Marbella Visalia

87465(h)(6) - 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 is not met as evidenced by: Based on interviews conducted and records reviewed, facility had an issues receiving Centrally Stored Medication records from Pharmacy. Facility staff were supposed to log medications on Centrally Stored Medication and Destruction log and failed to do so.

87465(a)(4) Incidental Medical and Dental Care (a) A plan for incidental medical and 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: (4) The licensee shall assist residents with self-administered medications as needed.This requirement is not met as evidenced by: Based on observation, interview, and record, facility did not comply with the regulations listed above, which poses an immediate health and safety risk to residents in care. R1 – R6 did not receive their medications the evening of 3/2/26.

87609 Allowable Health Conditions and the Use of Home Health Agencies(b) Incidental medical care may be provided to residents through a licensed home health agency provided the following conditions are met:(4) The licensee and home health agency agree in writing on the responsibilities of the home health agency, and those of the licensee in caring for the resident’s medical condition(s).(A) The written agreement shall reflect the services, frequency and duration of care.(B) The written agreement shall include day and evening contact information for the home health agency, and the method of communication between the agency and the facility, which may include verbal contact, electronic mail, or logbook.(C) The written agreement shall be signed by the licensee or licensee representative, and representative of the home health agency, and placed in the resident’s file.This requirement is not met as evidenced by: Based on observation, interview, and record, facility did not comply with the regulation listed above, which poses a potential health and safety risk to residents in care. LPA reviewed R3 & R4's files which did not have a Home Health Care Plan. The plans cannot be followed if there is no home health care plan on file.

87465 Incidental Medical and Dental Care(a) A plan for incidental medical and 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:(4) The licensee shall assist residents with self-administered medications as needed.This requirement is not met as evidenced by: Based on observation, interview, and record, facility did not comply with the regulation listed above, which poses an immediate health and safety risk to residents in care. R2 was not assisted with medication as needed/prescribed. R2’s medication Ropinirole HCL1 MG Tablet- Take 1 tablet by mouth at bedtime. This medication is showing with a start date of 1/15/2026, the bubble pack holds 30 pills, there are still 5 pills left in the bubble pack. LPA reviewed MARs which did not indicate the medication was missed or refused by the resident. The MARs shows this medication has been taken every night as prescribed, at 8:00 PM from January 15, 2026 thru February 11, 2026. R2 has too many pills left in the bubble pack, which indicates medication was missed or not given on three different occasions.

87211 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. Based on observation, interview, and record, facility did not comply with the regulation listed above, which poses a potential health and safety risk to residents in care. LPA reviewed R1's incident reports which did not indicate R1's fall was reported to the Dept.

a) A plan for incidental medical and 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:(4) The licensee shall assist residents with self-administered medications as needed. Based on records reviewed and interviews conducted, R1’s medication count is not accurate and medication administered does not match the MARS, which poses an immediate Health & Safety risk to the residents.

87506 (c) All information and records obtained from or regarding residents shall be confidential.This requirement was not met as evidence by: Based on interviews conducted, residents’ information are provided to outside medi-cal assisted agencies programs for referral to verify if the resident meets programs requirement without resident’s knowledge, which poses/posed a potential health, safety, or personal rights risk to persons in care.

87468.2 Additional Personal Rights of Residents in Privately Operated Facilities (a) 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: (8) To be free from neglect, financial exploitation, involuntary seclusion, punishment, humiliation, intimidation, and verbal, mental, physical, or sexual abuse. This requirement was not met as evidence by: review of records and interviews conducted. The licensee did not comply with the section cited above in that multiple residents had money or items stolen from them at the facility. This poses a potential health safety and or personal rights risk to residents in care.

1569.153 Theft and loss program; standards, property inventories and surrender of personal effects; secured areas (i) Reports to the local law enforcement agency within 36 hours when the administrator of the facility has reason to believe resident property with a then current value of one hundred dollars ($100) or more has been stolen. Copies of those reports for the preceding 12 months shall be made available to the State Department of Social Services and law enforcement agencies. This requirement was not met as evidence by: record review. The licensee did not comply with the section cited above in that incidents of theft of $100 or more were not reported appropriately. This poses a potential health safety and or personal rights risk to residents in care.

87211 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:… This requirement was not met as evidence by: records reviewed. The licensee did not comply with the section cited above in that special incident report(s) were not submitted to Community Care Licensing as required. This poses a potential health safety and or personal rights risk to residents in care.

87506 Resident Records. (a) The licensee shall ensure that a separate, complete, and current record is maintained for each resident in the facility or in a central administrative location readily available to facility staff and to licensing agency staff. This requirement was not observed as evidenced by. The facility staff failed to keep at the facility and provide requested documents for R1 which were requested and agreed upon due date, of November 14th, 2025 which poses potential health and safety risk to persons in care.

