MOUNTAIN VIEW COTTAGES-VIII

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 record review, the licensee did not comply with the section cited above by not ensuring that resident #2 (R2) administered medication is recorded on the medication administration record (MAR). which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 04/17/2025 Plan of Correction Licensee stated to train all staff on CCR 87465(c)(3) and submit proof to LPA Serrano on plan of correction (POC) due date.

Official classification

Type B

Official code

1569.695(c)

Regulation authority

HSC

What the official deficiency says

(c) A facility shall conduct a drill at least quarterly for each shift. The type of emergency covered in a drill shall vary from quarter to quarter, taking into account different emergency scenarios. An actual evacuation of residents is not required during a drill. While a facility may provide an opportunity for residents to participate in a drill, it shall not require any resident participation. Documentation of the drills shall include the date, the type of emergency covered by the drill, and the names of staff participating in the drill. 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 by not ensuring that the facility have an updated emergency disaster/fire drill log, which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 04/17/2025 Plan of Correction LIcensee will submit an updated emergency disaster/fire drill training log signed by the staff on POC due date.

Official classification

Type B

Official code

87211(a)(1)(D)

Regulation authority

HSC

What the official deficiency says

87211 Reporting Requirements (a) Each licensee shall furnish to the licensing agency such reports ...Any incident which threatens the welfare, safety or health of any resident... This requirement is not met as evidenced by Based on observations and interviews the Administrator did not report the incident resulting in the facility's disrepaired window, which poses a potential Health, Safety, or Personal Rights risk to persons in care.

Official plan of correction

Licensee will submit a statement of undertsnding of the reporting requirements by way of completing an LIC9098 form self certifying that the reporting requirement is understood and will be followed.

Deadline recorded: Apr 14, 2023. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87303(a)

Regulation authority

CCR

What the official deficiency says

87303 Maintenance and Operation - (a) The facility shall be clean, safe, sanitary and in good repair at all times. Maintenance shall include provision of maintenance services and procedures for the safety and well-being of residents, employees and visitors.

Official plan of correction

Administrator agrees to review regulations regarding reporting requirements and what incidents warrant an incident report. Administrator will complete a statement of understanding of this regulation by way of completing a LIC9098 within 7 business days.

Deadline recorded: Apr 13, 2023. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

1569.38(b)

Regulation authority

HSC

What the official deficiency says

POSTING OF LICENSING REPORTS; DISCLOSURE TO NEW RESIDENTS: Requires the licensee of a residential care facility for the elderly to provide written notification to the residents, resident's responsible party (if any) and to the local Long-Term Care Ombudsman within 10 days..: The Department of Social Services commences proceedings to suspend or revoke the license of the facility. This occurs when the accusation is served to the respondent. This requirement was not met as evidenced by: Licensee verified that they have not provided written notification as required...to the residents/resident's responsible party, and Ombudsman.

Official plan of correction

Licensee shall post accusations: 8219211401, 8219211401B, 8219211401C and 8219211401D in a conspicuous place and provide written notification to the residents/resident's responsible party and Ombudsman. The facility was issued a civil penalty of $100 a day which is imposed until the facility complies with a maximum of $5000.

Deadline recorded: Apr 19, 2022. A deadline is not proof that correction was completed.