CARMEL VILLAGE MEMORY CARE

Official classification

Type A

Official code

87465(a)(4)

Regulation authority

CCR

What the official deficiency says

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 orders were delayed, thus doses were missed, which poses an immediate Health & Safety risk to the residents.

Official plan of correction

Licensee agrees to conduct in-service training and submit completion documents to CCLD by POC due date.

Deadline recorded: Aug 13, 2025. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87465(a)(4)

Regulation authority

CCR

What the official deficiency says

(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 and R2 was given the incorrect dosage of medications, which poses an immediate Health & Safety risk to the residents.

Official plan of correction

Licensee agrees to conduct in-service training and submit completion documents to CCLD by POC due date.

Deadline recorded: Apr 12, 2025. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87468.2

Regulation authority

CCR

What the official deficiency says

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: (5) To be served food of the quality and quantity necessary to meet their nutritional needs. This requirement was not met as evidenced by the facility’s report and investigation that 2 staff scrapped food off resident’s plate prior to serving them, which poses a potential health, safety, and personal rights risk.

Official plan of correction

Licensee agrees to terminate the 2 Caregiver employees for violating residents’ personal rights. Notify resident’s RP’s who reside on South Hallway who were potentially impacted by the violation incident. Conduct Inservice training that includes: -Generations MC Dining Room Policy and Procedures -Resident Personal Rights -Mandated Reporter Expectations -Managing Mealtime with Dementia Enroll all MC Caregivers and MC med aides in the following Relias Courses. They include: -Abuse, Neglect, and Exploitation in the Elder Care Setting -Resident Rights in Assisted Living -Managing Malnutrition and Dehydration Continue to monitor and document the monthly weight of all residents. Notify MD per policy of weight changes month-over-month. Supervisor(s) will randomly monitor dining room activity; goal is to validate training is now a BEST PRACTICE(S)

Deadline recorded: Feb 7, 2025. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87555(b)(29)

Regulation authority

CCR

What the official deficiency says

(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 is not met as evidenced by: Deficient Practice Statement Based on observation, Ice machine was observed with yellow discoloring and half of the mechinism had black spots over the yellow discoloring, which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 09/05/2024 Plan of Correction Licensee agrees to clean/sanitize ice machine and submit photo of clean white mechinism to to CCLD.

Official classification

Type A

Official code

87465(a)(4)

Regulation authority

CCR

What the official deficiency says

(4) The licensee shall assist residents with self-administered medications as needed. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, interview, and record review, the licensee did not comply with the section cited above in 1 out of 1 medication R1's medication count was over the required amount which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 09/05/2024 Plan of Correction Administrator agrees to submit inservice medication training completion forms to CCLD.

Official classification

Type B

Official code

87465(a)(6)

Regulation authority

CCR

What the official deficiency says

(6) When requested by the prescribing physician or the Department, a record of dosages of medications which are centrally stored shall be maintained by the facility. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation interview, record review Centrally Stored Medication Record was incomplete, which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 09/05/2024 Plan of Correction Administrator agrees to submit inservice medication training completion forms to CCLD.

Official classification

Type B

Official code

87507(g)(B)

Regulation authority

CCR

What the official deficiency says

Admission Agreements (g) Admission agreements shall specify the following: (B) Rate for additional items and services This requirement is not met as evidenced by: Based on records reviewed and interview conducted, the licensee did not comply with the section cited above. Licensee applied surcharge fee to resident that was not included in the admission agreement, which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

Licensee shall submit a plan of steps that will be taken to ensure the regulation is met by the due date.

Deadline recorded: Sep 6, 2022. A deadline is not proof that correction was completed.