Penngrove Shangri-la

Provide resident hot water for personal care

Based on observation, the licensee did not comply with the section cited above in two out of two resident bathroom faucets measured 131.1 degrees F & 132.4 degrees F which poses an immediate health, safety or personal rights risk to persons in care.

Maintain records of centrally stored medication dosages

Based on LPA's & LIcensees observation, interview , and record review, the licensee did not comply with the section cited above in spot medication count found five out of five resident medication to not be recorded as required on the Centrally Stored Medication Record which poses/posed a potential health, safety or personal rights risk to persons in care. 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.

Ensure hazardous items are locked and not unattended

Based on observation, the licensee did not comply with the section cited above in finding toxins-laundry detergent observed in laundry closet unlocked (see pics) & cleaning supplies observed in unlocked cabinet in garage (see pics), sharps observed in kitchen drawer with broken lock which poses an immediate health, safety or personal rights risk to persons in care.

Keep prescriptions in original containers

Based on LPA & Licensee observation, the licensee did not comply with the section cited above in 5 out of 5 residents medications were pre-poured for the entire day, which poses/posed a potential health, safety or personal rights risk to persons in care.

Update reappraisal at required intervals

Based on record review, the licensee did not comply with the section cited above in 4 out of 4 resident files which poses/posed a potential health, safety or personal rights risk to persons in care.

Maintain facility in clean, safe, sanitary condition

Based on observation, the licensee did not comply with the section cited above in three out of three railings to be loose and wobbly, bathroom cabinet door to be in poor condition falling off the hinge, and the air vent located on floor found to be rusted and bent which poses/posed a potential health, safety or personal rights risk to persons in care.

Based on record review, the licensee did not comply with the section cited above in 4 out of 4 staff files reviewed did not have required medication training. Which poses a potential health, safety or personal rights risk to persons in care.

Document behavioral expression and related causes

Based on LPA/Licensee's file review showing that resident's care plans for 2 out of 2 residents (R1 & R2) were not been performed and signed by the resident of their representative within last 12 months. This is a potential risk to the health and safety of residents in care.

Ensure hazardous items are locked and not unattended

Based on observation, the licensee did not comply with the section cited above in 4 out of 4 areas (see pics) in the facility had disinfectants/cleaning solutions inaccessible to clients which poses an immediate health, safety or personal rights risk to persons in care.

Resident access to hazardous items with safety review

Based on observation, the licensee did not comply with the section cited above in 3 bags of medications for disposal were stored in unlocked kitchen cabinet which poses an immediate health, safety or personal rights risk to persons in care.

Store centrally held medications in locked secure place

Based on LPA’s observation of many medication bottles in unlocked kitchen cabinet, medications were accessible to residents in care. This is an immediate Health and Safety risk to residents in care. LIcensee removed medications during visit.

Notify agency before locking doors or gates

Based on observation, knives were found in unlocked kitchen drawer accessible to residents which poses an immediate health, Safety risk to residents in care. LPA toured the facility at 11:01 AM & observed unlocked sharps. (Photos taken)

First aid training requirements

Based on staff files review & interview with Licensee, the facility did not ensure that all staff have current 1st aid. LPA learned that 1 of 4 staff (S1) does not have proof of current first aid certification which poses a potential health & safety risk to residents in care.

Document behavioral expression and related causes

Based on observation,interview, and record review, the licensee did not comply with the section cited above in 2 out of 4 residents' reappraisals which poses/posed a potential health, safety or personal rights risk to persons in care.LPA learned that Resident R1 most resent reappraisal dated 9/28/2020 and Resident R3 reappraisal dated 11/2/2020.

Notify agency before locking doors or gates

Based on observation & record review, the licensee did not comply with the section cited above in 2 out of 2 residents w/dementia which poses an immediate health, safety or personal rights risk to persons in care.Facility has 2 residents w/diagnosis of dementia -kitchen draw with sharps wasnt locked,unlocked toxins under bathroom sink & kitchen cabinet under the sink wasn't locked, unlocked ODC meds in staff room and toxins in garage.

Submit and maintain current mailing address

87355(e)(1) Criminal Record:All individuals subject to a criminal record review...shall prior to working, residing or volunteering in a licensed facility:Obtain a California clearance or a criminal record exemption ... This requirement is not met as evidenced by:Based on obs. & file review,the licensee didnot comply w/section cited above in 1 out of 2 staff fingerprint clearance which poses an immediate health, safety or personal rights risk to persons in care.LPA interviewed Adm & learned that staff S1started working on 11/20/21,however has no fingerprint clearance>(CP)

Maintain fire clearance before retaining specified persons

Fire Clearance:All facilities shall maintain a fire clearance approved by the city,county, or city & county fire department, or district providing fire protection services... This requirement is not met as evidenced by: Based on observation & interview licensee didn't comply with this section above in 1 of 1 facility fire clearance on file which poses an immediate risk to health & safety of residents in care. Facility has a staff sleeping rest area room that was build in the garage. (see pic, CP)