PRESTIGE CARE HOMES II

Official classification

Type A

Official code

87465(a)(4)

Regulation authority

CCR

What the official deficiency says

" (4) The licensee shall assist residents with self-administered medications as needed. " This requirement was not met as evidenced by: Based on observation and record review, medications for R1 were mismanaged, which poses an immediate health, safety, and/or personal rights risk.

Official plan of correction

Licensee agrees to provide LPA Moleski with a schedule of forthcoming staff trainings on medication management. vincent.moleski@dss.ca.gov

Deadline recorded: Jul 2, 2025. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87211(a)(1)

Regulation authority

CCR

What the official deficiency says

(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. This report shall include the resident's name, age, sex and date of admission; date and nature of event; attending physician's name, findings, and treatment, if any; and disposition of the case. This requirement is not met as evidenced by: Deficient Practice Statement Based on record review, at least two incidents which posed a risk to resident health and welfare were not reported to CCLD, which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 05/20/2025 Plan of Correction Licensee agrees to conduct a staff training regarding reporting requirements and to provide LPA Moleski with a staff sign-in sheet by POC due date. vincent.moleski@dss.ca.gov

Official classification

Type B

Official code

87465(a)

Regulation authority

CCR

What the official deficiency says

87465(a): " A plan for incidental medical and dental care shall be developed by each facility... The plan shall encourage routine medical and dental care and provide for assistance in obtaining such care... " This requirement was not met as evidenced by: Deficient Practice Statement Based on record review, start dates were not recorded for multiple medications for all residents in care, which means there is no plan in place to verify the accuracy of dosages given, which poses a potential health, safety, and/or personal rights risk.

Official plan of correction

POC Due Date: 05/20/2025 Plan of Correction Licensee agrees to conduct staff training regarding medication documentation, and to provide LPA Moleski a staff sign-in sheet from said training by POC due date. vincent.moleski@dss.ca.gov

Official classification

Type A

Official code

87608(a)

Regulation authority

CCR

What the official deficiency says

87608(a): “Postural supports may be used under the following conditions … [et seq.]” This requirement was not met as evidenced by: Based on interview and record review, R1 was restricted from leaving their bed with devices not approved for use by their physician or hospice agency, and which did not permit quick release by the resident, which poses an immediate health, safety, and/or personal rights risk.

Official plan of correction

Licensee agrees to conduct a staff training regarding the use of restraints. Licensee agrees to provide LPA with a training schedule by POC due date. vincent.moleski@dss.ca.gov

Deadline recorded: Feb 13, 2025. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87465(b)

Regulation authority

CCR

What the official deficiency says

87465(b): “If the resident's physician has stated in writing that the resident is able to determine and communicate his/her need for a prescription or nonprescription PRN medication, facility staff shall be permitted to assist the resident with self-administration of his/her PRN medication.” This requirement was not met as evidenced by: Based on record review, R1 did not have the necessary physician’s authorization to receive assistance with PRN medications from facility staff, which poses a potential health, safety, and/or personal rights risk.

Official plan of correction

Licensee agrees to review this Section and provide a written acknowledgement of its requirements by POC due date. vincent.moleski@dss.ca.gov

Deadline recorded: Feb 25, 2025. 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

87458(a): “Prior to a person's acceptance as a resident, the licensee shall obtain documentation of a medical assessment, signed by a licensed medical professional acting within the scope of their practice and made within the last year, to be kept in the resident's record.” This requirement was not met as evidenced by: Based on record review, R1 was examined for their medical assessment after already being admitted to this facility, which poses a potential health, safety, and/or personal rights risk.

Official plan of correction

Licensee agrees to review this Section and provide a written acknowledgement of its requirements by POC due date. vincent.moleski@dss.ca.gov

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

Official classification

Type A

Official code

87464(f)(1)

Regulation authority

CCR

What the official deficiency says

87464(f)(1): “Basic services shall at a minimum include: Care and supervision as defined in Section 87101(c)(3) and Health and Safety Code section 1569.2(c).” This requirement was not met as evidenced by: Based on interview and record review, a resident was not provided appropriate and/or effective assistance necessary to prevent self-inflicted injuries, which poses an immediate health, safety, and/or personal rights risk.

Official plan of correction

Licensee agrees to provide a written acknowledgement of this requirement, and a written outline of care for terminally ill residents by POC due date. vincent.moleski@dss.ca.gov

Deadline recorded: Feb 13, 2025. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87633(a)(4)

Regulation authority

CCR

What the official deficiency says

87633(a)(4): “(a) The licensee shall be permitted to accept or retain residents who have been diagnosed as terminally ill … when all of the following conditions are met: … all hospice care plans are fully implemented by the licensee …” This requirement was not met as evidenced by: Based on interview and record review, fall assessments were not documented or provided to R1’s hospice agency, and other unusual behaviors requiring immediate attention were not reported immediately to the hospice agency, which poses an immediate health, safety, and/or personal rights risk.

Official plan of correction

Licensee agrees to conduct a staff training regarding communications to be made to hospice agencies. Licensee agrees to provide LPA Moleski with a schedule for training by POC due date. vincent.moleski@dss.ca.gov

Deadline recorded: Feb 13, 2025. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87465(a)(4)

Regulation authority

CCR

What the official deficiency says

“The licensee shall assist residents with self-administered medications as needed.” This requirement was not met as evidenced by: Based on interviews and record review, a resident was given more medication that permitted by their physician on 11/4/24, which poses an immediate health, safety, and/or personal rights risk.

