Jps Home Care Services

87211 Reporting Requirements (a) Each licensee shall furnish... (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. (A) Death of any resident from any cause regardless of where the death occurred, including but not limited to a day program, a hospital, en route to or from a hospital, or visiting away from the facility. This requirement not met by licensee as evidenced by: Based on LPA record review and interview, the licensee did not comply with the section cited above as facility did not report R1s death to CCL which poses a potential health, safety or personal rights risk to persons in care.

§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...This requirement is not met by licensee as evidence by video review and interviews...... conducted, the licensee did not ensure R1 received assistance from S1 and/or staff on duty. This poses an immediate Health, Safety or Personal Rights risk to persons in care.

Based on LPAs and staff observation, the facility did not comply with the section cited above in 2 out of 2 bathroom sinks accessible to residents were measured above 120 degrees F (49 degree C) which poses/posed a potential health, safety or personal rights risk to persons in care.

Based on LPA's/Licensee observation, interview and record review, the licensee did not comply with the section cited above in four out of five residents (R1, R2, R3 & R4) needs an updated care plan, which poses/posed a potential health, safety or personal rights risk to persons in care.

Based on LPA's/Licensee observation, interview and record review, the licensee did not comply with the section cited above by not having an active administrator certificate which poses/posed a potential health, safety or personal rights risk to persons in care.

Based on LPA's/Licensee observation and interview, the licensee did not comply with the section cited above by having cleaning solutions and disinfectans available to residents in care which poses an immediate health, safety or personal rights risk to persons in care.

Based on LPA's/Licensee Asst observation, interview and record review, the licensee did not comply with the section cited above in two out of three staff have not completed their additional 20 hours annually, which poses/posed a potential health, safety or personal rights risk to persons in care.

Based on LPA/Licensee observation the hot water measured 127 and 134.4 degrees Fahrenheit, which is not in compliance with regulation, the licensee did not comply with the section cited above which poses an immediate health, safety risk to persons in care.

87465(a)(4) Incidental Medical and Dental Care-A plan for incidental medical & 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: The licensee shall assist residents with self-administered medications as needed. This requirement was not met- As evidenced by: During medication audit of 6/10/2024 and today, the facility failed to properly provide some medication to R1. (Prednisone, Albuterol, Doxyclyne/antibiotic, verapamil)This is an immediate risk to the Health & Safety of 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: The facility failed to report several incidents for resident R1. This is a potential risk to the health & safety of residents in care

87465 Incidental Medical and Dental Care (h) The following requirements shall apply to medications which are centrally stored: (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 and includes: This requirement was not met as evidenced by: The facility failed to properly document the centrally stored medication log as required for all residents. This is a potential risk to the health & safety of residents in care.

Based on today's inspection and observation with licensee, Evelyn Serrano, the licensee did not comply with the section cited above in 4 out of 4 fire extingueshers had not been serviced within the last year,which poses/posed a potential health, safety or personal rights risk to persons in care.

87458(a) Medical Assessment- Prior to a person's acceptance as a resident, the licensee shall obtain and keep on file, documentation of a medical assessment, signed by a physician, made within the last year. The licensee shall be permitted to use the form LIC 602 (Rev. 9/89), Physician's Report, to obtain the medical assessment. This requirement was not met as evidenced by:During facility resident record review, 2 of 5 residents did not have the required Physician report for R2 and R3.This is a potential risk to the Health & Safety of residents in care

87465(a)(5) Incidental Medical and Dental Care-A plan for incidental medical & 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: The licensee shall assist residents with self-administered medications as needed. This requirement was not met- As evidenced by: During medication audit of 9/14/21 an d today 9/22 the facility failed to provide some medication to R1. (Metaformin, Docusate & Clozapinerx) was not provided, or correct doze was not provided.This is an immediate risk to the Health & Safety of residents in care

87355 (e)(2) - Criminal Record Clearance(e) All individuals subject to a criminal record review...(b) shall prior to working, residing or volunteering in a licensed facility: (2) Request a transfer of a criminal record clearance...This requirement was not met as evidenced by: Based on record review, observations, and interviews conducted: Facility did not request a transfer of a criminal record clearance for individual (I1) prior to working at the facility.This is an immediate safety risk to the residents in care.