Finest Living at Crestwood

Provide resident hot water for personal care

Based on observation, the licensee did not comply with the section cited above as hot water measured at 137.5 degrees Fahrenheit at 04:05PM in the hall bathroom, which poses an immediate health and safety 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 five of five resident files reviewed did not contain an updated appraisal, which poses a potential health, safety or personal rights risk to persons in care.

Onsite food stock levels for nonperishables and perishables

Based on observation, the licensee did not comply with the section cited above as the licensee did not have a minimum one week supply of nonperishable food which poses a potential health, safety or personal rights risk to persons in care.

Maintain fire clearance before retaining specified persons

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 record review, the licensee did not comply with the section cited above as R1's resided in room #3 and is bedridden, but room #5 is the only room approved for bedridden, which posed an immediate health, safety or personal rights risk to resident in care.

Licensees who accept and retain residents with dementia shall be responsible for ensuring the following: (5) Each resident with dementia shall have an annual medical assessment as specified in Section 87458, Medical Assessment, and a reappraisal done at least annually, both of which shall include a reassessment of the resident’s dementia care needs. This requirement was not met as evidenced by: Based on record review, the licensee did not comply with the section cited above as R1 was admitted with a diagnosis on dementia and had not had a new medical assessment or reappraisal conducted since moving in, which posed a potential health and personal rights risk to residents in care.

Right to sufficient care and qualified staff

In addition to the rights listed in Section 87468.1, residents…shall have all of the following personal rights: 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 is not met as evidenced by:Based on record review and interviews, the licensee did not comply with the section cited above, as S1 was sleeping during their shift, which posed an immediate health and safety risk to residents in care.

Maintain facility in clean, safe, sanitary condition

87303(a) Maintenance and Operation - The facility shall be clean, safe, sanitary and in good repair at all times...safety and well-being of residents, employees and visitors.This requirement is not met as evidenced by Based on interviews and observations, the licensee failed to comply with the section cited above as evidence of spiders and spider webs were observed in multiple rooms, which poses a potential health and personal rights risk to persons in care.

Fire approval and staff access to unlock systems

Based on observation, the licensee did not comply with the section cited above as the LPA observed vitamins, Lysol toilet bowl cleaner, over the counter healing ointment and groomiing/hygiene accessible to residents which poses an immediate health, safety or personal rights risk to persons in care.

Maintain fire clearance before retaining specified persons

Based on observation, the licensee did not comply with the section cited above as fire extinguishers were serviced over a year ago which poses/posed a potential health, safety or personal rights risk to persons in care

Health screening and fitness requirements

Based on record review, the licensee did not comply with the section cited above in one out five staff need TB results, 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 as one resident requires an updated medical assesment and a appraisal/needs and services which poses/posed a potential health, safety or personal rights risk to persons in care.

Based on observation, the licensee did not comply with the section cited above as the exit door in room #3 and sliding glass door in the living room were observed with auditory alarms turned off which poses/posed a potential health, safety or personal rights risk to persons in care.

Provide resident hot water for personal care

Based on observation, the licensee did not comply with the section cited above in 3 out of 3 resident restrooms water temperature tested between 99.1 and 100.7 which poses a potential health, safety or personal rights risk to persons in care.

Facility must safeguard entrusted cash and valuables

87217 Safeguars for Resident Cash, Personal Property, and Valuables (b) Every facility shall take appropriate measures to safeguard residents' cash resources, personal property and valuables which have been entrusted to the licensee or facility staff.This requirement is not met as evidenced by: Based on interviews and observation, the licensee did not comply with the section cited above as R1's personal property was not safeguarded by the facility which poses a potential health, safety and personal rights rist to person in care;

87468.2 Additional Personal Rights of Residents in Privately Operated Facilities (a)(27) To keep, have access to, and use their own personal possessions,.....This requirement is not met as evidenced by: Based on interviews and observation, the licensee failed to comply with the section cited above, as the licensee did not ensure R1's personal possessions (photos) were returned back on the wall after painting, which is a personal rights violation to R1 in care.

Assist residents with self-administered medication

87465 Incidental Medical and Dental Care (a) A plan for incidental medical and dental care shall be developed by each facility... (4) The licensee shall assist residents with self-administered medications as needed.This requirement is not met as evidenced by: Based on interview and record review, the licensee did not comply with the above cited section, as R1's medications were not administered as prescribed, as they were not present in the facility, which poses an immediated health risk to residents in care.

