The Village at Rancho Solano Assisted Living

§1569.269 Enumerated rights... a)Residents...shall have all of the following rights:(6) To care, supervision, and services that meet their individual needs...This requirement not met by licensee as evidenced by: Based on LPA review of facility's Response Time Alert, between 3/29/26 and 4/11/26 9 instances of call alarms went unanswered for 1+hours which poses a potential health, safety or personal rights risk to persons in care.

87224(d)The licensee shall set forth in the notice to quit the reasons relied upon for the eviction with specific facts to permit determination of the date, place, witnesses, and circumstances concerning those reasons.This requirement not met by licensee as evidenced by: Resident (R1) was given an eviction notice that did not provided detailed information as specified in the regulation cited as for the reason for eviction which poses/posed a potential health, safety or personal rights risk to persons in care

87465(a)(2) The licensee shall provide assistance in meeting necessary medical and dental needs...This requirement not met by licensee as evidenced by: Resident (R1) did not receive adequate body checks that resulted in partial amputation of their big toe from an ulcer which poses/posed an immediate health, safety or personal rights risk to persons in care.

87629 Injections(b)... licensees who admit or retain residents who require injections...(1) Ensuring that injections are administered by an appropriately skilled professional should the resident require assistance. This requirement not met as evidence by:Five out of Nine staff interviewed indicated non-skilled staff did not receive proper training on injections which poses/posed an immediate health and safety or personal rights risk to residents in care.

Based on observation, the licensee did not comply with the section cited above in two (2) counts of spoiled food which poses/posed a potential health, safety or personal rights risk to persons in care.

1569.657(a) For any rate increase due to a change in the level of care... licensee shall provide… written notice of the rate increases… The notice shall include a detailed explanation of the additional services to be provided... and an accompanying itemization of the charges. This requirement not met by Licensee as evidenced by:Based on documentation and interviews, R1 was charged a rate increase without being provided proper notice as outlined in Title 22 regulation 87307(3)(f).

87466 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… This requirement not met by Licensee as evidenced by:Facility staff were not informed of additional checks to completed for R1 following hospital discharge.

87307(3) Equipment and supplies necessary for personal care and maintenance of adequate hygiene practice shall be readily available to each resident…(F) Basic laundry service (washing, drying, and ironing of personal clothing). This requirement not met by Licensee as evidenced by: Based on documentation and interviews, R1 was not provided laundering services as outlined in resident agreement for more then one (1) month.

87411 Personnel Requirements - General87411(a) Facility personnel shall at all times be sufficient in numbers, and competent to provide the services necessary to meet resident needs… This requirement not met by Licensee as evidenced by: R1 alarm pendant was activated and rang for more than 1 hour as "invalid zone" before R1 was discovered.

Incidental Medical and Dental Care 87465(a)(4) The licensee shall assist residents with self-administered medications as needed.This requirement not met by licensee as evidenced by: Resident (R1) was injected with Humalog intended for resident (R2) which poses/posed an immediate health and safety or personal rights risk to residents in care.

87468.2(a)(4) Additional Personal Rights of Residents in Privately Operated Facilities. (4) To care, supervision, and services that meet their individual needs... This requirement not met by licensee as evidenced by: Based on a review of Response Time Report for Pendant Alarms/Bath E-Calls showed 39 instances of Pendant Alarms/Bath E-Calls going unanswered for 30 minutes to 2 plus hours which posed/poses a potential health, safety or personal rights risk to persons in care.

Personal Accommodations and Services87307(a)(3)(D) Hygiene items of general use such as soap and toilet paper.This requirement not met as evidenced by: Licensee did not ensure resident was supplied with basic hygeine items as outlined in Title 22 regulations

Personal Rights of Residents in All Facilities87468.1(a)(9) To have communications to the licensee from their representatives answered promptly and appropriately.This requirement not met as evidenced by: Licensee did not ensure representative communications were answered promptly as representative was made to wait twelve (12) days to receive a call back regarding resident health and safety.

Observation of the Resident 87466 The licensee shall ensure that residents are regularly observed for changes in physical, mental, emotional and social functioning ... This requirement not met by licensee as evidenced by: 3 instances of missed status check over the course of a 10 day fall intervention plan, including 1 instance of 22 hours and 40 minutes elapsing between checks which poses a potential health, safety or personal rights risk to persons in care.

