REDWOOD SENIOR LIVING BAKERSFIELD

Official classification

Type A

Official code

87468.2(a)(1)

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: (1) To have a reasonable level of personal privacy in accommodations, medical treatment, personal care and assistance, visits, communications, telephone conversations, use of the Internet, and meetings of resident and family groups. This requirement was not met as evidenced: Based on interviews, records reviewed, and videos, resident personal privacy was violated.

Official plan of correction

Administrator/ Licensee agrees to review personal rights and provide training to staff and submit documentation when completed to ensure residents personal rights are not violated in a similar manner.

Deadline recorded: Apr 18, 2026. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87705(f)(2)

Regulation authority

CCR

What the official deficiency says

87705 Care of Persons with Dementia (f) Licensees that lock exterior doors or perimeter fence gates shall meet the following initial and continuing requirements: (2) The licensee shall ensure that the fire clearance includes approval of locked exterior doors or perimeter fence gates and that facility staff on all shifts have access to, and know how to use, equipment needed to unlock exterior doors or perimeter fence gates. This requirement is not met as evidenced by: Based on observation, interviews, and record review, the licensee failed to report changes to the fire clearance, which poses an immediate Health, Safety, or Personal Rights risk to residents in care.

Official plan of correction

Licensee/Administrator will submit the proper paperwork to have the current fire clearance updated with licensing.

Deadline recorded: Oct 31, 2025. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87705(f)(1)

Regulation authority

CCR

What the official deficiency says

87705 Care of Persons with Dementia (f) Licensees that lock exterior doors or perimeter fence gates shall meet the following initial and continuing requirements: (1) Licensees shall notify the licensing agency of their intention to lock exterior doors and/or perimeter fence gates. Based on observation, interviews, and record review, the licensee failed to report update to fire clearance indicating there was a knockbox added, this poses a potential Health, Safety, or Personal Rights risk to residents in care.

Official plan of correction

Licensee/Administrator will submit the proper paperwork to have the current fire clearance updated with licensing.

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

Official classification

Type A

Official code

87608(a)(5)(B)

Regulation authority

CCR

What the official deficiency says

(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 LPA observation of three residents in hospital beds with full rail and the subsequent review of those resident files, only 1 had a hospice approval for the use of a full rail. Licensee did not comply with the section cited above for 2 of 3 residents which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 06/13/2024 Plan of Correction Licensee agrees to remove full bed rails and to have residents reassessed for the need of bed rails. If a resident is in need of a bed rail, the licensee will obtain a phsycian's order. Administrator provided this LPA with documation at the continuation visit for 1 of the residents and the full rail was removed from the remaining resident's bed.

Official classification

Type B

Official code

1569.625(b)(2)

Regulation authority

HSC

What the official deficiency says

(2) In addition to paragraph (1), training requirements shall also include an additional 20 hours annually, eight hours of which shall be dementia care training, as required by subdivision (a) of Section 1569.626, and four hours of which shall be specific to postural supports, restricted health conditions, and hospice care, as required by subdivision (a) of Section 1569.696. This training shall be administered on the job, or in a classroom setting, or both, and may include online training. 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 3 of 4 staff files reviewed by this LPA which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 07/05/2024 Plan of Correction Licensee will have all annual training completed within 3 weeks of today's date. Going forward, training will be completed on a monthly basis.

Official classification

Type B

Official code

87506(c)

Regulation authority

CCR

What the official deficiency says

(c) All information and records obtained from or regarding residents shall be confidential. This requirement was not met evident by: Based on LPA observation of text messages on staff phones and staff interviews. Administrator and staff were using personal communication devices to communicate resident medical information using pictures and text, which is a potential personal rights risk to persons in care.

Official plan of correction

Licensee will implement communication binder and facility manager will work alternative shift so that a supervisor is available to provide guidance to staff. Overnight staff will call administrator when urgent issue arises. Use of text messages to communicate resident medical information will cease immediately. Licensee will submit written plan of correction on how staff will communicate resident medical information going forward to this LPA by 4/22/2024.