87411(d)(4) Knowledge required to safely assist with prescribed medications which are self-administered.This requirement was not met as evidenced by: Based on observation, records reviewed, and interview conducted, R1 was given evening medication Atorvastatin and staff recorded that medication was administered. Atorvastatin medication tablet was found the following day. S1 did not ensure R1’s evening medication was administered as prescribed prior to recording that medication was administered, which poses/posed an immediate health and safety risk for the person in care.

87211(a)(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.This requirement was not met as evidenced by: Based on record review and interview conducted, a written report was not reported to the department within 7 days of incident when R1’s Atorvastatin medication tablet was found the following day after medication was recorded administered, this poses a potential health and safety risk to residents in care.

87468 Personal Rights (c) Licensees shall prominently post personal rights, nondiscrimination notice, and complaint information in areas accessible to residents, representatives, and the public. (2) Information on the appropriate reporting agency in case of a complaint or emergency, including procedures for filing confidential complaints, shall be posted as follows: (A) Licensees may use the Residential Care Facility for the Elderly (RCFE) Complaint Poster (PUB 475) or may develop their own poster as provided in this section. A poster developed by the licensee shall contain the same content as the PUB 475. The poster that is posted shall be 20" x 26" in size and be posted in the main entryway of the facility. PUB 475 may be accessed, downloaded, and printed from the www.ccld.ca.gov website. This requirement was not met as evidence by LPA observation. The licensee did not comply with the section cited above in that the RCFE complaint poster was not posted at the facility. This poses a potential health safety and or personal rights risk to residents in care.

87468.1 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: (3) To be free from punishment, humiliation, intimidation, abuse, or other actions of a punitive nature, such as withholding residents’ money or interfering with daily living functions such as eating, sleeping, or elimination. This requirement was not met as evidence by LPA observations on 6/10/25 and 10/25/25. The licensee did not comply with the section cited above in that a gate with lock to kitchenette preventing access to food/drink and posing a tripping hazard observed in memory care. This poses a potential health safety and or personal rights risk to residents in care.

87405 Administrator - Qualifications and Duties (d) The administrator shall have the qualifications specified in Sections 87405(d)(1) through (7). If the licensee is also the administrator, all requirements for an administrator shall apply. (1) Knowledge of the requirements for providing care and supervision appropriate to the residents. This requirement was not met as evidence by residents file review. The licensee did not comply with the section cited above in that review of special incident reports disclosed R3 had an allergic reaction on 5/14/25 and R1 had medication in their room unlocked and accessible on 5/15/25. This poses a potential health safety and or personal right risk to residents in care.

87468 Personal Rights (c) Licensees shall prominently post personal rights, nondiscrimination notice, and complaint information in areas accessible to residents, representatives, and the public. This requirement was not met as evidence by LPA observation. The licensee did not comply with the section cited above in that required postings are not posted in the facility. This poses a potential health safety and or personal rights risk to residents in care.

87468.1 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: (15) To send and receive unopened correspondence in a prompt manner. This requirement was not met as evidenced by: Licensee opened R1's mail without permission which poses a health safety and or personal rights risk to residents in care.

87507 Admission Agreements (g) Admission agreements shall specify the following: (5) Refund conditions (A) Facility policy concerning refunds, including the conditions under which a refund for advanced monthly fees will be returned.... pursuant to Health and Safety Code section 1569.652. This requirement was not met as evidenced by: Licensee did not refund R1 timely. R1's admissions agreement states refunds will be issued within 21 business days. R1 moved out of facility on 7/3/25 and refund was not issued until 8/22/25 which poses a potential health safety and or personal rights risk to residents in care.

87468.2 Additional Personal Rights of Residents in Privately Operated Facilities (a) 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: (8) To be free from neglect, financial exploitation, involuntary seclusion, punishment, humiliation, intimidation, and verbal, mental, physical, or sexual abuse. This requirement was not met as evidenced by: Licensee cashed and deposited two of R1's checks into facility bank account which poses an immediate health safety and or personal rights risk to residents in care.

87211 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:2) Occurrences, such as epidemic outbreaks, poisonings, catastrophes or major accidents which threaten the welfare, safety or health of residents, personnel or visitors, shall be reported within 24 hours either by telephone or facsimile to the licensing agency and to the local health officer when appropriate. This requirement was not met by: Licensee did not report R1's contagious prohibited condition, which poses a potential health, safety and or personal rights risk to residents in care.

87465 Incidental Medical and Dental Care (a) A plan for incidental medical and 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: (4) The licensee shall assist residents with self-administered medications as needed. This requirement was not met as evidenced by: Licensee did not ensure R1 swallowed administered AM medication which was later found in the afternoon which poses an immediate health safety and or personal rights risk.

