WHITTIER GLEN ASSISTED LIVING

Official classification

Type B

Official code

87457(c)(3)

Regulation authority

CCR

What the official deficiency says

Pre-Admission Appraisal (c) Prior to admission a determination of the prospective resident's suitability for admission shall be completed and shall include an appraisal of their individual service needs in comparison with the admission criteria specified in Section 87455, Acceptance and Retention Limitations.(3) The prospective resident, or his/her responsible person, if any, shall be involved in the development of the appraisal. This requirement is not met as evidenced by: during record review it was noted that there is no indication that Resident 1’s Preplacement Appraisal was completed appropriately because the appraisal the facility provided to the department for review is missing a signature from Resident 1 and/or authorized representative.

Official plan of correction

Licensee will ensure that this form is thoroughly completed as a part of the admissions process/intake assessment for all future residents. Licensee will email LPA confirmation that the regulation was reviewed and a plan on how appropriate monitoring for accurary and completion of residents' documents will take place by POC due date.

Deadline recorded: Aug 11, 2026. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87468.1(a)(1)

Regulation authority

CCR

What the official deficiency says

(a) Residents in all residential care facilities for the elderly shall have all of the following personal rights: (1) To be accorded dignity in their personal relationships with staff, residents, and other persons. This regulation is not met as evidenced by: Based on resident interviews and a observation, LPA determined that 5 out of 10 residents had either been handled roughly or pushed by staff while being assisted with transfers or care, which poses a potential health and safety threat to clients in care.

Official plan of correction

Administrator is to ensure residents are assisted with care needs and bed transfers without being handled in a rough manner or leading to injury. Administrator to provide a staff training on proper procedures for bed transfers and to submit proof of training including the (...) sign-in sheet with staff signatures, date of training, duration of training and curriculum used for training to LPA by POC due date.

Deadline recorded: Feb 11, 2026. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87458(a)

Regulation authority

CCR

What the official deficiency says

(a) Prior to a person's acceptance as a resident, the licensee shall obtain and keep on file, documentation of a medical assessment, signed by a physician, made within the last year. The licensee shall be permitted to use the form LIC 602 (Rev. 9/89), Physician's Report, to obtain the medical assessment. This requirement is not met as evidenced by: Based on record reviewed, R1 LIC602A dated 08/29/2025 did not clearly indicate if resident can administer injections and test glucose levels as it was marked N/A on page 8 , #6 under Medication Management b. and c.

Official plan of correction

Administrator will obtained up to date LIC602A from RI Physician and sent it to LPA as proof by POC date which is 11/21/2025

Deadline recorded: Nov 25, 2025. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87457(c)

Regulation authority

CCR

What the official deficiency says

(c) Prior to admission a determination of the prospective resident's suitability for admission shall be completed and shall include an appraisal of their individual service needs in comparison with the admission criteria specified in Section 87455, Acceptance and Retention Limitations. This regulation is not met as evidence by: Based on record review, it was determined that there was no available pre-admission appraisal or recent appraisal available for C1, which poses a potential health and safety risk to residents in care.

Official plan of correction

Administrator is to ensure that appraisals for all residents are available at all times. Administrator is to create a plan explaining how the facility will ensure that appraisal are conducted, documented, and available at all times in the facility and submit this plan to the LPA by the POC due date.

Deadline recorded: Feb 14, 2025. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87463(a)

Regulation authority

CCR

What the official deficiency says

87463 Reappraisals (a) The pre-admission appraisal shall be updated, in writing as frequently as necessary to note significant changes and to keep the appraisal accurate. The reappraisals shall document changes in the resident's physical, medical, mental, and social condition. This requirement was not met as evidenced by: Baased on records review, Licensee failed to update R1's appraisal/plan of care to implement fall interventions due to R1's fall history that led to R1 sustaining a head laceration, which poses a potential Health, Safety, or Personal Rights risk to persons in care.

Official plan of correction

Licensee will submit a written plan indicating how facility will ensure to document and update resident's plan of care any time a change in condition is observed. POC to be emailed to LPA by POC due date.

Deadline recorded: Apr 24, 2024. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87633(b)

Regulation authority

CCR

What the official deficiency says

(b) A current and complete hospice care plan shall be maintained in the facility for each hospice resident and include the following: 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 a Resident #1-#3's hospice care plans were incomplete by not showing licensee/staff involvement in residents hospice care plan which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 11/14/2023 Plan of Correction Facility to provide LPA with updated Hospice Care Plan's for residents #1-#3 showing facility involvement in residents care. Hospice Care Plans due by POC date provided.

Official classification

Type B

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: LPA observed 3 ovens and over head vent in the kitchen not operable which poses a health and stafety risk to residents in care.

Official plan of correction

Executive Director will repair or replace the 3 ovens and over head vent by POC date and send proof to LPA by POC date.

Deadline recorded: Oct 30, 2023. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87303(a)(1)

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...(1) Floor surfaces in bath, laundry and kitchen areas shall be maintained in a clean, sanitary, and odorless condition. This requirement was not met as evidenced by: Based on observation and interview, licensee failed to maintain (2) of (5) resident restrooms inspected, clean and odorless, and (1) of (5) resident room carpets clean, which poses a potential Health, Safety, or Personal Rights risk to persons in care.

