Life Pastiche

Based on record review, the licensee did not comply with the section cited above in 1 out of 1, staff member did not have a criminal record transfer request in their file, and is not associated in guardian to the facility which poses an immediate health, safety or personal rights risk to persons in care.

Based on observation, the licensee did not comply with the section cited above in 3 of 5 bedrooms had exits to the outside. All of these outside exits were blocked not allowing access to the backyard from the bedroom which posesd a potential health, safety or personal rights risk to persons in care.

Based on observation and record review, the licensee did not comply with the section cited above in 2 of 6 residents had bedrails with no medical order in the file which poses/posed a potential health, safety or personal rights risk to persons in care.

Accountability of Licensee Governing Body (a)The licensee, whether an individual or other entity, shall exercise general supervision over the affairs of the licensed facility and establish policies concerning its operation in conformance with these regulations... This requirement is not met as evidenced by: based on The licensee did not exercise internal supervision over the affairs ofthe facility which lead to staff financially abusing a resident for a year and a half. This poses an immediate Health, Safety and Personal Rights risk to clients in care

Administrator - Qualifications and Duties (h)(5) Provide or ensure the provision of services to the residents with appropriate regard for the residents' physical and mental well-being and needs This requirement is not met as evidenced by: based on Adminitrator did not provide supervision and security regarding one of one (1 of 1) residents financial property. This poses an immediate Health, Safety and Personal Rights risk to clients in care

Additional Personal Rights of Residents in Privately Operated Facilities (a)(8) To be free from neglect, financial exploitation, involuntary seclusion, punishment, humiliation, intimidation, and verbal, mental, physical, or sexual abuse. This requirement is not met as evidenced by: based on The licensee did not protect R1 from S1's financial abuse for over a year. This poses an immediate Health, Safety and Personal Rights risk to clients in care.

87405(a) (a) All facilities shall have a qualified and currently certified administrator. The licensee and the administrator may be one and the same person. The administrator shall have sufficient freedom from other responsibilities and shall be on the premises a sufficient number of hours to permit adequate attention to the management and administration of the facility as specified in this section. When the administrator is not in the facility, there shall be coverage by a designated substitute who shall have qualifications .......