Personal assistance and care for required daily activities

87464 Basic Services (f) Basic services shall at a minimum include:(4) Personal assistance and care as needed by the resident... and assistance with taking prescribed medications, as specified in Section 87608, Postural SupportsThis requirement is not met as evidenced by: Based on interview and observation, the licensee did not comply with the above cited section, as residents observed did not have their nails and toenails appropriately groomed and showers refusals are not regularly documented, which poses an immediate health risk to residents in care.

Require physician order and label for PRN medication

87465 (e) For every prescription and nonprescription PRN medication for which the licensee provides assistance there shall be a signed, dated written order from a physician...and a label on the medication...of the following information.This requirement is not met as evidenced by: Based on observation, the licensee did not comply with the above cited section, as R1's medication Chronik Tonic and Triaminolone Acetonide were observed to be not labeled and the Triaminolone Acetonide was expired in 07/20, which poses an immediate health and safety risk to residents in care.

87705 Care of Persons with Dementia (c) (5) Each resident with dementia shall have an annual medical assessment as specified in Section 87458... and a reappraisal done at least annually... include a reassessment of the resident’s dementia care needs.This requirement is not met as evidenced by: Based on record review, R1, who has a diagnosis of dementia, had a medical assessment dated 04/13/2021 and no reappraisal in their file, which poses a potential personal rights risk to residents in care.

Maintain facility in clean, safe, sanitary condition

87303 Maintenance and Operation (a) The facility shall be clean, safe, sanitary and in good repair at all times.This requirement is not met as evidenced by: Based on interviews and observation, the licensee did not comply with the section cited above as rat droppings were observed throughout the facility which poses a potential health, safety and personal rights risk to persons in care.

Provide resident hot water for personal care

Based on observation, the licensee did not comply with the section cited above as 3 out of 3 hand washing stations exceeded normal temperature range, with the highest testing at 137.1 degreee F which poses a potential health, safety or personal rights risk to persons in care.

Maintain facility in clean, safe, sanitary condition

87303 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 is not met as evidenced by: Based on LPA’s observations, the licensee failed to ensure that staff were emptying R3's commode chair frequently to avoid urine smell which poses a potential personal rights risk to persons in care.

Store centrally held medications in locked secure place

87465 Incidental Medical and Dental Care Services (h)(2) Centrally stored medicines shall be kept in a safe and locked place that is not accessible to persons other than employees responsible for the supervision of the centrally stored medication.This requirement is not met as evidenced by: Based on LPA's observation, the licensee did not comply with the section cited above as staff and resident medications were accessible to residents which posed an immediate health risk to persons in care.

Maintain facilities for fire and panic safety

87203 Fire Safety. All facilities shall be maintained in conformity with the regulations adopted by the State Fire Marshal for the protection of life and property against fire and panic.This requirement is not met as evidenced by: Based on LPA's observations, the licensee did not comply with the section cited above as smoke detector in R1's room was inoperable which poses an immediate safety risk to persons in care.

87555 General Food Service Requirements(b)(15) All persons engaged in food preparation and service shall observe personal hygiene and food services sanitation practices which protect the food from contamination.This requirement is not met as evidenced by: Based on LPA’s observations, the licensee failed to ensure that staff were preparing food inside the facility which poses a potential health risk to persons in care.

Fire approval and staff access to unlock systems

87705 Care of Persons with Dementia(f)(2) The following shall be stored inaccessible to residents with dementia: Over-the-counter medication, nutritional supplements or vitamins, alcohol, cigarettes, and toxic substances such as certain plants, gardening supplies, cleaning supplies and disinfectants.This requirement is not met as evidenced by: Based on LPA's observations and record review, the licensee did not comply with the section cited above as over the counter medication, nutritional supplements, vitamins, alcohol and toxic substances were observed accessible to residents which posed an immediate health risk to persons in care.

Requirement for building permit before construction

Alterations to Existing Building or New Facilities. Prior to construction or alterations, all facilities shall obtain a building permit.This requirement is not met as evidenced by: Based on LPA's observations, the licensee did not comply with the section cited above as the kitchen cabinets and appliances were all removed from the kitchen which poses a potential safety and personal rights risk to persons in care.