Official plan of correction

Administrator will have the carpet cleaned in R2's room, and the restrooms cleaned in R1, R4 and R5's rooms. Pictures of the cleaned toilets and bathtubs will be emailed to LPA by the POC due date.

Deadline recorded: Mar 31, 2023. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

80088(f)(1)

Regulation authority

CCR

What the official deficiency says

80088 Furniture, Fixtures, Equipment, and Supplies(f) Solid waste shall be stored...in a manner that will not transmit...odors...(1)All containers...used for...solid wastes shall have tight-fitting covers kept on the containers... This requirement was not met as evidenced by: Based on observation and interview, the licensee failed to maintain trash bins with a lid to dispose of soiled adult briefs in R4's room, which poses a potential Health, Safety, or Personal Rights risk to persons in care.

Official plan of correction

Administrator will obtain a trash bin with a tight fitting lids in R4's room to dispose of soild waste appropriately. A picture of the bin will be sent to LPA via email by the POC due date.

Deadline recorded: Mar 21, 2023. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87468.1(a)(2)

Regulation authority

CCR

What the official deficiency says

87468.1 Personal Rights of Residents in All Facilities (a) Residents...shall have...the following personal rights:(2)To be accorded safe, healthful and comfortable accommodations...and equipment. This requirement was not met as evidenced by: Based on observation and interview, the licensee failed to allow safe access to the signal system in R5's room, as there is furniture placed in front of it making it inaccessible, which poses a potential Health, Safety, or Personal Rights risk to persons in care.

Official plan of correction

Administrator will rearrange R4's room furniture to give easy and safe access to the signal system. A picture of the rearranged furniture will be sent to LPA via email by the POC due date.

Deadline recorded: Mar 21, 2023. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87307(3)(C)

Regulation authority

CCR

What the official deficiency says

87307 Personal Accommodations and Services (3)Equipment and supplies necessary for...maintenance of adequate hygiene...shall be...available to... resident...if...unable...the licensee shall assure provision of:(C)Clean linen, including blankets... This requirement was not met as evidenced by: Based on observation and interview, the licensee failed to ensure R4 had clean blankets on their bed, which poses a potential Health, Safety, or Personal Rights risk to persons in care.

Official plan of correction

Administrator will ensure R4 receives laundry services as needed. A picture of clean bed linens on the bed will be sent to LPA via email by POC due date.

Deadline recorded: Mar 21, 2023. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87468.2(a)(2)

Regulation authority

CCR

What the official deficiency says

87468.2 Additional Personal Rights of Residents in Privately Operated Facilities: (a) ...residential care facilities for the elderly shall have... personal rights: (2) To have their records and personal information remain confidential and to approve their release, except as authorized by law. This requirement is not met as evidence by: Based on documents reviewed Licensee did not ensure medical diagnosis/directives were maintain confidential for residents in care which poses an immediate health, safety, or personal rights violation for the residents in care.

Official plan of correction

Administrator will ensure staff is properly train on section 87468.2 Personal Rights - maintaining personal information confidential for Residents in care and will submit a plan for training by POC due date 2/3/23 and a copy of training and signing logs by 2/9/23.

Deadline recorded: Feb 3, 2023. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87455(c)(3)(A)

Regulation authority

CCR

What the official deficiency says

87455 Acceptance and Retention Limitations c) No resident shall be accepted or retained if any of the following apply: (3) The resident's primary need for care and supervision results from either:(A)An ongoing behavior, caused by a mental disorder, that would upset the general resident group; This what not met as evidenced by: R1's primary diagnoses led to an ongoing behavior of shouting at yelling at staff and residents that upsets the general resident group. This poses a potential health and safety risk to residents in care and supervision.

Official plan of correction

Administrator to reach out to Department of Mental health (DMH) for assistance regarding R1. Faciltiy to reassess R1 to review proper placement. Administrator will send letter to LPA of contacts made to DMH and reassessment by POC Due Date.

Deadline recorded: Sep 9, 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

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 degree C) and not more than 120 degree F (49 degree C). This requirement is not being met as evidenced by: LPA Rea observed that the water temperature measured at 130.6 * F in staff restroom, 127.4 * F in kitchen/coffee bar area, 129 *F in common bathroom on 2nd floor, and 125.6 * F in Room #201. This poses a health and safety risk to residents in care.

Official plan of correction

The Administrator will ensure that hot water provided for the use of residents shall be maintained between 105 and 120 degrees F at all times. Administrator will adjust the thermostat on the water heater to ensure water provided is within the required range. Administrator shall provide evidence that the deficiency has been corrected by 3/22/2022.

Deadline recorded: Mar 22, 2022. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87211(a)(1)(D)

Regulation authority

CCR

What the official deficiency says

(a) Each licensee shall furnish to the licensing agency such reports... (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... (D) Any incident which threatens the welfare, safety or health of any resident.... This was evidence by: LPA interviews and file review show that Resident fell on 3/1/22 and it was not reported until 3/10/22 when LPA visited the facility, this poses a potential health and safetey risk to residents in care and supervision.

Official plan of correction

Adminstrator was able to provide LPA with the Incident Report at time of visit. POC cleared during the visit.

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