87555 General Food Service Requirements (b)The following food service requirements shall apply: (29) All equipment, fixed or mobile, and dishes, shall be kept clean and maintained in good repair and free of breaks, open seams, cracks or chips.This requirement was not met as evidenced by: Based on observations and interview the facility kitchen sink disposal has not been operating causing water to buildup in the sink.

87468.1 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: (1) To be accorded dignity in their personal relationships with staff, residents, and other persons. (3) To be free from punishment, humiliation, intimidation, abuse, or other actions of a punitive nature, such as withholding residents’ money or interfering with daily living functions such as eating, sleeping, or elimination.This requirement is not met as evidenced by: Based on staff and resident interviews staff we observed speaking rudely to residents and being “rough” when providing care. Interviews revealed when residents required additional support of time residents were intimidated or punished.

87465(a)(4) Incidental Medical and Dental Care. The licensee shall assist residents with self-administered medications as needed.This requirement is not met as evidenced by: Based on the interviews conducted Staff missed medicaiton or missed dosage for residents.

87507(f) Admission Agreements - The licensee shall comply with all applicable terms and conditions set forth in the admission agreement, including all modifications and attachments. This requirement was not met as evidenced by: Based on the records reviewed and interviews conducted, staff failed to abide by the resident’s care plan of providing 2 person transfers for R1, which poses a potential health and safety risk.

87411(d)(3) Personnel Requirements – General - Skill and knowledge required to provide necessary resident care and supervision, including the ability to communicate with residents. This requirement was not met as evidenced by: Based on the interviews conducted and records reviewed, staff were not trained on two person transfers of R1, which poses an immediate health and safety risk.

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 the interviews conducted and records reviewed, R1 sustained multiple fractures after staff failed to abide by R1’s care plan and fell, which poses an immediate health and safety risk to the residents in care.

Based on observation, interview, and record review, the licensee did not comply with the section cited above in 1 out of 3 residentsr response was not documented to PRN medication which poses an immediate health, safety or personal rights risk to persons in care.

Based on observation and interview, the licensee did not comply with the section cited above in 1 out of 1 nonperishable foods did not meet 7 day requirements which poses an immediate health, safety or personal rights risk to persons in care.

Based on observation and record review, the licensee did not comply with the section cited above in 3 out of 5 residents records reviewed, which poses an immediate health, safety or personal rights risk to persons in care. R1's physicians report does not contain accurate diagnoses of Diabetes, medication management regarding insulin and glucose testing. R2’s Physicians report missing ambulatory status.

Based on observation, record review, the licensee did not comply with the section cited above in 3 out of 6 residents rooms were observed with sharps, chemicals which poses an immediate health, safety or personal rights risk to persons in care.

87309(a) Disinfectants, cleaning solutions, poisons, firearms and other items which could pose a danger if readily available to clients shall be stored where inaccessible to clients.This requirement is not met as evidenced by: Based on observation, the licensee did not comply with the section cited above in 1 out of 1 unlocked maintenance room that contained Clorox Bleach Cleaner, Bleach Wipes, sharp tools, aerosol cans which poses an immediate health, safety or personal rights risk to persons in care.

Based on observation and record review, the licensee did not comply with the section cited above in 2 out of 4 person medication audit revealed for Resident 1 (R1) 2 dosages missed with no notes on MARS and Resident 2 (R2) one pill was missing which poses an immediate health, safety or personal rights risk to persons in care.

Based on observation, the licensee did not comply with the section cited above in 1 out of 1 Ice Machine to have brown buildup underneath the door lift area which poses an immediate health, safety or personal rights risk to persons in care.

87355 Criminal Record Clearance(a) The Department shall conduct a criminal record review of all individuals specified in Health and Safety Code section 1569.17 and shall have the authority to approve or deny a facility license, or employment, residence, or presence in the facility, based upon the results of such review. Staff 1's background clearance was still pending while staff was working at the facility, which poses an immediate health, safety, or personal rights risk to residents in care.

Based on observation, at 12:00PM LPA and Administrator observed a Clorox Bleach Germicidal Cleaner bottle on top of counter in the dining room while 18 residents were sitting in the dining room. At 12:10 PM, LPA and Administrator observed five cleaning chemicals stored under sink in the activity room unlock accessible to residents in care this poses an immediate health, safety or personal rights risk to persons in care.

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: (1) To be accorded dignity in their personal relationships with staff, residents, and other persons.This requirement is not met as evidenced by: Based on records reviewed and interview conducted, on 06/01/22 Staff 1 (S1) removed resident 1 (R1) items from resident room without resident’s permission which poses/posed a potential health, safety or personal rights risk to persons in care.