Incidental Medical and Dental Care 87465(a)(4) The licensee shall assist residents with self-administered medications as needed.This requirement not met by licensee as evidenced by: Based on interviews and review of MAR, R1 was not administered fourteen (14) doses of prescribed medication over the course of thirty-one (31) days which poses an immediate health, safety or personal rights risk to persons in care.

Incidental Medical and Dental Care 87465(a)(4) The licensee shall assist residents with self-administered medications as needed.This requirement not met by licensee as evidenced by: Based on interviews and facility's incident report of medication error of not discontinuing one of R1’s, 2 anti-seizure medications as indicated by Dr., which poses an immediate health, safety or personal rights risk to persons in care.

Incidental Medical and Dental Care 87465(a)(4) The licensee shall assist residents with self-administered medications as needed.This requirement not met by licensee as evidenced by: Based on facility's submitted incident report reporting medication error, which poses an immediate health, safety or personal rights risk to persons in care.

87468.1(a)(3) Personal Rights of...Residents…all residents…shall have personal rights to be free from …interfering with daily living functions such as…sleeping… *** Based on statements and videos, this requirement has not been met as evidenced by: Resident R2 has repeatedly ventured into Resident R1’s space and handled R1’s belongings and is seen on video taken on 2/21/25 entering R1’s bed while an apparent sleeping R1 is occupying the bed. This posed an immediate violation of R1’s personal rights.

Based on observation, interview and record review, the licensee did not comply with the section cited above not having records available for Licensing to review during visit including updated personnel records which poses a potential health and safety risk to persons in care.

Based on record review, Licensee did not comply with the section cited above. Resident 1 eloped from facility. R1's Physician Reports state they are unable to leave without assistance and has a diagnosis of dementia. This poses an immediate health and safety risk to residents in care.

87465(a)(1) Incidental Medical and Dental Care. The licensee shall arrange, or assist in arranging, for medical and dental care appropriate to the conditions and needs of residents. ***Based upon records reviewed and statements taken, this requirement has not been met as evidenced by: Medical tests ordered for R1 on 1/24/2025 were not made until 2/4/2025. This posed an immediate risk to the health of R1.

87468© Personal Rights. Licensees shall prominently post personal rights, nondiscrimination notice, and complaint information in areas accessible to residents, representatives, and the public. ***Based on statements and observation, this requirement not met as evidenced by: Inspection on 12/10/24 found complaint sign posting was not required size and no residents’ rights posted. This posed a potential denial of residents’ personal rights.POC: Cleared at time of visit. Required postings are currently in place.

87211(a)(1) Reporting Requirements. A written report shall be submitted to the licensing agency and to the person responsible for the resident within seven days of…Any incident which threatens the welfare, safety or health of any resident….***Based on statements and documents reviewed, this requirement has not been met as evidenced by: Responsible Person for R1 was not provided copies of Reports for R1’s elopements from facility on 10/13 and 11/12 until 01/22/2025. This posed a potential risk to the personal rights and safety of R1.

. Facility personnel shall be sufficient in numbers, and competent to provide the services necessary to meet resident needs. *** Based upon interviews and records reviewed, this requirement not met as evidenced by: On 10/13/2024 R1 left facility without staff’s knowledge and remained away therefrom between 7:30pm and 9pm when R1 was returned by Law Enforcement. R1’s has dementia cannot leave facility unassisted. This posed an immediate risk to the safety of R1.

CA H&S 1569.657(a)For any rate increase (for) change in level of care …the Licensee shall provide…written notice..within two business days. *** Based on statements and documents, this requirement not met as evidenced by: R1’s Representative was provided written notice of increase effective 10/04/24 on 10/09/24 and effective 10/21/24 on 10/25/24. This posed a potential risk to the personal rights of the Resident.

Based on observation, the licensee did not comply with the section cited above in 7 out of 11 (4 in memory care) faucets accessible to residents in care ranged from 120.2 to 125.2 degrees F which poses an immediate health, safety or personal rights risk to persons in care.

Based on observation, Licensee did not comply with the section cited above. During tour of memory care LPAs and Administrator observed laundry room unlocked with cleaning chemicals on shelves. This is a potential health and safety risk to residents in care.

Personal Rights of Residents. Residents in all residential care facilities for the elderly shall have all of the following personal rights: (1) To be accorded dignity in their personal relationships with staff, residents, and other persons. ***Based upon statements and observations, this requirement not met as evidenced by: Cameras placed in the common areas of facility had the audio function activated. This posed an immediate violation of the residents' personal rights.

