STERLING SENIOR LIVING 3

Official classification

Type B

Official code

87211(a)(B)(D)

Regulation authority

CCR

What the official deficiency says

87211(a)(B)(D) Reporting Requirements (a) Each licensee shall furnish to the licensing agency such reports as the Department may require... (B) Any serious injury... occurring while the resident is under facility supervision. (D) Any incident which threatens the welfare, safety, or health of any resident... This requirement is not met as evidenced by: Based on records and interviews, the facility failed to submit a written report to Licensing for resident R1 who sustained multiple unexplained injuries while in care. This violation poses a potential health, safety, or personal rights risk to persons in care.

Official plan of correction

Licensee/Administrator shall read Title 22, Section 87211 “Reporting Requirements” and send a written statement to CCLD that you have read and understand this section and report all resident's incidents in the future. Written statement must be submitted to LPA Perry Scott at email perry.scott@dss.ca.gov by POC due date 08/14/2024.

Deadline recorded: Aug 14, 2024. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87465(a)(5)

Regulation authority

CCR

What the official deficiency says

87465 Incidental Medical..Care (a) A plan for incidental medical..care shall be..by each facility. The plan shall encourage routine medical..care and provide for assistance in obtaining such care, by compliance with the following: (6) When requested by..the Department, a record of dosages which are centrally stored shall be maintained by the facility. This has not been met as evidenced by: LPA observed 12/04/23 and 12/06/23 without medications prescribed by physician's order recorded as written above.

Official plan of correction

LPA and Licensee have agreed that the E-Mar will also be printed in the MAR book. This way, for those staff who have not yet been trained at how to record medications electronically, staff will still be able to record the medication provided and number of dosages for residents at the facility.

Deadline recorded: Dec 12, 2023. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87412(a)

Regulation authority

CCR

What the official deficiency says

87412 Personnel Records (a) The licensee shall ensure that personnel records are maintained on the licensee, administrator and each employee. Each personnel record shall contain the following information. This has not been met as evidenced by: Based on LPA's observations, the Licensee's current CPR certificate expired 12/02/23. Licensee later provided CPR certificate, updated 12/12/23.

Official plan of correction

LPA and Licensee have agreed that Licensee will stay aware of all required certification(s) for staff to stay in compliance. Licensee will review staff folders to make sure all staff will stay in complaince for future State Licensing visits and to avoid future citations.

Deadline recorded: Dec 12, 2023. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87309(a)(1)

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. (1) Storage areas for poisons, and firearms and other dangerous weapons shall be locked. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, the licensee did not comply with the section cited. A bottle of wound solution was found under bathroom #2 sink accessible to resident with dementia. This violation which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 10/06/2023 Plan of Correction Licensee will ensure that all hazardous and toxic materials are kept out of reach and unaccessible to residents in care. These materials must be stored in locked storage. Proof of correction must be sent sent by 10/06/23. (Corrected during visit 10/05/23)

Official classification

Type A

Official code

87309(b)

Regulation authority

CCR

What the official deficiency says

(b) Medicines shall be stored as specified in Section 87465(c) and separately from other items specified in (a) above. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation], the licensee did not comply with the section cited above. LPA identified prescribed medications that required refrigeration were store in refrigerator for residents. The medications were accessible to residents in care. This violaton which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 10/06/2023 Plan of Correction Licensee will ensure that all prescribed medications for residents that required refrigeration, must be store properly and locked compartment. Proof of correction must be sent sent by 10/06/23. (Corrected during visit on 10/05/23)

Official classification

Type B

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 is not met as evidenced by: Deficient Practice Statement Based on observation, the licensee did not comply with the section cited above. LPA identified window blinds in room #3 with broken blinds and room #5 bedside table as a missing drawer. The violaiton which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 10/26/2023 Plan of Correction Licensee will ensure the facility is maintained in good repair at all times. Broken blinds must be replaced and bedside end table will be replaced with working drawers. Proof of correction must be sent to LPA by due date: 10/26/23 via email.ernand.dabuet@dss.ca.gov

Official classification

Type B

Official code

87415(a)

Regulation authority

CCR

What the official deficiency says

(a) The following persons providing night supervision from 10:00 p.m. to 6:00 a.m. shall be familiar with the facility's planned emergency procedures, shall be trained in first aid as required in Section 87465, Incidental Medical and Dental Care Services, and shall be available as indicated below to assist in caring for residents in the event of an emergency: 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. The facility does not have a NOC shift staff according to LIC 500 and administrator. This violation which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 10/26/2023 Plan of Correction Licensee will ensure to provide a night supervision for all residents during NOC shift. The staff must be familiar with planned emergency procedures, and shall be be fully trained. Proof of correction a submission of an updated LIC 500 must be sent by POC due date: 10/26/23 to LPA via email: ernand.dabuet@dss.ca.gov

Official classification

Type B

Official code

87465(d)

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: This requirement is not met as evidenced by: Deficient Practice Statement Based on observation and record review, the licensee did not comply with the section cited above. LPA identified no record keeping records were foun for resident # 4 on file. This violation which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 10/26/2023 Plan of Correction Licensee will ensure that all residents must have medication recordkeeping on records (Medication Administration Record) MAR for CCLD to audit. Licensee will obtain a copy of documentation noting medications were disbursed properly per PCP orders. Proof of correction receipt must be sent to by fax to 323-981-1782 attn: LPA Dabuet by 10/26/23.

