MERISOL CARE HOME

Official classification

Type A

Official code

87466

Regulation authority

CCR

What the official deficiency says

87466 Observation of the Resident The licensee shall ensure that residents are regularly observed for changes in physical, mental, emotional and social functioning and that appropriate assistance is provided when such observation reveals unmet needs. When changes such as unusual weight gains or losses or deterioration of mental ability or a physical health condition are observed, the licensee shall ensure that such... This requirement is not met as evidenced by: The facility did not provide appropriate assistance to R1 to ensure safety despite observing R1’s wandering behavior. R1 was able to leave the facility without staff knowledge and was found deceased by the railroad tracks.

Official plan of correction

Plans of correction (POCs) will be addressed in the NCC on 8/15/2024.

Deadline recorded: Aug 15, 2024. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87705(b)(2)

Regulation authority

CCR

What the official deficiency says

87705(b)(2) Care of Persons with Dementia (b) In addition to the requirements as specified in Section 87208, Plan of Operation, the plan of operation shall address the needs of residents with dementia, including: (2) Safety measures to address behaviors such as wandering, aggressive behavior and ingestion of toxic materials. This requirement is not met as evidenced by: Based on interviews and record reviews conducted, R1 who has Alzheimer’s/Dementia, confused, disoriented and has sundowning behavior exited the facility without staff knowledge, got struck by a train and died on 12/7/2023.

Official plan of correction

Plans of Correction will be addressed in the NCC on 8/15/2024. Civil penalty determination related to serious bodily injury is pending.

Deadline recorded: Aug 15, 2024. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87705(f)(1)

Regulation authority

CCR

What the official deficiency says

(f) The following shall be stored inaccessible to residents with dementia: (1) Knives, matches, firearms, tools and other items that could constitute a danger to the resident(s). This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, the licensee did not comply with the section cited above in having 2 knives unlocked and accessible in the kitchen which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 03/29/2024 Plan of Correction Knives were observed locked during the visit. This deficiency is cleared.

Official classification

Type B

Official code

87555(b)(23)

Regulation authority

CCR

What the official deficiency says

(b) The following food service requirements shall apply: (23) All readily perishable foods or beverages capable of supporting rapid and progressive growth of micro-organisms which can cause food infections or food intoxications shall be stored in covered containers at appropriate temperatures. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, the licensee did not comply with the section cited above in having carrots with mold which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 03/29/2024 Plan of Correction Carrots were thrown away during the visit.

Official classification

Type B

Official code

1569.695(c)

Regulation authority

HSC

What the official deficiency says

(c) A facility shall conduct a drill at least quarterly for each shift. The type of emergency covered in a drill shall vary from quarter to quarter, taking into account different emergency scenarios. An actual evacuation of residents is not required during a drill. While a facility may provide an opportunity for residents to participate in a drill, it shall not require any resident participation. Documentation of the drills shall include the date, the type of emergency covered by the drill, and the names of staff participating in the drill. 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 in not having current fire and earthquake drill which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 04/05/2024 Plan of Correction By POC date, proof of training will be sent to CCL.

Official classification

Type B

Official code

87618(b)(3)(A)

Regulation authority

CCR

What the official deficiency says

(3) Ensuring that the use of oxygen equipment meets the following requirements: (A) A report shall be made in writing to the local fire jurisdiction that oxygen is in use at the facility. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, the licensee did not comply with the section cited above in not notifying local fire department about a resident with oxygen which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 04/01/2024 Plan of Correction The Administrator will notify fire department within 24 hours about oxygen use and submit proof to CCL by POC date.

Official classification

Type B

Official code

87705(j)

Regulation authority

CCR

What the official deficiency says

(j) The licensee shall have an auditory device or other staff alert feature to monitor exits, if exiting presents a hazard to any resident. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, the licensee did not comply with the section cited above in not having an alarm that is loud enough to alert staff which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 04/05/2024 Plan of Correction By POC date, Administrator will replace the alarm and send LPA proof.

Official classification

Type A

Official code

87307(d)(6)

Regulation authority

CCR

What the official deficiency says

This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, the licensee did not comply with the section cited above in blocking exit door in R1's room which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 03/29/2024 Plan of Correction The Administrator removed the blockage during visit. Deficiency cleared.