Deadline recorded: Apr 23, 2024. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87303(a)

Regulation authority

CCR

What the official deficiency says

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 was not met as evidence by: Based on observation and interviews, the Licensee did not comply with section 87303 (a). LPA observed thick layer of unknown white powder along the walls in 4 resident rooms. This poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

Licensee will remove powder from resdient rooms by POC date and will discontinue its use in this faclity going forward. LIcensee will provide written statement on how Licensee will comply with this regulation.

Deadline recorded: Feb 2, 2024. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87465(c)(2)

Regulation authority

CCR

What the official deficiency says

87465(c)(2) Incidental Medical and Dental Care (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 was not met as evidenced by: Deficient Practice Statement Based on observation, the licensee did not comply with the section cited above in 1 out of 1 when LPA reviewed the residents’ medication with MARS and centrally stored list and observed medication was not disturbed to the resident for 16 consecutive days which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 04/21/2023 Plan of Correction AD has agreed to provide training to all staff who assist residents with medication. Training will include the facility documentation procedure. A copy of the training in service sign in and materials used will be provided to CCLD via email or fax. AD has scheduled resident to be taken to doctors to get labs completed and have doctors review missed medication.

Official classification

Type A

Official code

87411(a)

Regulation authority

CCR

What the official deficiency says

87411(a) Personnel Requirements - General: Facility personnel shall at all times be sufficient in numbers, and competent to provide the services necessary to meet resident needs. In facilities licensed for sixteen or more, sufficient support staff shall be employed to ensure provision of personal assistance and care... The licensing agency may require any facility to provide additional staff whenever it determines through documentation that the needs of the particular residents, the extent of services provided, or the physical arrangements of the facility require such additional staff for the provision of adequate services. This requirement was not met as evidenced by: Based on interviews conducted and records reviewed, the facility failed to prevent R1 from engaging in non-consensual sexual relations with other residents.

Official plan of correction

Licensee agrees to ensure enough staff at the facility go ensure provision of care and supervision to meet client needs.

Deadline recorded: Dec 31, 2022. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

80078(a)

Regulation authority

CCR

What the official deficiency says

80078 Responsibility for Providing Care and Supervision (a) The licensee shall provide care and supervision as necessary to meet the client's needs. This requirement was not met as evidenced by: Based on records review and interview, the licensee did not not ensure that Client 1(C1) was provided proper care and supervision, which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

Administrator agreed to provide a plan of correction to CCLD by POC due date.

Deadline recorded: Mar 25, 2022. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87459(a)

Regulation authority

CCR

What the official deficiency says

87459 Functional Capabilities (a) The facility shall assess the person's need for personal assistance and care by determining his/her ability to perform specified activities of daily living. This requirement is not met as evidenced by: During the course of the investigation, LPA reviewed records for R1. The Needs and Services Plan for R1 was incomplete.

Official plan of correction

Administrator agreed to complete Needs and Services plan for R1 by POC due date.

Deadline recorded: Feb 15, 2022. 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... This requirement was not met evident by: Based on observation, the Licensee did not ensure the facility was free of urine odor which poses a potential health and safety risks to persons in care.

Official plan of correction

Plan of correction POC Licensee agrees to ensure facility is free of urine odor by POC due date 12/17/2021. LPA will return to facility to ensure POC was completed.

Deadline recorded: Dec 17, 2021. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87211(a)

Regulation authority

CCR

What the official deficiency says

87211 Reporting Requirements (a) Each licensee shall furnish to the licensing agency such reports as the Department may require, including, but not limited to, the following: (1) A written report shall be submitted to the licensing agency and to the person responsible for the resident within seven days of the occurrence of any of the events specified in (A) through (D) below. This report shall include the resident's name, age, sex and date of admission; date and nature of event; attending physician's name, findings, and treatment, if any; and disposition of the case. This requirement was not met evident by: Based on observation of documentation licensee did not submit report within 7 days which poses a potential health and safety risks to persons in care.

