ANASTASIA

Official classification

Type A

Official code

87411(g)(1)

Regulation authority

CCR

What the official deficiency says

Personnel Requirements - General. Obtain a California clearance or a criminal record exemption as required by law or Department regulations... This requirement is not met as evidence by: Based on record review, licensee did not comply with the section cited above by not having staff fingerprint cleared which poses an immediate health and safety risk to the persons in care.

Official plan of correction

Administrator has agreed to obtain fingerprint clearance for S1 and submit written plan or fingerprint documents to CCLD by POC date. Civil penalty of $200 is being assess.

Deadline recorded: Sep 27, 2024. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87411(g)(1)

Regulation authority

CCR

What the official deficiency says

87411 Personnel Requirements - General (g)...Prior to employment or initial presence...(1) Obtain a California clearance or a criminal record exemption as required by law or Department regulations... -This requirement is not met as evidenced by: -Based on interviews and observation, the licensee did not comply with the section above by not associating S4 to the facility.

Official plan of correction

Licensee to submit proof to CCLD by POC date by reading the regulations and self certify. Submit proof that S4 has criminal background clearance and is associated to the facility.

Deadline recorded: Jul 19, 2024. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

1569.629(a)(2)

Regulation authority

HSC

What the official deficiency says

1569.69 Employees assisting residents with self-administration of medication; training requirements (a)...facility who assists residents...(2)...15 or fewer persons... six hours of initial training...two hours of hands-on shadowing training... -This requirement is not met as evidenced by: -Based on interviews, observation, and record review, the licensee did not comply with the section above by providing medication training to staff that assist residents with self-administration of medication.

Official plan of correction

Licensee to submit proof to CCLD by POC of medication training for all staff that assist residents with self-administration of medication.

Deadline recorded: Jul 19, 2024. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87633(f)(1)

Regulation authority

CCR

What the official deficiency says

(1) The record of each training session shall specify the names and credentials of the trainer, the persons in attendance, the subject matter covered, and the date and duration of the training session. This requirement is not met as evidenced by: Deficient Practice Statement Based on record review, the licensee did not comply with the section cited above by not having hospice training records available which poses a potential health and safety risk to persons in care.

Official plan of correction

POC Due Date: 07/15/2024 Plan of Correction Administrator has agreed to obtain training from hospice agency and submit training documents to CCLD by POC date.

Official classification

Type B

Official code

87412(g)

Regulation authority

CCR

What the official deficiency says

(g) All personnel records shall be maintained at the facility and shall be available to the licensing agency for review. This requirement is not met as evidenced by: Deficient Practice Statement Based on record review, the licensee did not comply with the section cited above by not having S4's file completed which poses a potential health and safety risk to persons in care.

Official plan of correction

POC Due Date: 07/15/2024 Plan of Correction Administrator has agreed to complete all forms necessary for S4's file and submit a written statement to CCLD by POC date.

Official classification

Type A

Official code

87465(h)(2)

Regulation authority

CCR

What the official deficiency says

(h) The following requirements shall apply to medications which are centrally stored: (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: Deficient Practice Statement Based on observation, the licensee did not comply with the section cited above by having unlocked medications in the refrigerator and R3's room which poses an immediate health and safety risk to persons in care.

Official plan of correction

POC Due Date: 06/20/2024 Plan of Correction Staff locked up the medications during inspection. Deficiency cleared.

Official classification

Type A

Official code

87465(c)(2)

Regulation authority

CCR

What the official deficiency says

(c) If the resident's physician has stated in writing that the resident is unable to determine his/her own need for nonprescription PRN medication but can communicate his/her symptoms clearly, facility staff designated by the licensee shall be permitted to assist the resident with self-administration, provided all of the following requirements are met: (2) Once ordered by the physician the medication is given according to the physician's directions. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, the licensee did not comply with the section cited above by not having PRN medications available which poses an immediate health and safety risk to persons in care.

Official plan of correction

POC Due Date: 06/20/2024 Plan of Correction Administrator has agreed to obtain medications for R3 (Chlorhexidine Gluconate and Guaifenesin) and submit pictures to CCLD by POC date.

Official classification

Type B

Official code

87465(c)(3)

Regulation authority

CCR

What the official deficiency says

(c) If the resident's physician has stated in writing that the resident is unable to determine his/her own need for nonprescription PRN medication but can communicate his/her symptoms clearly, facility staff designated by the licensee shall be permitted to assist the resident with self-administration, provided all of the following requirements are met: (3) A record of each dose is maintained in the resident's record. The record shall include the date and time the PRN medication was taken, the dosage taken, and the resident's response. This requirement is not met as evidenced by: Deficient Practice Statement Based on record review, the licensee did not comply with the section cited above by not having MAR for PRN medications which poses a potential health and safety risk to persons in care.

