GRACE HOME ATHENA

Official classification

Type A

Official code

87309(a)

Regulation authority

CCR

What the official deficiency says

(a) Except as specified in subsection (b), the licensee shall ensure that disinfectants, cleaning solutions, poisonous substances, knives, matches, tools, sharp objects, and other similar items which could pose a danger to residents are in locked storage and are not left unattended if outside the locked storage. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, the licensee did not comply with the section cited above by not ensuring that potentially dangerous first aid items such as Normal saline, liquid wound cleanser, hydrogen peroxide, and betadide were kept inaccessible to residents in care, which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 08/12/2025 Plan of Correction Staff removed the items from the unlocked cabinet and placed them in the locked laundry room. Administrator will complete a staff training on storing chemical or dangerous items and submit proof ot this training to LPA.

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 by not ensuring that R2's medications were given according to R2's physician orders as evidenced of discrepancy oberved on the quantity of R2's two (2) medications which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 07/28/2024 Plan of Correction Licensee stated to train all staff on CCR 87465(c)(2) and submit proof of staff training log to LPA Brown on Plan of Correction (POC) due date.

Official classification

Type A

Official code

87705(c)(4)(A)

Regulation authority

CCR

What the official deficiency says

(c) Licensees who accept and retain residents with dementia shall be responsible for ensuring the following: (4) There is an adequate number of direct care staff to support each resident's physical, social, emotional, safety and health care needs as identified in his/her current appraisal. (A) In addition to requirements specified in Section 87415, Night Supervision, a facility with fewer than 16 residents shall have at least one night staff person awake and on duty if any resident with dementia is determined through a pre-admission appraisal, reappraisal or observation to require awake night supervision. 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 by not ensuring that there's a staff scheduled to work the night shift, awake and on duty as required for facility with dementia residents as evidenced of two (2) of two (2) staff interviewed reported that no staff's scheduled to work the night shift which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 07/28/2024 Plan of Correction Licensee stated to submit an updated Personnel Report (LIC500) showing a staff scheduled to work the night shift, awake and on duty as required for facility with dementia residents to LPA Brown on POC due date.

Official classification

Type B

Official code

87608(a)(5)(A)

Regulation authority

CCR

What the official deficiency says

(A) A bed rail that extends from the head half the length of the bed and used only for assistance with mobility shall be allowed. 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 allowing Resident #2 (R2) with half bed rail and not ensuring that there's a physician order indicating the need fof half bed rail for mobility for R2 which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 08/05/2024 Plan of Correction Licensee stated to obtain a written order from R2's physician indicating the need for half bed rail for mobility and submit proof to LPA Brown on Plan of Correction (POC) due date.

Official classification

Type A

Official code

87355(e)(2)

Regulation authority

CCR

What the official deficiency says

87355(e)(2) (e) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1569.17(b) shall prior to working, residing or volunteering in a licensed facility: (2) Request a transfer of a criminal record clearance as specified in Section 87355(c) or This requirement is not met as evidenced by: S2 is cleared but not associated to the facility. This poses an immediate health safety or personal risk to persons in care.

Official plan of correction

The licensee agrees to associate S1 in Guardian by 5 pm on the due date indicated.

Deadline recorded: Mar 16, 2023. A deadline is not proof that correction was completed.