Official plan of correction

Plan of correction POC Licensee agrees to submit in writing understanding of this regulation by POC due date.

Deadline recorded: Dec 3, 2021. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87615(a)(5)

Regulation authority

CCR

What the official deficiency says

87615 Prohibited Health Conditions. (a) Persons who require health services...those specified below shall not be admitted or retained..., (5) Residents who depend on others to perform all activities of daily living... This requirement was not met evident by: Based on record reviews, the Licensee did not ensure an exception was obtained prior to accepting Resident 1 who had a prohibited health condition, which poses a potential health and safety risk to persons in care.

Official plan of correction

Resident 1 no longer resides at the facility. Licensee has agreed to review Sections 87611 through 87617 regarding health restrictions. Licensee will submit document acknowleding reading and understanding of the regulations to the Department by Plan Of Correction due date of 11/8/2021.

Deadline recorded: Nov 8, 2021. 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... This requirement was not met evident by: Based on observation, the Licensee did not ensure the kitchen backsplash was clean and sanitary, which poses a potential health and safety risks to persons in care.

Official plan of correction

Licensee has agreed to clean and paint the backsplash. Additionally, the Licensee has agreed to repair the drywall damage by Plan of Correction due date of 11/11/2021. Licensee has agreed to submit photo of corrections the Department by POC due date.

Deadline recorded: Nov 11, 2021. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87468.1(a)(3)

Regulation authority

CCR

What the official deficiency says

87468.1 Personal Rights of Residents in All Facilities; (a) Residents...shall have all of the following personal rights:; (3) To be free from punishment, humiliation, intimidation, abuse, or other actions... This requirement was not met evident by: Based on interviews and record reviews, the Licensee did not ensure Resident 1 was free from being sexually assualted by another resident, which poses an immediate health and safety risk to person's in care.

Official plan of correction

POC was corrected on the spot. Resident 1 and the suspect no longer reside at the facility. Additionally, The Licensee is conducting interviews on 10/21/2021, and 10/22/2021, to hire additional staff to increase supervision. Licensee has agreed to submit documentation to CCLD regarding the number of staffed hired and schedule on 10/25/2021.

Deadline recorded: Oct 22, 2021. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87507(c)

Regulation authority

CCR

What the official deficiency says

87507 Admission Agreements; (c) Admission agreements shall be signed and dated, ...by the resident or the resident’s representative,...no later than seven days following admission. This requirement was not met evident by: Based on interview and record reviews, the Licensee did not ensure an admission agreement was signed by Resident 1 or authorized representative, which poses a potential personal rights risk to persons in care.

Official plan of correction

Resident 1 moved to another facility June 2021. Licensee has agreed to audit files for current Admission Agreements, and the reasoning if an agreement is not current, by POC due date of 10/29/2021.

Deadline recorded: Oct 29, 2021. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87224(a)(1)

Regulation authority

CCR

What the official deficiency says

87224 Eviction Procedures (a) The licensee may evict a resident for one or more of the reasons listed in Section 87224(a)(1) through (5). Thirty (30) days written notice to the resident is required except as otherwise specified in paragraph 5. This requirement was not evidenced by: Licensee issued a 30 Day Notice of Eviction to R1 on 8/31/21 that did not include the reason for eviction, Nonpayment of the rate for basic services within ten days of the due date. This poses a potential health and safety risk to persons in care.

Official plan of correction

Licensee has agreed to revise the 30 Day Notice of Eviction to include the reason for eviction as specified along with cooresponding documentation. Licensee will submit a written statement to include the revisions to the notice to include 1. Reason for Eviction and 2. That a copy of the Notice will be provided to CCLD within 5 days if issue date. Licensee will submit the revised 30 Day Notice of Eviction and written statement to CCLD via email by 9/17/21.

Deadline recorded: Sep 17, 2021. A deadline is not proof that correction was completed.