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 has not been met as evidenced by: Based on records reviewed and interviews conducted, facility staff were unable to respond to call buttons in a timely manner. Records reviewed indicated that multiple call buttons had response times of 20 minutes or more. This poses an immediate risk to the health and safety of residents in care.

87303(a) Maintenance and Operation. The facility shall be clean, safe, sanitary and in good repair at all times. ***Based upon photographs and statements, this requirement not met as evidenced by: 10/25/24 photographs of R1’s shower depict mold on the floor and wall. This poses an immediate risk to the health of R1.

87465(a)(4) Incidental Medical and Dental Care. …The licensee shall assist residents with self-administered medications as needed… Based on records and statements, this requirement not met as evidenced by: On 10/14/24 R1 was administered a medication not ordered and the wrong dose of a medication that was ordered. The ordered medication dosage was incorrectly listed in the Medication Administration Record. This posed an immediate risk to the health of R1.

Eviction Procedures. The licensee may evict a resident for one or more of the reasons listed in Section 87224(a)(1) through (5). Thirty (30) days written notice to the resident is required except as otherwise specified in paragraph (5) ***Based on statements and documents, this requirement not met as evidenced by: R1 was not allowed to return to facility from hospitalization due to a medical condition that is not a prohibited condition. This posed an immediate violation of R1’s personal rights.

87464. Basic Services. Basic services shall at a minimum include:...Personal assistance and care...such as dressing, eating, bathing..***Based on documents, this requirement not met as evidenced by: Care report for 8/2024 indicate R1 was not showered 8/16 thru 8/31/2024. This posed an immediate risk to the health and personal rights of R1.

87555(b)(7) General Food Service Requirements. Modified diets prescribed by a resident's physician as a medical necessity shall be provided. ***Based on documents and statements, this requirement has not been met as evidenced by: Kitchen staff were reminded by Administration on two occasions to follow diet prescribed by R1’s physician in the assessment of 1/7/2023. This posed a potential risk to R1's health

87211(a)(1) Reporting Requirements. A written report shall be submitted to the licensing agency and to the person responsible for the resident …***Based upon statements, this requirement has not been met as evidenced by: Administrator has stated that written incident reports have not been provided to R1’s Responsible Person. This posed a potential risk to the personal rights and health of Residents in Care.

H&S code section 1569.657 For any rate increase due to a change in level of care..licensee shall provide ..resident and resident representative..written…detailed explanation of additional services provided and itemization of charges. ****Based on documents and statements, this requirement not met as evidenced by: Facility did not provide R1 detailed explanation of services and charges for changes in level of care. This posed an immediate violation of personal rights.POC: Facility

General Food Service Requirements. Sufficient food service personnel shall be employed, trained and their working hours scheduled to meet the needs of residents.****Based on statements, this requirement has not been mete as evidenced by: Residents have waited up to 2 hours for food service in the dining rood. This posed an immediate violation of residents' rights.

87466 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. Based on statements and documents, this requirement was not met as evidenced by; On 4/22/2024, Staff did not note that R1 was feverish and required medical attention for UTI. This posed an immediate risk to the health of R1.

87465(c)(2) Incidental Medical and Dental Care. Once ordered by the physician the medication is given according to the physician's directions. ***Based on documents and statements, this requirement has not been met as evidenced by: On July 23 and July 24 R1 and R2 were not administered injections ordered by the physician. this posed an immediate risk to the health of the residents.

Based on record review the licensee did not comply with the section cited above in 3 out of 5 staff records review did not have first aid training which poses a potential health, safety or personal rights risk to persons in care.

Maintenance and Operation. The facility shall be clean, safe, sanitary and in good repair at all times. ***Based upon statements and photographs, this requirement not met as evidenced by: Extension and assorted electrical cords were noted across the bed and pillows of R1 and R2 in December of 2022; loose medication belonging to R1 was noted on the floor and furniture of R1’s room in December 2022. This posed and immediate risk to health and safety of residents. Civil penalty for $250.00 Issued for repeat violation within 12 months.

Personal Accommodations and Services. All outdoor and indoor passageways and stairways shall be kept free of obstruction. *** Based upon statements and photographs, this requirement not met as evidenced by: In February of 2023 and other occasions, furniture was observed to be blocking outdoor passageways in the Memory Care Unit of the facility. This posed an immediate risk to safety of residents. Immediate Civil Penalty issued in amount of $500.00 for Zero Tolerance violation.

