Health inspection·August 5, 2024

F 0726 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being. Based on interview and record review, the facility failed to ensure that a Registered Nurse (RN) completed the assessments to seven of nine sampled residents (Resident 1, 2, 3, 4, 5, 6, and 7) when the residents had a change in condition. The facility deficient practice has the potential harm on the resident safety and well-being. Findings: A review of the facility fall incidents on 8/5/24, indicated Residents 1,2,3,4,5,6, and 7 had fall incidents. During an interview on 8/5/24 at 1:02 PM, the Director of Nursing (DON) reviewed the post fall assessments and stated, the assessments for Residents 1,2,3,4,5,6, and 7 were completed by Licensed Vocational Nurse (LVN) 1,2,3,4, and 5. During an interview on 8/6/24, at 4:30 PM, the Administrator stated, If an LVN is assigned to the resident, the LVN performs the post fall assessment and evaluate the resident for injury. The Registered Nurse is not necessarily present. During a review of the job description for LVN dated 5/2017, indicated, .Under the direct supervision of a registered nurse, implement and established plan of care for each assigned group of residents. Responsibilities includes total care for chronically ill and technologically dependent residents, administrations of medications, performance of treatments, provision of resident/family education as directed, and maintenance of record of the care provided. Under the direct supervision of an RN, assist with planning, coordination, and provision of individualized resident care in accordance with the established policies and procedures of the facility . .The licensed vocational nurse performs services requiring technical and manual skills which include the following: (a) Uses and practices basic assessment (data collection), participates in planning, executes interventions in accordance with the care plan or treatment plan, and contributes to evaluation of individualized interventions related to the care plan or treatment plan. (b) Provides direct patient/client care by which the licensee: (1) Performs basic nursing services as defined in subdivision (a); Page 1 of 2 056122 056122 08/05/2024 Millbrae Care Center 33 Mateo Avenue Millbrae, CA 94030

F 0726 (2) Administers medications; Level of Harm - Minimal harm or potential for actual harm (3) Applies communication skills for the purpose of patient/client care and education; and Residents Affected - Some (4) Contributes to the development and implementation of a teaching plan related to self-care for the patient/client . § 2518.5. Scope of Vocational Nursing Practice. Board of Vocational Nurse and Psychiatric Technician Examiners of the State of California. 056122 Page 2 of 2