Official classification

Type B

Official code

873039(a)

Regulation authority

CCR

What the official deficiency says

This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, the licensee did not comply with the section cited above in having grass more than a foot tall, construction equipment, ladder, etc in the backyard which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 04/05/2024 Plan of Correction The Administrator will clean up the backyard and send photos to LPA by POC date.

Official classification

Type A

Official code

87705(j)

Regulation authority

CCR

What the official deficiency says

87705 Care of Persons with Dementia (j) The licensee shall have an auditory device or other staff alert feature to monitor exits, if exiting presents a hazard to any resident. This requirement is not met as evidenced by: LPA observed auditory device installed in Room 4 is not functional which poses an immediate threat to the health and safety of clients under care.

Official plan of correction

Administrator replaced the battery during visit.Deficiency is cleared

Deadline recorded: Dec 19, 2023. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87303(a)

Regulation authority

CCR

What the official deficiency says

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 observation, wood planks, gravel, construction tools, dresser, chairs etc were observed in the side/back yards and kitchen windows with black mold which poses a potential risk to health and safety of clients under care.

Official plan of correction

Administrator states will conduct general cleaning of the facility and will notify LPA. LPA will need to come back to verify completion.

Deadline recorded: Dec 29, 2023. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87705(j)

Regulation authority

CCR

What the official deficiency says

87705 Care of Persons with Dementia (j) The licensee shall have an auditory device or other staff alert feature to monitor exits, if exiting presents a hazard to any resident. This requirementt is not met as evidenced by: R2 who has Alzheimer's Disease left the facility without staff knowledge on 12/7. Administrator & staff tried to find R2 but failed. The incident was reported to the police department and R2's family. On 12/10/23, R2's husband notified facility that R2 died on 12/8.

Official plan of correction

Administrator will install Ring video camera on all exits and submit proof to CCL. Safety check every hour during the day; every 2 hours at night pending installation of ring camera. Once installed, every 4 hrs at night; hourly during the day safety check. A Non Compliance Conference will be scheduled to address issues.

Deadline recorded: Dec 15, 2023. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87705(h)

Regulation authority

CCR

What the official deficiency says

87705 Care of Persons with Dementia (j) The licensee shall have an auditory device or other staff alert feature to monitor exits, if exiting presents a hazard to any resident. This requirement is not met as evidenced by:Based on interview conducted, facility did not comply with section above in not having a working auditory device installed in R1's room resulting to R1 exiting the facility. R1 has dementia and is not allowed to leave facility unassisted.

Official plan of correction

Administrator has installed an auditory device in R1's room which was observed operational during the visit. Also,LPA advised Administrator to come up with a plan regarding checking all auditory devices regularly. Deficiency is cleared.

Deadline recorded: Oct 20, 2023. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87705(f)(1)

Regulation authority

CCR

What the official deficiency says

87705(f)(1) Care of Persons with Dementia: (f) The following shall be stored inaccessible to residents with dementia: (1) Knives, matches, firearms, tools and other items that could constitute a danger to the resident(s). 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 locking kitchen knives that are located in the kitchen draw which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 02/18/2023 Plan of Correction Licensee agree to lock up all knives in the kitchen away from residents in care. Deficiency cleared

Official classification

Type A

Official code

87303(e)(2)

Regulation authority

CCR

What the official deficiency says

87303(e)(2) Maintenance and Operation: (e) Water supplies and plumbing fixtures shall be maintained as follows: (2) Faucets used by residents for personal care such as shaving, and grooming shall deliver hot water. Hot water temperature controls shall be maintained to automatically regulate the temperature of hot water used by residents to attain a temperature of not less than 105-degree F (41 degree C) and not more than 120-degree F (49 degree C). 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 lowering the hot water temperature and making sure hot water is maintained and is in between 105-120 Degrees F to reflect the regulation above which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 02/18/2023 Plan of Correction Licensee agreed to lower a hot water temperature and to maintain water temperature for the safety of residents and to submit a photo to CCL of the corrected hot water temperature by POC due date.

Official classification

Type B

Official code

87555(b)(27)

Regulation authority

CCR

What the official deficiency says

87555(b)(27) General Food Service Requirements: (b) The following food service requirements shall apply: (27) All kitchen areas shall be kept clean and free of litter, rodents, vermin and insects. 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 making sure that the facility is free of insects, ants and other bugs located in the kitcken draw and common area bathroom which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 02/22/2023 Plan of Correction Licensee agreed to make sure the facility is free from all insects, including ants and other bugs and to submit a self-certification on the above regulation to CCL by POC due date.