SUMMERFIELD OF ROSEVILLE

Official classification

Type B

Official code

87412(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: This requirement is not met as evidenced by: Deficient Practice Statement Based on record reviewed, LPA observed that health screening and TB is missing 1 out of 5 files, and 5 out of 5 were missing a job application, which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 05/15/2024 Plan of Correction Facility shall complete all required documents for all staff files per this regulation and will send proof to department by POC date 5/15/2024.

Official classification

Type B

Official code

87705(c)(5)

Regulation authority

CCR

What the official deficiency says

(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 interview and records review 3 out of 5 residents did not have updated physician's report in their files which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 05/15/2024 Plan of Correction Facility shall submit updated physician's report by POC due date to CCL via email by 5/15/2024.

Official classification

Type A

Official code

87465(c)(2)

Regulation authority

CCR

What the official deficiency says

Incidental Medical and Dental Care (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 ... 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: Based on observation, the facility did not ensure medication was given according to physician directions. During the review of medications, the LPA found that for R1’s medications were found to be full and not given to R1.

Official plan of correction

Administrator agrees to audit centrally stored medication. The facility will hold training with staff concerning medication management. The facility will send the staff sign in sheet and training syllabus. These documents will be due by the POC date of 06/01/2023.

Deadline recorded: Jun 1, 2023. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87705(c)(5)

Regulation authority

HSC

What the official deficiency says

87705 Care of Persons with Dementia (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: Based on records review, the facility did not comply with he section cited. R1 did not have updated medication assessment which poses a potential health, safety, or personal rights risk to person in care

Official plan of correction

Facility agrees to schedule R1 by 6/09/2023 to get updated Medical Assessment and submit in updated Medical Assessments by 6/30/2023

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

Official classification

Type B

Official code

87705(c)(5)

Regulation authority

HSC

What the official deficiency says

87705(c)(5) Care of Persons with Dementia (c) Licensees who accep and retain residents with dementia shall be responsible for ensuring the following: Assesssment ... (5) Each resident with dementia shall have an annual medical assessment as specified in Section 87455, medical and reappraisal done at least annually. Deficient Practice Statement This requirement is not met as evidenced by: Based on interview and records review 2 out of 5 residents did not have updated physician's report in their files which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 05/17/2023 Plan of Correction Facility shall submit updated physician's report by POC due date to CCL via email by 5/17/2023.