Maintenance and Operation. Facilities licensed for 16 or more…shall have a signal system which meets specified requirements. ***Based on statements and written log reports, this requirement not met as evidenced by: Of 14 calls for assistance to room of R1 and R2 for 3 days in May 2023, 8 were over 20 minutes and 1 over an hour and 1 over 3 hours. This posed an immediate risk to health and safety of residents.

87705 Care of Persons with Dementia - (b)(2)Safety measures to address behaviors such as wandering.This requirement is not met as evidenced by: Based on incident report dated for March 24, 2023, Resident R1 eloped from facility without staff knowledge on March 20, 2023. Staff found resident and resident was escorted back into the community. Current medical assessment for resident states resident is not able to leave facility unassisted.

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 records reviewed and interviews conducted, facility staff were unable to respond to resident care needs and call buttons in a timely manner from January 20 through January 23, 2023. Records reviewed indicated that multiple call buttons had response times of 20 minutes or longer. In addition, December 2022 Call Pendants were not available for viewing. This poses an immediate risk to the health and safety of residents in care.

87707(a)(1) & 87707((a)(2) Training Requirements If Advertising Dementia Special Care, Programming And/Or Environments: (a) Licensees who advertise, promote, or otherwise hold themselves out as providing special care, programming, and/or environments for residents with dementia or related disorders shall ensure that all direct care staff, described in Section 87706(a)(1), who provide care to residents with dementia, meet the following training requirements:(1) Direct care staff shall complete six hours of orientation specific to the care of residents with dementia within the first four weeks of working in the facility.(2) Direct care staff shall complete at least eight hours of in-service training on the subject of serving residents with dementia within 12 months of working in the facility and in each succeeding 12-month period. Direct care staff hired as of July 3, 2004 shall complete the eight hours of in-service training within 12 months of that date and in each succeeding 12-month period.This requirement was not met as evidenced by:Based off of facility records review on February 6, 2023 with the Regional Vice President, LPA and Regional Vice President identified 10 staff members including the former Administrator who did not have the sufficient number of hours as outlined in Title 22 regulation. This poses a potential Health, Safety and Personal Rights risk to the residents in care.

87468.1(a)(9) Personal Rights of Residents in All Facilities:(a) Residents in all residential care facilities for the elderly shall have all of the following personal rights:(9) To have communications to the licensee from their representatives answered promptly and appropriately. Based off of facility records review which included the After-Hours phone history on February 6, 2023 with the Regional Vice President, LPA and Regional Vice President identified on January 20, 2023 and January 24, 2023 phone calls were missed and not returned back in a timely fashion. This poses an immediate Health, Safety and Personal Rights risk to the residents in care.

Based on LPA observation, the licensee did not comply with the section cited above in 3 out of 3 elevators that were last inspected on August 9, 2019 with an expiration of August 9, 2020 which poses a potential health, safety or personal rights risk to persons in care. In addition, this regulation poses a potential risk to visitors and staff members.

87202 Fire Clearance(a) All facilities shall maintain a fire clearance approved by the city, county, or city and county fire department, or district providing fire protection services, or the State Fire Marshal. Prior to accepting or retaining any of the following types of persons, the applicant or licensee shall notify the licensing agency and obtain an appropriate fire clearance approved by the city, county, or city and county fire department, or district providing fire protection services, or the State Fire Marshal.(1) Nonambulatory persons.(2) Bedridden persons This requirement was not met as evidenced by:Based on observation of the STD 850, the fire clearance was not approved due to the Fire Alarm system being inoperable during the inspection with the Fairfield Fire Department. In addition, during the tour, LPA and Fire Inspector observed 16-24 residents in the Memory Care Unit on the 2nd floor that was not Fire Clearance approved.

87465(a)(5): Incidental Medical and Dental Care Services. The licensee shall assist residents with self-administered medications when needed.This requirement is not met as evidenced by: Based off an incident report and an interview with the Administrator, the nurse over-medicated the resident on insulin. This is an immiedate health, safety and personal rights risk to residents in care.

87303(a) Maintenance and Operation :(a) The facility shall be clean, safe, sanitary and in good repair at all times. Maintenance shall include provision of maintenance services and procedures for the safety and well-being of residents, employees and visitors. This requirement was not met as evidenced by:Based on interviews and observations, LPA confirmed that the metal plate was present on November 7, 2022 and during the incident on the alleged date. This is a potential health, safety and personal rights risk to the residents in care.

