VISTA ROSEVILLE MEMORY CARE

Official classification

Type A

Official code

87705(f)(6)

Regulation authority

CCR

What the official deficiency says

87705 Care of Persons with Dementia (f) Licensees that lock exterior doors or perimeter fence gates shall meet the following initial and continuing requirements: (6) Locked exterior doors or perimeter fences with locked gates shall not substitute for trained staff in sufficient numbers to meet the care and supervision needs of all residents. This requirement is not met as evidenced by: Based on documentation reviewed and an interview conducted, the Licensee did not ensure that resident (R1) was not able to exit the facility, unassisted, on July 16, 2026 (2:26 pm) and on July 19, 2026 (1:30 pm), which posed an immediate health and safety risk to residents in care. (R1) was located in the facility parking lot within 1-2 minutes and 5 minutes, respectively, following each incident, and with no visible injuries.

Official plan of correction

The HSD recently conduct staff training on preventing resident elopements. Specifically, you trained staff to wait until the door alarm is bypassed and realarms, 30 seconds after the code is entered. Staff will ensure 30 seconds pass before walking away from the egress door. Additionally, staff has been providing 1:1 to (R1), when needed, during certain times of the day (1:00 pm- 8:00 pm) Documentation of training to be faxed to LPA by 7/27/2026.

Deadline recorded: Jul 24, 2026. A deadline is not proof that correction was completed.

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 record review, the licensee did not comply with the section cited above in 2 out of 5 persons which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 05/10/2024 Plan of Correction Administrator agrees to obtain a health screening for S1 and S2. Copy of health screening to be sent into CCL by 5/10/24.

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 5 out of 5 persons which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 05/10/2024 Plan of Correction Administrator to obtain first aid certificates for all care staff at the facility. Additionally Administrator agrees to have 1 staff member per shift have CPR certification. Copy of first aid certificates and CPR certification to be sent into CCL by 5/10/24.

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 is not met as evidenced by: Deficient Practice Statement Based on record review, the licensee did not comply with the section cited above in 4 out of 5 persons which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 05/17/2024 Plan of Correction LPA found that R1, R2, R3, R4 had a diagnosis of dementia and a LIC602 that was over one year old. Administrator agrees to obtain new LIC602's for residents.

Official classification

Type A

Official code

87705(f)(1)

Regulation authority

CCR

What the official deficiency says

87705(f)(1) Care of Personal with Dementia (f) The following shall be stored inaccessible to residents with dementia: (1) Knives, matches, firearms, tools and other items that could constitute a danger to the resident(s). This requirement is not met as evidenced by: Based on records review, observation, and interviews, electric fireplace located in common area was accessible to residents in care causing R1's injuries. This poses an immediate health, safety, and personal rights violation to residents in care.

Official plan of correction

The facility agrees to remove electric fireplace from the common area and submit a statement of understanding and compliance to CCL via email by POC due date, 10/04/2023.

Deadline recorded: Oct 4, 2023. A deadline is not proof that correction was completed.

Official classification

Type A

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 in all residential care facilities for the elderly shall have all of the following personal rights: (2) To be accorded safe, healthful and comfortable accommodations, furnishings and equipment. This requirement is not met as evidenced by: Based on records review, observation, and interviews, the facility did not ensure that electric fireplace was inaccessible to residents in care. This poses an immediate health, safety, and personal rights violation to residents in care.

Official plan of correction

The facility agrees to review regulation section 87468.1 and submit a letter of understanding to CCL via email by POC due date, 10/04/2023.

Deadline recorded: Oct 4, 2023. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

1569.269(a)(21)

Regulation authority

HSC

What the official deficiency says

1569.269 Enumerated rights; severability (a) Residents of residential care facilities for the elderly shall have all of the following rights: (21)To have prompt access to review all of their records and to purchase photocopies. Photocopied records shall be promptly provided, not to exceed two business days, at a cost not to exceed the community standard for photocopies. This requirement is not met as evidenced by: Based on records review and interviews, On 1/18/23 records were requested. On 1/23/23 R1's records were provided and exceeded two days. This poses a potential health, safety, and personal rights violation to residents in care.

Official plan of correction

ED agrees to review Health and Safety Code section 1569.269 and submit a letter of understanding to CCL by POC due date, 02/27/2023.

Deadline recorded: Feb 27, 2023. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

1569.269(a)(21)

Regulation authority

HSC

What the official deficiency says

1569.269 Enumerated rights; severability (a) Residents of residential care facilities for the elderly shall have all of the following rights: (21)To have prompt access to review all of their records and to purchase photocopies. Photocopied records shall be promptly provided, not to exceed two business days, at a cost not to exceed the community standard for photocopies. This requirement is not met as evidenced by: Based on records review and interviews, R1's records were provided to RP aboout month later from the request date. This poses a potential health, safety, and personal rights violation to residents in care.

Official plan of correction

Regional Nurse agrees to contact Records Manager and provide requested docuemnts. Regional Nurse is provide proof and submit to LPA by POC due date, 10/07/2022.

Deadline recorded: Oct 7, 2022. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

1569.269(a)(21)

Regulation authority

HSC

What the official deficiency says

1569.269 Enumerated rights; severability (a) Residents of residential care facilities for the elderly shall have all of the following rights: (21)To have prompt access to review all of their records and to purchase photocopies. Photocopied records shall be promptly provided, not to exceed two business days, at a cost not to exceed the community standard for photocopies. This requirement is not met as evidenced by: Based on records review and interviews, R1's records were provided to RP aboout month later from the request date. This poses a potential health, safety, and personal rights violation to residents in care.

Official plan of correction

Executive Director provided resident's records to RP.

Deadline recorded: Sep 29, 2022. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87217(b)

Regulation authority

CCR

What the official deficiency says

87217 Safeguards for Resident Cash, Personal Property, and Valuables. (b) Every facility shall take appropriate measures to safeguard residents' cash resources, personal property and valuables which have been entrusted to the licensee or facility staff. The licensee shall give the residents receipts for all such articles or cash resources.This requirement is not met as evidenced by: Based on records review and interviews, R1’s hearing aid, fitted sheets, and clothing were missing. This poses a potential health and safety risk to residents in care.

Official plan of correction

Administrator agrees to review Title 22, Division 6, Chapter 8 Article 04. Operating Requirements 87217 Safeguards for Resident Cash, Personal Property, and Valuables. Administrator agrees to submit written documentation to CCL that regulation was reviewed.

Deadline recorded: Nov 19, 2021. A deadline is not proof that correction was completed.