Official plan of correction

POC Due Date: 07/15/2024 Plan of Correction Administrator has agreed to obtain MARs for all PRN medications for all residents. Administrator will submit written statement of completion to CCLD by POC date.

Official classification

Type B

Official code

87463(a)

Regulation authority

CCR

What the official deficiency says

(a) The pre-admission appraisal shall be updated, in writing as frequently as necessary to note significant changes and to keep the appraisal accurate. The reappraisals shall document changes in the resident's physical, medical, mental, and social condition. Significant changes shall include but not be limited to: This requirement is not met as evidenced by: Deficient Practice Statement Based on record review, the licensee did not comply with the section cited above by not having reappraisal/needs and service plans for R1 and R4 which poses a potential health and safety risk to persons in care.

Official plan of correction

POC Due Date: 07/14/2023 Plan of Correction Administrator has agreed to obtain reappraisal/needs and service plans for R1 & R4 and submit a copy to CCLD by POC date.

Official classification

Type B

Official code

87465(d)(3)

Regulation authority

CCR

What the official deficiency says

(d) If the resident is unable to determine his/her own need for a prescription or nonprescription PRN medication, and is unable to communicate his/her symptoms clearly, facility staff designated by the licensee, shall be permitted to assist the resident with self-administration, provided all of the following requirements are met: (3) The date and time the PRN medication was taken, the dosage taken, and the resident's response shall be documented and maintained in the resident's facility record. This requirement is not met as evidenced by: Deficient Practice Statement Based on record review, the licensee did not comply with the section cited above by not having medication administration records for resident's PRN medications which poses a potential health and safety risk to persons in care.

Official plan of correction

POC Due Date: 07/14/2023 Plan of Correction Administrator has agreed to review all resident's PRN medications and create MAR (Medication Administration Record) for all residents. Administrator will submit a copy of the MAR to CCLD by POC date.

Official classification

Type A

Official code

87608(a)(5)(B)

Regulation authority

CCR

What the official deficiency says

(a) Based on the individual's preadmission appraisal, and subsequent changes to that appraisal, the facility shall provide assistance and care for the resident in those activities of daily living which the resident is unable to do for himself/herself. Postural supports may be used under the following conditions. (5) Under no circumstances shall postural supports include tying, depriving, or limiting the use of a resident's hands or feet. (B) Bed rails that extend the entire length of the bed are prohibited except for residents who are currently receiving hospice care and have a hospice care plan that specifies the need for full bed rails. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, the licensee did not comply with the section cited above by having full bed rail for R3 who is not on hospice care which poses an immediate personal rights violation to persons in care.

Official plan of correction

POC Due Date: 06/24/2023 Plan of Correction Administrator removed full bed rails during inspection. Administrator may submit exception request to CCLD at a later time if resident/family wish to have full bed rails. Deficiency cleared.

Official classification

Type A

Official code

87309(a)

Regulation authority

CCR

What the official deficiency says

(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: Deficient Practice Statement Based on observation, the licensee did not comply with the section cited above by having unlocked cleaning supplies in the bathroom and kitchen which poses an immediate health and safety risk to persons in care.

Official plan of correction

POC Due Date: 09/27/2022 Plan of Correction Staff locked up the cleaning supplies during inspection. Deficiency cleared.

Official classification

Type B

Official code

87411(f)

Regulation authority

CCR

What the official deficiency says

(f) All personnel, including the licensee and administrator, shall be in good health, and physically and mentally capable of performing assigned tasks. Good physical health shall be verified by a health screening, including a chest x-ray or an intradermal test, performed by a physician not more than six (6) months prior to or seven (7) days after employment or licensure. A report shall be made of each screening, signed by the examining physician. The report shall indicate whether the person is physically qualified to perform the duties to be assigned, and whether he/she has any health condition that would create a hazard to him/herself, other staff members or residents. A signed statement shall be obtained from each volunteer affirming that he/she is in good health. Personnel with evidence of physical illness or emotional instability that poses a significant threat to the well-being of residents shall be relieved of their duties. This requirement is not met as evidenced by: Deficient Practice Statement Based on record review, the licensee did not comply with the section cited above by not having health screening for S1 which poses a potential health and safety risk to persons in care.

Official plan of correction

POC Due Date: 10/17/2022 Plan of Correction Administrator has agreed to obtain health screening for S1 and submit a copy to CCLD by POC date.