87303(a) Maintenance and Operation. The facility shall be clean, safe, sanitary and in good repair at all times. ***This requirement not met as evidenced by: Based on photo’s and statements, R1’s room was observed to be dirty from feces, including floor and bedding. This posed an immediate risk to health of resident.

87307(3)(C) Personal Accommodations and Services. (Licensee shall provide) Clean linen, including blankets, bedspreads… ***This requirement has not been met as evidenced by: Based on statements and photos, R1 has not been provided adequate clean linens. This posed a potential risk to the health of R1.

87507(f) Admission Agreements. The licensee shall comply with all applicable terms and conditions set forth in the admission agreement…This requirement not met as evidenced by: Based on statements and documents, facility failed to provide notice of fee increased to R1 as specified in the Admission agreement. This posed a potential risk to the personal rights of R1.

1569.618 (b)(3)Ensure that at least 1 staff member who has cardiopulmonary resuscitation (CPR) training & first aid training is on duty & on the premises at all times.This requirement isn't met as evidenced by: Based on staff file review & interviews 3 out of3 staff file had no proof of 1st Aid and on 2/17/22 there were no staff w/ CPR on premises as per 8/11/22 visit and records requested on email which poses a potential health, safety, & personal rights risk to residents in care.

87355 Criminal Record Clearance.This requirement isnt met as evidenced by: Based on records reviewed facility didn't comply w/section above on 1 out of 3 staff fingerprint clearance & staff association before providing care to residents which poses an immediate health, safety, & personal rights risk to residents in care.CCLD reviewedtimecards provided by facility & learned that staff S3 isnt associated to facility.Staff S3 worked 2 days between 2/13 & 2/17/22.

87463(c) Reappraisals...once every 12 months...as specified in Section 87467.This requirement is not met as evidenced by: Based on observation,interview, and record review, facility did not comply with the section cited above in 4 out of 4 residents' reappraisals which poses a potential health,safety or personal rights risk to persons in care.Dept learned that residents R1,2,3,4 have no reappraisal or they are over 12 months.(see copies)

87412 Personnel Records:This requirement is not met as evidenced by: Based on records reviewed & interview facility didn't comply w/section above on 3 out of 3 staff files which poses a potential safety risk to residents in care. During visit on 8/11/22 LPA requested to review 2 staff files S1, S2, S3 based on timecards provide by facility. Facility staff files for S1 & S2 only contained resume & training. S3 had no file available.

§1569.625 Staff training; legislative findings…This requirement isn't met as evidenced by:Based on records review & interviews,licensee didn't comply w/section cited above in 3 out of 3 staff training which poses a potential health, safety,& personal risk to residents in care.During visit on 8/11 & email follow up, facility wasn't able to provide sufficient initial & on going proof of training for staff S1&S2 and no proof of training for S3.

87465(a)(5)-Incidental Medical and Dental Care:The licensee shall assist residents with self-administered medications as needed. This requirement was not met as evidenced by: Based on Self report made by facility, a staff member administered the wrong medication to R1. This is an immediate Health and Safety risk to the resident(s) in care. A civil penalty of $250 is being issued for this Repeated violation within in a 12 month period.

Maintenance and Operation. The facility shall be clean, safe, sanitary and in good repair at all times. Maintenance shall include provision of maintenance services and procedures for the safety and well-being of residents, employees and visitors. ***Based on LPA observations and statements, this requirement has not been met as evidenced by: Main entrance door to MC facility has not been functioning properly for at least 4 months. This poses a potential risk to the safety of the residents.

87465(a)(5)-Incidental Medical and Dental CareThe licensee shall assist residents with self-administered medications as needed. This requirement was not met as evidenced by: Based on an interview with the Administrator, a review of the discharge paperwork, Medication List and the Medication Assessment Record (MAR) for July 12, 2022, staff member administered the wrong dosage to R1. This is an immediate Health and Safety risk to the resident(s) in care.

87411 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 has not been met based on document review showing that a resident who was unable to leave facility unassisted eloped the facility. This poses an immediate health and safety risk to residents.

87465 Incidental Medical and Dental Care (g) The licensee shall immediately telephone 9-1-1 if an injury or other circumstance has resulted in an imminent threat to a resident’s health including, but not limited to, an apparent life-threatening medical crisis except as specified in Sections 87469(c)(2), (c)(3), or (c) (4). This requirement has not been met as evidenced by interview and record review showing that 911 was not called for resident despite complaints of pain and inability to walk. This is an immediate risk to the health and safety of residents in care.

