple falls resulting in injuries after 11/30/2023 which poses an immediate health, safety and personal rights risk to persons in care.

(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: (4) 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. This requirement is not met as evidenced by: Based on interview, record review and observation the licensee did not comply with the section cited wherein R1's alert button was not responded to on 7 different occasions and based on LPA Dolores observation on 10/18/23 which poses an immediate health, safety, and personal rights risk to persons in care.

(c) The licensee shall arrange a meeting with the resident, the resident’s representative, if any, appropriate facility staff, and a representative of the resident’s home health agency, if any, when there is significant change in the resident’s condition, or once every 12 months, whichever occurs first, as specified in Section 87467, Resident Participation in Decision Making. This requirement was not met as evidenced by: Based on record review and observation, the licensee did not ensure to review R1’s updated service plans with R1’s responsible party which poses a potential health, safety and personal rights risk to persons in care.

(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 evidenced by: Based on record review and observation, the licensee did not ensure resident (R1) was re-evaluated and R1’s service plans were updated after falls resulting in the resident sustaining injuries due to the falls which poses an immediate health, safety, and personal rights risk to persons in care.

(b) The licensee shall immediately bring any such changes to the attention of the resident's physician and his family or responsible person. This requirement was not met as evidenced by: Based on record review and observation, the licensee did not ensure to report R1’s falls to R1’s physician on 04/30/2022, 06/24/2022, 07/05/2022, 07/06/2022, 08/09/2022, 09/23/2022, 10/07/2022 which poses a potential health, safety and personal rights risk to persons in care.

(a) A plan for incidental medical and dental care shall be developed by each facility. The plan shall encourage routine medical and dental care 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 requirement was not met as evidenced by: Based on record review and observation, the licensee did not ensure to obtain an updated physician’s report for resident (R1) after staff observed changes in R1’s conditions based on the re-evaluations and updated service plans, and did not obtain follow-up with R1's physician in a timely manner for an order for R1's nutritional beverage which poses a potential health, safety and personal rights risk to persons in care.

(a) Residents in all residential care facilities for the elderly shall have all of the following personal rights: (3) To be free from punishment, humiliation, intimidation, abuse, or other actions of a punitive nature, such as withholding residents’ money or interfering with daily living functions such as eating, sleeping, or elimination. This requirement is not met as evidenced by: Based on interview and record review, the licensee did not ensure resident (R1) was free from abuse by staff (S1) who handled R1 roughly on the night of 06/13/2022 which poses an immediate, health, safety and personal rights risk to persons in care.

Based on record review and observation, licensee did ensure staff (S1) and (S4) health screening and TB result was not on file which poses a potential health, safety and personal rights risk to persons in care.

(d) The administrator shall have the qualifications specified in Sections 87405(d)(1) through (7). If the licensee is also the administrator, all requirements for an administrator shall apply. (2) Knowledge of and ability to conform to the applicable laws, rules and regulations. This requirement is not met as evidenced by: Based on interview, record review, and observation the Administrator failed to exhibit the knowledge of applicable laws, rules and regulations resulting in serious violations which poses an immediate health safety and personal rights risk to persons in care.

(e) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1569.17(b) shall prior to working, residing or volunteering in a licensed facility: (1) Obtain a California clearance or a criminal record exemption as required by the Department orThis requirement is not met as evidenced by: Based on interview and record review the licensee did not obtain a criminal record clearance for staff (S1) prior to S1 starting work which poses an immediate health, safety, and personal rights risk to persons 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: (2) Occurrences, such as epidemic outbreaks, poisonings, catastrophes or major accidents which threaten the welfare, safety or health of residents, personnel or visitors, shall be reported within 24 hours either by telephone or facsimile to the licensing agency and to the local health officer when appropriate. This requirement is not met as evidenced by: Based on interview, record review, and observation the licensee did not ensure to report the resident (R1)'s death and incident to the department within 24 hours which poses / posed an immediate health, safety, and personal rights risk to persons in care.

The licensee shall ensure that residents are regularly observed for changes in physical, mental, emotional and social functioning and that appropriate assistance is provided when such observation reveals unmet needs. When changes such as unusual weight gains or losses or deterioration of mental ability or a physical health condition are observed, the licensee shall ensure that such changes are documented and brought to the attention of the resident's physician and the resident's responsible person, if any. This requirement is not met as evidence by: Based on interview, record review, and observation the licensee did not ensure resident (R1) was checked on regularly for 72 hours after being discharged back to the facility from the hospital. On 08/27/2023, resident was found on the floor with injuries to include a golf size bump on the forehead and skin discoloration on the eye, elbow, hands and knees. This poses/posed an immediate health, safety, and personal rights risk to persons in care.

(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: (3) Any illness, injury, trauma, or change in the health care needs of the resident that results in a circumstance or … This requirement is not met as evidenced by: Based on interview, record review, and observation the licensee did not ensure resident (R1)’s reappraisal was accurate and documented R1’s diagnosis and changes to the resident’s condition after returning to the facility from the hospital on 08/19/2023 which poses/posed an immediate health, safety, and personal rights risk to persons in care.

(a) Residents in all residential care facilities for the elderly shall have all of the following personal rights: (2) To be accorded safe, healthful and comfortable accommodations, furnishings and equipment. This requirement is not met as evidence by: Based on interview, record review, and observation the licensee did not ensure resident (R1) was accorded a healthful and comfortable accommodation due to being found on the floor with ants on R1’s body which poses/posed an immediate health, safety, and personal rights risk to persons in care.

(e) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1569.17(b) shall prior to working, residing or volunteering in a licensed facility: (2) Request a transfer of a criminal record clearance as specified in Section 87355(c) or. This requirement was not met as evidenced by: Based on record review, interview, and observation the Licensee did not comply with the section cited above by not requesting a transfer to associate S1 and S2 to the facility prior to individuals starting work, which poses an immediate health, safety, and personal rights risk to persons in care.

(a) Residents in all residential care facilities for the elderly shall have all of the following personal rights: (3) To be free from punishment, humiliation, intimidation, abuse, or other actions of a punitive nature ... This requirement is not met as evidenced by: Based on interview and observation of the fall detection video, it was evident that after S1 and S2 failed to assist R1 back onto the wheelchair after a fall, S1 kneed R1 on the left side causing R1 to budge, which poses an immediate health, safety, and personal rights risk to persons in care.

(e) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1569.17(b) shall prior to working, residing or volunteering in a licensed facility: (2) Request a transfer of a criminal record clearance as specified in Section 87355(c) or ... This requirement was not met as evidenced by: Based on record review, interview, and observation the Licensee did not comply with the section cited above for staff (S2) which poses an immediate health, safety, and personal rights risk to persons in care.

(e) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1569.17(b) shall prior to working, residing or volunteering in a licensed facility: (1) Obtain a California clearance or a criminal record exemption as required by the Department or ... This requirement was not met as evidenced by: Based on record review, interview, and observation the Licensee did not comply with the section cited above for staff (S1) which poses an immediate health, safety, and personal rights risk to persons in care.

Based on observation and interview, the licensee did not comply with the section cited above by having multiple sharp gardening tools and toxins accessible in the commuity garden to persons with dementia which poses an immediate health, safety or personal rights risk to persons in care.