ARS FOUNTAIN HOMES

Official classification

Type B

Official code

87465(b)

Regulation authority

CCR

What the official deficiency says

87465 Incidental Medical and Dental Care (b) If the resident's physician has stated in writing that the resident is able to determine and communicate his/her need for a prescription or nonprescription PRN medication, facility staff shall be permitted to assist the resident with self-administration of his/her PRN medication. This requirement was not met as evidence by: During initial visit on 7/1/25 LPA observed all PRN medications that were listed on Medication List, were missing for R1 and it was confirmed by S2 that the medication has not been ordered. During todays visit per S2 all PRN medication has been discontinued, there was no documentation stating discontinuation from doctor.

Official plan of correction

Licensee/Administrator to provide LPA with a copy of the discontinue order for PRN's that were listed on medication list dated 7/1/25. Copy of Discontinuation Order to be emailed to LPA by POC due date. tena.herrera@dss.ca.gov

Deadline recorded: Jul 15, 2025. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87506(a)

Regulation authority

CCR

What the official deficiency says

87506 Resident Records (a)The licensee shall ensure that a separate, complete, and current record is maintained for each resident in the facility or in a central administrative location readily available to facility staff and to licensing agency staff. This requirement was not met as evidence by: During initial visit on 7/1/25 LPA observed MAR was not being signed for properly as dates 6/29/25, 6/30/25 and 7/1/25 were all missing signatures from S2 who assisted with medications. S2 confirmed medication was provided to residents, however, they forgot to sign.

Official plan of correction

Licensee/Administrator to retrain staff on medication administration and how to properly document and utilize the MAR to avoid any confusion or discrepancies. Training Log with participant signatures must be emailed to LPA by POC due date. tena.herrera@dss.ca.gov

Deadline recorded: Jul 15, 2025. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87204(a)

Regulation authority

CCR

What the official deficiency says

87204 Limitations - Capacity and Ambulatory Status (a) A licensee shall not operate a facility beyond the conditions and limitations specified on the license, including specification of the maximum number of persons who may receive services at any one time. An exception may be made in the case of catastrophic emergency when the licensing agency may make temporary exceptions to the approved capacity. 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 one (1) out of six (6) residents R1 is bedridden and not in approved bedroom # 3 which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 08/10/2024 Plan of Correction Administartor agrees to move R1 to approved room shown on license and send proof to LPA via email

Official classification

Type B

Official code

87412(a)(6)(A)

Regulation authority

CCR

What the official deficiency says

(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: (A) For administrators this shall include verification that he/she meets the educational requirements in Section 87405(d) through (g). 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 in the file for the administrator did not have the required verification indicating they meet the educational requirement, which poses a potential 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 submit a copy of the Adminstrator's verification that they meet the educational requirement, to LPA, via email by the POC due date.

Official classification

Type B

Official code

87412(a)(11)

Regulation authority

CCR

What the official deficiency says

(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: (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: (11) A health screening as specified in Section 87411, Personnel Requirements - General. 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 3 of 4 staff's health screenings not maintained in their file, which poses a potential 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 provide a copy of the health screenings for S1, S2, and S4, to LPA via email, by the POC due date.

Official classification

Type B

Official code

87608(a)(3)

Regulation authority

CCR

What the official deficiency says

(a) Based on the individual's preadmission appraisal, and subsequent changes to that appraisal, the facility shall provide assistance and care for the resident in those activities of daily living which the resident is unable to do for himself/herself. Postural supports may be used under the following conditions: (a) Based on the individual's preadmission appraisal, and subsequent changes to that appraisal, the facility shall provide assistance and care for the resident in those activities of daily living which the resident is unable to do for himself/herself. Postural supports may be used under the following conditions: (3) A written order from a physician indicating the need for the postural support shall be maintained in the resident's record. The licensing agency shall be authorized to require other additional documentation if needed to verify the order. 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 in3 of 3 resident files missing written orders from a physician, indicating the need for bed rails, which poses a potential 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 obtain written orders from R1-R3's physician/hospice agency, indicating the need for the bed rails and will email to LPA, by the POC due date.

Official classification

Type B

Official code

87412(c)

Regulation authority

CCR

What the official deficiency says

87412(c) Personnel Records (c) Licensees shall maintain in the personnel records verification of required staff training and orientation. 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 3 of 4 staff not having proof of required annual training and orientation available in their file, which poses a potential 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 submit proof of required annual training and orientation for Staff# 1-3, to LPA via email, by the POC due date.

Official classification

Type B

Official code

87705(c)(5)

Regulation authority

CCR

What the official deficiency says

87705(c)(5) Care of Persons with Dementia (c) Licensees who accept and retain residents with dementia shall be responsible for ensuring the following: (c) Licensees who accept and retain residents with dementia shall be responsible for ensuring the following: (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, interview, and record review, the licensee did not comply with the section cited above in 1 of 3 residents with dementia without an updated medical assessment and appraisal, which poses a potential 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 obtain an updated medical assessment and appraisal for R1, as required. Proof will be sent to LPA via email by the POC due date.