ROYALIST HOME CARE

Official classification

Type A

Official code

87465(c)(2)

Regulation authority

CCR

What the official deficiency says

(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 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 which poses an immediate health, safety or personal rights risk to persons in care. Resident 2 (R2) is prescribed Donepezil for bedtime only. LPA observed Donepezil was given to R2 in the AM per AD instruction.

Official plan of correction

POC Due Date: 04/16/2026 Plan of Correction Licensee will ensure that once ordered by the physician the medication is given according to the physician's directions. Licensee to submit written plan to LPA outlining how the facility will ensure medication will be dispensed as prescribed by POC date.

Official classification

Type B

Official code

87465(c)(3)

Regulation authority

CCR

What the official deficiency says

(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: (3) A record of each dose is maintained in the resident's record. The record shall include the date and time the PRN medication was taken, the dosage taken, and the resident's response. 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 which poses a potential health, safety or personal rights risk to persons in care. LPA observed R4 log does not match medications. R4 log has not been signed off by staff when medication is being administered.

Official plan of correction

POC Due Date: 05/06/2026 Plan of Correction Licensee to provide training to all staff on section cited by POC due date. Licensee will provide in-service training to all staff on cited section. Provide proof of scheduled in-service training and copies of attendance sign in sheet of training to LPA by POC due date.

Official classification

Type B

Official code

1569.695(a)(2)

Regulation authority

HSC

What the official deficiency says

(a)In addition to any other requirement of this chapter, a residential care facility for the elderly shall have an emergency and disaster plan that shall include, but not be limited to, all of the following: (2) Plans for the facility to be self-reliant for a period of not less than 72 hours immediately following any emergency or disaster, including, but not limited to, a short-term or long-term power failure. If the facility plans to shelter in place and one or more utilities, including water, sewer, gas, or electricity, is not available, the facility shall have a plan and supplies available to provide alternative resources during an outage. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation and interview, the licensee did not comply with the section cited above in which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 05/06/2026 Plan of Correction Licensee to have emergency water readily available by POC date. Photograph of water and receipt to be sent to LPA email by POC date.

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 record review, the licensee did not comply with the section cited above in one out of two staff members not obtaining a valid CPR and first aid certification which poses a potential health and saftey risk to persons in care.

Official plan of correction

POC Due Date: 04/18/2025 Plan of Correction Administrator states that they will schedule time for employee 1 to take CPR and first aid course, and renew their certification. Administrator will send proof of correction via email to LPA by POC due date.

Official classification

Type B

Official code

87208(a)

Regulation authority

CCR

What the official deficiency says

(a) Each facility shall have and maintain a current, written definitive plan of operation. The plan and related materials shall be on file in the facility and shall be submitted to the licensing agency with the license application. Any significant changes in the plan of operation which would affect the services to residents shall be submitted to the licensing agency for approval. The plan and related materials shall contain the following: This requirement is not met as evidenced by: Deficient Practice Statement Based on an interview with Administrator Asawadilokchai and review of the Facility Sketch (LIC 999), the " office " is being used as Resident 2's (R2's) bedroom and resident " Bedroom 4 " is being used as a staff room. Administrator reported they also installed a toilet in R2's room ( " office " ) after the facility's fire inspection on 2/22/2024.which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 08/29/2024 Plan of Correction Licensee reported they will submit an LIC200 with a revised LIC999 reflecting the changes and request an appropriate fire clearance. Proof of correction to be emailed to LPA by close of business on 8/29/2024.

Official classification

Type B

Official code

87465(a)(5)(D)

Regulation authority

CCR

What the official deficiency says

(5) Facility staff, except those authorized by law, shall not administer injections, but staff designated by the licensee may assist persons with self-administration as needed. Assistance with self-administered medications shall be limited to the following: (D) Assistance with self-administration does not include forcing a resident to take medications, hiding or camouflaging medications in other substances without the resident's knowledge and consent, or otherwise infringing upon a resident's right to refuse to take a medication. This requirement is not met as evidenced by: Deficient Practice Statement Administrator reported the facility a mortar and pestle to crush R1's medication and camouflages it in their apple sauce at the request of R1's family. The administrator reported the facility does not have a physician's order to crush/camouflage R1's medication and R1 is not cognizant to provide consent, which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 08/29/2024 Plan of Correction Licensee reported they will conduct a staff training regarding regulation 87465, Incidental Medical and Dental Care. Proof of correction to be emailed to LPA by close of business on 8/29/2024.

Official classification

Type B

Official code

87506(b)

Regulation authority

CCR

What the official deficiency says

(b) Each resident's record shall contain at least the following information: This requirement is not met as evidenced by: Deficient Practice Statement Based on an interview and record review, R1's resident file only contained a signed admission agreement, emergency ID contact information and did not have information commonly found on a physician's report, needs and services plan, functional capabilities assessment, and preappraisal which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 08/29/2024 Plan of Correction Licensee reported they will conduct a staff training regarding the Department's required resident records/information. Proof of correction to be emailed to LPA by close of business on 8/29/2024.

Official classification

Type A

Official code

87202(a)

Regulation authority

CCR

What the official deficiency says

(a) All facilities shall maintain a fire clearance approved by the city, county, or city and county fire department, or district providing fire protection services, or the State Fire Marshal. Prior to accepting or retaining any of the following types of persons, the applicant or licensee shall notify the licensing agency and obtain an appropriate fire clearance approved by the city, county, or city and county fire department, or district providing fire protection services, or the State Fire Marshal... This requirement is not met as evidenced by: Deficient Practice Statement Based on interviews conducted, R1 is unable to reposition themselves or independently transfer themselves to and from bed, requires cosistent repositioning by staff every two (2) to three (3) hours and is bedbound. Per a STD. 850 dated 2/22/2024, the facility has a fire clearance for six (6) non-ambulatory elderly residents, which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 08/23/2024 Plan of Correction Licensee reported they will contact their local fire department and report the facility has a bedridden resident. Licensee added R1 will be relocated to a facility with an appropriate fire clearance. Licensee stated POC to be submitted to LPA via email by close of business on 8/23/2024.

Official classification

Type A

Official code

87355(e)(1)(2)

Regulation authority

CCR

What the official deficiency says

87355(e)(1)(2) Criminal Record Clearance-All individuals subject to a criminal record review shall obtain a California clearance or a criminal record exemption as required by the Department or request a transfer of a criminal record clearance as specified in Section 87355 prior to working, residing or volunteering in a licensed facility. This requirement was not met as evidenced by: Licensee allowed " boyfriend " to stay in the facility overnight without a fingerprint clearance. This poses an immediate health and safety risk to residents in care.

Official plan of correction

Licensee/Administrator agrees to fingerprint all staff and non-residents before working or residing in the facility. Proof of understanding will be provided by 12/23/22. Civil penalties assessed

Deadline recorded: Dec 20, 2022. A deadline is not proof that correction was completed.