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 observation, interview and review, the licensee did not comply with the section cited above. LPA identified in resident #2, #3, and #5 PRNs and prescibed medications by PCP were not included on the Medication Administration Record (MAR). This violation which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 10/26/2023 Plan of Correction Licensee shall ensure medications are administered according to PCP orders with proof of documentation. Licensee will obtain a copy of documentation noting medications were disbursed properly per PCP orders. Proof of correction receipt must be sent to by fax to 323-981-1782 attn: LPA Dabuet by 10/26/23.

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 and interview, the licensee did not comply with the section cited above. LPA was informed by staff that no emergency drills have been conducted. The facility did not have log drills have been performed. This violation which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 10/26/2023 Plan of Correction Licensee shall ensure that emergency drills are conducted from quarter to quarter and that is documentated when it was conducted and participates of staff and residents. Proof of correction receipt must be sent to by fax to 323-981-1782 attn: LPA Dabuet by 10/26/23.

Official classification

Type B

Official code

87608(5)(B)

Regulation authority

CCR

What the official deficiency says

87608 Postural Supports (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 and record review the licensee did not comply with the section cited above. LPA identified resident #3 had full bed rails and not on hospice care with no dotor's orders. This violationwhich poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 10/26/2023 Plan of Correction Licensee will ensure to that bedrails are permitted with hospice residents and that any resident requiring full bedrails must accompany doctor's orders. Proof of correction must be sent to LPA by POC due date: 10/26/23 via email: ernand.dabuet@dss.ca.gov

Official classification

Type B

Official code

87705(5)

Regulation authority

CCR

What the official deficiency says

87705 Care of Persons with Dementia (5) Each resident with dementia shall have an annual medical assessment as specified in Section 87458, Medical Assessment, and a reappraisal done at least annually, both of which shall include a reassessment of the resident’s dementia care needs. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation and record review, the licensee did not comply with the section cited above. LPA identified resident #4 did have a current medical/appraisal assessment and is diagnosed with Dementia. The last medical assessment is 2021. This violation which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 10/26/2023 Plan of Correction Licensee with adhere to Title 22 Sec 87705 and ensure that all residents with Dementia receives medical/appraisals annually. Proof of correction must be sent to LPA by due date; 10/26/23 via email: ernand.dabuet@dss.ca.gov

Official classification

Type B

Official code

87411(c)(1)

Regulation authority

CCR

What the official deficiency says

87411 Personnel Requirements - General - All RCFE staff...shall receive initial and annual training as specified in Health and Safety Code sections 1569.625 and 1569.69 (1) Staff providing care shall receive appropriate training in first aid from persons qualified by such agencies as the American Red Cross. 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. LPA identified staff #1 and #5 did not a valid or current CPR/First Aid on file. This violation which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 10/26/2023 Plan of Correction The licensee is to obtain current first aid certificates for staff #1 and #5 will create a plan to ensure that ensure that caregiver staff who assist residents with personal activities of daily living receive annual first aid training. Proof of correction will be submitted to CCL via email at ernand.dabuet@dss.ca.gov by 10/26/23. The licensee may ask for an extension if more time is needed via email.

Official classification

Type B

Official code

87407(d)

Regulation authority

CCR

What the official deficiency says

87407 Administrator Recertification Requirements (d) To apply for recertification prior to the expiration date of the certificate, the certificate holder shall submit to the Department’s Administrator Certification Section, post-marked on, or up to ninety (90) days before, the certificate expiration date: This requirement is not met as evidenced by: Deficient Practice Statement Based on observation and record review, the licensee did not comply with the section cited above. LPA identified staff #1 did not have a current administratior certificate. The certificate expired 08/30/23 and not proof of evidence that renewal was submitted to Department Administrator Certification. This violaton which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 10/26/2023 Plan of Correction Licensee will show proof of a renewal for administator's certificaiton was sent by mail. Proof of correction will be submitted to CCL via email at ernand.dabuet@dss.ca.gov. by due date: 10/26/23.The administrator may ask for an extension if more time is needed via email.

Official classification

Type B

Official code

87405(b)(2)

Regulation authority

CCR

What the official deficiency says

87405(b)(2) Administrator - Qualifications and Duties. (b)The administrator of a facility or facilities shall have the responsibility and authority to carry out the policies of the licensee. (2 )Knowledge of and ability to conform to the applicable laws, rules and regulations. This requirement is not met as evidenced by: Deficient Practice Statement Based on interview and record reviews the Licensee/Administrator failed to adhere to Title 22 regulations, resulting to multiple deficiencies cited. Administrator is not meeting the required hours for supervision at the facility according to staff. The admnistrator spend less than 20 hour per week. This which poses a potential health and safety risk to residents in care.

Official plan of correction

POC Due Date: 10/26/2023 Plan of Correction The licensee will create a plan to ensure that the administrator performs knowledge of and conforms to applicable laws, rules and regulations. The plan will included the required hours of 20 hours spent for operation and supervison at the facility. Plan of correction will be submitted by POC due date: 10/26/23 via emal: ernand.dabuet@dss.ca.gov