Sundial Assisted Living

General Food Service Requirements The following food service ...(17) In facilities licensed for fifty (50) or more, and providing three (3) meals per day, a full-time employee qualified by formal training ... If this person is not a nutritionist, a dietitian, or a home economist, provision shall be made for regular consultation from a person so qualified. The consultation services shall be provided at appropriate times, during at least one meal. A written record of the frequency... This requirement is not met as evidenced by: Based on documentation reviewed, the facility did not ensure the facility had a nutritionist with written records. Which poses a potential health, safety, and personal rights risk to residents in care.

Reappraisals (f) The licensee shall immediately, or as soon as reasonably possible, communicate with the resident and, if applicable, the resident's representative, about any significant change in condition and the recommendation, if any, of the appropriate licensed medical professional, and if applicable, other specialized care provider. Documentation of such communication shall be added to the resident’s record. This requirement is not met as evidenced by: Based on documentation reviewed the facility did not perform a reappraisal when the resident had weight loss. Which poses a potential health, safety, and personal rights risk to residents in care.

Observation of the Resident 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 evidenced by: The licesenee did not address the residents weight loss. Which poses a potential health, safety, and personal rights risk to residents in care.

87464(f)(1) Basic Services (f) Basic services shall at a minimum include: (1) Care and supervision as defined in Section 87101(c)(3) and Health and Safety Code section 1569.2(c). This requirement is not met as evidenced by: Based on documentation reviewed, the facility did not ensure resident (R1) was receiving assistance with bathing as agreed in the Individualized Assessment, which poses a potential health, safety, and personal rights risk to residents in care.

87411(a) Personnel Requirements, General - Facility personnel shall at all times be sufficient in numbers, and competent to provide the services necessary to meet resident needs… This requirement was not met as evidenced by: Based on interviews and records the residents ADL’s were not completed during the time of a resident with a contagious medical confinement. This poses an immediate risk to residents in care.

87470(b)(2)(A) - Infection Control Requirements - In addition to subsection (a), when one or more residents in the facility are diagnosed with a contagious disease, the following shall apply: All staff and volunteers providing direct care to a resident who has a contagious disease shall wear appropriate Personal Protective Equipment (PPE) to prevent exposure to infectious agents… This requirement was not met as evidenced by: Based on interviews and records reviewed, the licensee/administrator did not ensure that staff were provided with all PPE supplies during a time when a resident had MRSA. This poses an immediate risk to residents in care.

87616(a) Exceptions for Health Condition - As specified in Section 87209, Program Flexibility, the licensee may submit a written exception request if he/she agrees that the resident has a prohibited and/or restrictive health condition but believes that the intent of the law can be met through alternative means. This requirement was not met as evidenced by: Based on interviews and records reviewed, the licensee/administrator did not follow the guidelines of the Prohibited Health Conditions. Licensee/administrator should have requested to have an exception in place. This poses an immediate risk to residents in care.

Personnel Requirements, General - Facility personnel shall at all times be sufficient in numbers, and competent to provide the services necessary to meet resident needs… This requirement was not met as evidenced by: Based on interviews and records reviewed, the licensee/administrator did not provide formal training to staff regarding Methicillin-Resistant Staphylococcus Aureus (MRSA). This poses an immediate risk to residents in care.

Personal Rights - 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: 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 was not met as evidenced by: Based on interviews and records reviewed, the licensee/administrator did not ensure that all staff were aware that residents had Methicillin-Resistant Staphylococcus Aureus (MRSA), or other serious infection. This poses an immediate risk to residents in care.

87465(c)(2) Incidental Medical and Dental Care:(c) If the resident's physician has stated in writing that the resident is unable to determine his/her own need for nonprescription PRN medication but can communicate his/her symptoms clearly, facility staff designated by the licensee shall be permitted to assist the resident with self-administration, provided all of the following requirements are met:(2) Once ordered by the physician the medication is given according to the physician's directions.This requirement was not met as evidenced by: Based on an observation of the Medication Administration Record, LPA observed that facility staff missed a dosage of medication that was supposed to be administered to the resident in care which is a potential health, safety, and personal rights risk to the residents in care.

87411(a) Personnel Requirements - General(a) Facility personnel shall at all times be sufficient in numbers, and competent to provide the services necessary to meet resident needs......This requirement was not met as evidenced by: Based on an interview that was conducted with the Administrator on October 22, 2024, the alleged staff member had her belongings searched with no medication being found which is an immediate health, safety, and personal rights risk to the residents in care.

87466 Observation of the ResidentThe 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…This requirement was not met as evidenced by: Based on interviews that were conducted, LPA learned that a resident was left on the commode for a long period of time which presents an immediate health, safety and personal rights risk to the residents in care.

87211(a)(1)(d) Reporting Requirements(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 report shall include the resident's name, age, sex and date of admission; date and nature of event; attending physician's name, findings, and treatment, if any; and disposition of the case.(D) Any incident which threatens the welfare, safety or health of any resident, such as psychological abuse of a resident by staff or other residents, or unexplained absence of any resident.This requirement was not met as evidenced by: Based on interviews that were conducted on August 27, 2024, LPA learned that there were incident reports regarding residents’ health that was not reported to Community Care Licensing Division (CCLD) which presents a potential health, safety and personal rights risk to the residents in care.

87618(b)(3)(h) Oxygen Administration - Gas and Liquid(b) In addition to Section 87611(b), the licensee shall be responsible for the following:(3) Ensuring that the use of oxygen equipment meets the following requirements:(H) Equipment shall be operable.This requirement was not met as evidenced by: Based on interviews that were conducted, LPA learned that the facility did not plug in the portable oxygen tank all the way which presents an immediate health, safety and personal rights risk to the residents in care.

Based on observation and record review, the licensee did not comply with the section cited above in 2 out of 5 residents did not have their prescribed medications secured in the cart. Facility staff does not know if the medications have been discontinued or not. This regulation poses a potential health, safety or personal rights risk to persons in care.