Based on record review, Facility did not have the available record when requested by CCL. This poses a potential health and safety risk to residents in care.

87466 Observation of the Resident. Licensee shall ensure that residents are...observed for changes in physical,mental,emotional & social functioning & that appropriate assistance is provided when such observation reveals unmet needs. When changes...or deterioration of mental ability or a physical health condition are observed, licensee shall ensure that such changes are documented & brought to the attention of the resident's physician & responsible person, if any. Requirement wasn't met based on interviews & documents that show that some staff didn't observe bruising or pressure injury on R1 despite assisting with care & some observed injuries but didn't report. This is an immediate risk.

§1569.269 Enumerated rights; severability (a) Residents of residential care facilities for the elderly shall have all of the following rights: (6) 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 based on interviews and documents that show that facility did not seek timely medical care for resident, R1. This is an immediate risk to health and safety of residents in care.

87211(a)(1)(B) REPORTING REQUIREMENTS. ..Licensee shall report to the Department…within 7 days..Any serious injury as determined by the attending physician and occurring while the resident is under facility supervision. ***Based upon documents reviewed, statements, and photographs, this requirement not met as evidenced by: Facility did not report timely R1’s fall which resulted in injury and bruising. This posed an immediate risk to health and safety of resident.

87208(a)(2) PLAN OF OPERATION. Each facility shall have and maintain a current, written definitive plan of operation. (2) A copy of the Admission Agreement, containing basic and optional services. ***This requirement is not met as evidence by: Based on a review of records and interviews, , Licensee did not follow program plan as shown by call button logs. This poses an immediate Health and safety risk for residents in care. **Civil penalty issued in the amount of $250.00 for repeat violation within 12 months.

87303e(2) Maintenance and Operation. Hot water temperature controls shall be maintained to automatically regulate the temperature of hot water used by residents to attain a temperature of not less than 105 degree F (41 degree C) and not more than 120 degree F (49 degree C). ***Based upon statements and reviewed documents, this requirement has not been met as evidenced by: Hot water not available to residents for periods during the months of May and June, 2021. This posed an immediate risk to health and welfare of residents.

87555(b)(9) General Food Service Requirements… Procedures which protect the safety, acceptability and nutritive values of food shall be observed in food storage, preparation and service.***Based upon observations, this requirement not met as evidenced by: opened food observed stored without labels or dates. This posed an immediate risk to the health of the residents in care.

87555(b)(27) General Food Service Requirements. All kitchen areas shall be kept clean and free of litter, rodents, vermin and insects. ***Based upon observations, this requirement has not been met as evidenced by: LPA observed kitchen floor; food storage areas and carts in a dirty state. This posed an immediate risk to the health of the residents in care.

87625(b)(3) Managed Incontinence. …the licensee shall be responsible for the following: Ensuring that incontinent residents are kept clean and dry and that the facility remains free of odors from incontinence. ***Based upon statements taken, this requirement has not been met as evidenced by: R1 states R1 has waited up to 2 hours for assistance with incontinence on more that one occasion. This posed an immediate risk to the health and welfare of resident.

87468.1(a)(2) General Food Service Requirements . All kitchen areas shall be kept clean and free of litter, rodents, vermin and insects. ***Based upon statements made and documents reviewed, this requirement has not been met as evidenced by: staff and Administration state that there has been an ongoing problem with rodents in the facility kitchen. This poses an immediate risk to the health of the residents.

87303(a) MAINTENANCE AND OPERATION.The facility shall be clean, safe, sanitary and in good repair at all times.. *** Based upon observations made at site visits, this requirement has not been met as evidence by: On or about July 07, 2021, the kitchen was observed to contain dirty cold and hot wells, grill with old food under grates, and inoperable and broken appliances. This posed an immediate risk to the health of the residents in care.

1569.269 H&S (a)(6) Residents of residential care facility for the elderly shall have all of the following rights: (6) to care, supervision, and services that meet their individual needs..delivered by staff ..in sufficient numbers, qualifications, and competency to meet their needs. ***Based upon statements and reviewed records, this requirement has not been met as evidenced by: Front desk staff did not respond to R1’s call for help in a timely way following a fall. This posed an immediate risk to safety and health of resident in care.