GREEN MEADOWS BOARD AND CARE 11

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 observation, interview, record review, the licensee did not comply with the section cited above staff S1 missing TB test which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 12/29/2023 Plan of Correction The licensee will adhere to Title 22 Section 87411(f). Plan of correction is to be submit ta LPA via email to Antonine.Richard@dss.ca.gov

Official classification

Type B

Official code

1569.618(c)(3)

Regulation authority

HSC

What the official deficiency says

(c) The facility shall employ, and the administrator shall schedule, a sufficient number of staff members to do all of the following: (3) Ensure that at least one staff member who has cardiopulmonary resuscitation (CPR) training and first aid training is on duty and on the premises at all times. This paragraph shall not be construed to require staff to provide CPR. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, interview, record review, the licensee did not comply with the section cited above staff S1, and S2 are missing the first aid certificate on file, which poses/posed a potential health, safety or personal rights risk to persons in care.,

Official plan of correction

POC Due Date: 12/29/2023 Plan of Correction The licensee will adhere to Titled 22 Section 1569.618(c)(3). Plan of correction is for licensee to submit copies of the staff CPR's to LPA via emai. Antonine.Rchard@dss.ca.gov

Official classification

Type B

Official code

87608(a)(5)(B)

Regulation authority

CCR

What the official deficiency says

87608(a) Based on the individual's preadmission appraisal...(5) Under no circumstances shall postural supports...limiting the use of resident's hands and feet. (B) Bedrails that extend the entire length of the bed are prohibited except for residents who are currently receiving hospice care... This requirement is not met as evidence by: Based on observation by the LPA, R1 bed had full bed rails which poses a potential health and safety risk to persons in care.

Official plan of correction

Licensee to remove full bed rails and show proof by POC due date of 09/06/22.

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

Official classification

Type B

Official code

87307(d)(2)

Regulation authority

CCR

What the official deficiency says

87307(d) The following space and safety provisions shall apply to all facilities: (2) The premises shall be maintained in a state of good repair and shall provide a safe and healthful environment. This requirement is not met as evidence by: Based on observation by the LPA, room #4 had a broken sliding screen door which was detached and unusable.

Official plan of correction

Licensee to replace screen and send video proof by POC due date of 09/06/22.

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

Official classification

Type A

Official code

87303(e)(2)

Regulation authority

CCR

What the official deficiency says

(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 degrees C) and not more than 120 degree F (49 degrees 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 as the water measured 124.9 F in bathroom of room #4, 123.9 F in shared bathroom and 123.4 F in kitchen sink which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 08/10/2022 Plan of Correction Licensee immediately adjusted the water temperature via the water heater. LPA measured prior to departure and the water temperature now meets Title 22 regulations on 8/9/22.

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. There was scissors in the unlocked dish washer and in resident R1 room unlocked which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 08/10/2022 Plan of Correction Licensee immediately removed the scissors and locked it up with the other sharps on 8/9/22.

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 above. There was rust remover under the kitchen sink unlocked which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 08/10/2022 Plan of Correction Licensee immediately removed the toxin and locked it up with the other toxins on 8/9/22.