Official plan of correction

Licensee agrees to conduct a staff training regarding medication procedures. Licensee agrees to provide LPA Moleski with a schedule for training by POC due date. vincent.moleski@dss.ca.gov

Deadline recorded: Feb 12, 2025. 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

87468.1(a)(1): “Residents in all residential care facilities for the elderly shall have all of the following personal rights: To be accorded dignity in their personal relationships with staff, residents, and other persons.” This requirement was not met as evidenced by: Based on interviews and record review, a R2 was not accorded dignity in their relationships with staff, which poses an immediate health, safety, and/or personal rights risk.

Official plan of correction

Licensee agrees to conduct a staff training regarding personal rights. Licensee agrees to provide LPA Moleski with a schedule for training by POC due date. vincent.moleski@dss.ca.gov

Deadline recorded: Feb 12, 2025. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87211(a)(1)

Regulation authority

CCR

What the official deficiency says

87211(a)(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.” This requirement was not met as evidenced by: Based on interviews and record review, CCLD and R1’s RP were not notified of R1’s various injuries and other concerning behaviors, which poses a potential health, safety, and/or personal rights risk.

Official plan of correction

Licensee agrees to conduct a staff training regarding reporting requirements by POC due date. vincent.moleski@dss.ca.gov

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

Official classification

Type A

Official code

87202(a)(2)

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 ... (2) Bedridden persons. " This requirement was not met as evidenced by: Based on record review, the licensee admitted and retained a bedridden resident, which poses an immediate health and safety risk.

Official plan of correction

Licensee agrees to submit a written statement acknowledging fire clearance requirements and affirming that they will be adhered to in the future. Licensee said they will provide this by Friday. vincent.moleski@dss.ca.gov

Deadline recorded: Nov 13, 2024. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87465(h)(2)

Regulation authority

CCR

What the official deficiency says

" (2) Centrally stored medicines shall be kept in a safe and locked place that is not accessible to persons other than employees responsible for the supervision of the centrally stored medication. " This requirement was not met as evidenced by: Based on observation, the licensee left medications out unlocked and accessible to residents in care, which poses an immediate health and safety risk.

Official plan of correction

Licensee agrees to conduct a staff training by Friday and will provide LPA Moleski with a sign-in sheet afterward. vincent.moleski@dss.ca.gov

Deadline recorded: Nov 13, 2024. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87309(a)

Regulation authority

CCR

What the official deficiency says

" (a) Disinfectants, cleaning solutions, poisons, firearms and other items which could pose a danger if readily available to clients shall be stored where inaccessible to clients. " This requirement was not met as evidenced by: Based on observation, cleaning solutions, insecticide, and shears were left unlocked and accessible to residents in care, which poses an immediate health and safety risk.

Official plan of correction

Licensee agrees to conduct a staff training by Friday and will provide LPA Moleski with a sign-in sheet afterward. vincent.moleski@dss.ca.gov

Deadline recorded: Nov 13, 2024. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87611(b)

Regulation authority

CCR

What the official deficiency says

" (b) The licensee shall complete and maintain a current, written record of care for each resident that includes, but is not limited to, the following: " This requirement is not met as evidenced by: Deficient Practice Statement Based on record review, the licensee did not maintain a record of care with all required components for R2's foley catheter, which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 07/23/2024 Plan of Correction Licensee agrees to acquire the required documentation and will provide LPA Moleski with the documents by POC due date. vincent.moleski@dss.ca.gov

Official classification

Type A

Official code

87309(a)

Regulation authority

CCR

What the official deficiency says

(a) Disinfectants, cleaning solutions, poisons, firearms and other items which could pose a danger if readily available to clients shall be stored where inaccessible to clients. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, cleaning solutions and detergents were left unlocked and unsecured, which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 07/03/2024 Plan of Correction Licensee agrees to lock up all cleaning solutions and to provide LPA Moleski with a photograph of their new locked storage location. vincent.moleski@dss.ca.gov

Official classification

Type A

Official code

87465(h)(2)

Regulation authority

CCR

What the official deficiency says

(h) The following requirements shall apply to medications which are centrally stored: (2) Centrally stored medicines shall be kept in a safe and locked place that is not accessible to persons other than employees responsible for the supervision of the centrally stored medication. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, medications were not locked up and kept inaccessible to residents, which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 07/03/2024 Plan of Correction Licensee agrees to lock up all medications and provide LPA Moleski a photograph of their new locked storage location. vincent.moleski@dss.ca.gov

Official classification

Type A

Official code

1569.2(c)

Regulation authority

HSC

What the official deficiency says

" Care and supervision " means the facility assumes responsibility for, or provides or promises to provide in the future, ongoing assistance with activities of daily living without which the resident’s physical health, mental health, safety, or welfare would be endangered. Assistance includes assistance with taking medications, money management, or personal care. This requirement was not met as evidenced by staff allowed resident to leave the facility in a taxi stating he was going to the hospital. Resident never arrived at the hospital and family reported him missing once it was discovered he was not at the hospital which poses an immediate health, safety and personal rights risk to residents in care.

Official plan of correction

Facility conduct retraining for all staff who provide supervision for residents on the requirements for supervision and the plan for staff when a resident who cannot leave the facility unassisted is attempting to leave the facility without staff supervision.

Deadline recorded: Apr 24, 2023. A deadline is not proof that correction was completed.

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 LPA review of resident records, the licensee did not comply with the section cited above as 1 resident with a diagnosis of dementia did not have an annuall medical assessment as required by regulations which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 07/08/2022 Plan of Correction Facility will have an update physicans assessment for resident diagnosed with dementia. LPA observed facility staff provide the required form to family of resident at the time of vist.