Yerba Buena Residential Care Home

Based on LPA and Admin observation and record review, the licensee did not comply with the section cited above in that S2, S3, and S4 did not have the required number of annual trianing hours completed, which poses a potential health, safety or personal rights risk to persons in care.

Based on LPA observation, the licensee did not comply with the section cited above in that Room #2 was found to have a soiled brief in an uncovered waste basket, which poses a potential health, safety or personal rights risk to persons in care.

Keep prescriptions in original containers

Based on LPA and Admin observation,, the licensee did not comply with the section cited above in that facility was pre=pouring medications, which poses a potential health, safety or personal rights risk to persons in care.

Based on LPA and caregiver observation, the licensee did not comply with the section cited above in that room #2 had urine present in an uncovered bedside commode, which poses a potential health, safety or personal rights risk to persons in care.

Facility personnel sufficiency and competence

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 by licensee as evidenced by: elopement of R1, which poses an immediate potential health, safety, and personal rights risk to resident in care.

Health screening and fitness requirements

Based on LPA and Admin observation, the licensee did not comply with the section cited above in that Staff (S1) does not have a Health Screen on file which poses a potential health, safety or personal rights risk to persons in care.

Handle syringes and needles under bloodborne pathogen rules

Based on LPA and Admin observation, the licensee did not comply with the section cited above in that Sharps container containing sharps was left open on the kitchen floor and accessible to residents, which poses a potential health, safety or personal rights risk to persons in care.

Food quality controls and rejected damaged goods

Based on LPAs and caregiver observation, the licensee did not comply with the section cited above in that several heads of cauliflower found to have several brown and black spots, sandwich bag containing black avocado, bag of tomatoes with 3 tomatoes showing black spots and white rings, applesauce pouches with expiration date of 5/31/24, head of cabbage/lettuce in bag with brown liquification, box of snack pack of jello with expiration of 5/17/24, and open items in refrigerator covered but not labeled with a date of opening, which poses/posed a potential health, safety or personal rights risk to persons in care.

Keep prescriptions in original containers

Based on LPA and Admin conversation and observation, the licensee did not comply with the section cited above in that medications are prepoured which poses a potential health, safety or personal rights risk to persons in care.

Facility personnel sufficiency and competence

Based on observation, the licensee did not comply with the section cited above in that Residents R1 and R2 require two person assists per Physician's Report and Appraisal Needs and Services Plan. However facility only has one NOC shift employee scheduled per NOC shift. which poses/posed a potential health, safety or personal rights risk to persons in care.

Maintain facility in clean, safe, sanitary condition

Based on LPA and Admin conversation and observation, the licensee did not comply with the section cited above in that Per caregiver, the electricity in room #3 has been out for 2-3 days. When Admin arrived they said they were not aware of any outage in room #3 which poses a potential health, safety or personal rights risk to persons in care.

Maintain fire clearance before retaining specified persons

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. This requirement was not met as evidenced by:Based on the inspection from the LPAs, Assistant Fire Marshall and the Senior Code Enforcement Officer, it was determined that the structure in the back was not STD 850 fire clearance approved. This presents an immediate health, safety and personal rights risk to the residents in care. Civil Penalty Asssessed in the amount of $500.00.

Prohibit false or misleading facility statements

87207 False ClaimsNo licensee, officer or employee of a licensee shall make or disseminate any false or misleading statement regarding the facility or any of the services provided by the facility. This requirement was not met as evidenced by:Documents provided by the licensee were emailed on August 2, 2023 to the LPA reflecting a City of Santa Rosa Fire Department Inspection report that had falsified verbiage regarding the structure clearance

Based on observation and Guardian Review, the licensee did not comply with the section cited above in 1 out of 2 staff members were not background cleared which poses an immediate health, safety or personal rights risk to persons in care.Civil Penalty Assessed.

Based on observation, interview, and record review, the licensee did not comply with the section cited above in 1 out of 6 resident bedrooms. Resident bed had two half rails placed together running the full length of the bed which posed a potential health, safety or personal rights risk to persons in care.