ADVENT RESIDENTIAL HOME II

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 approved by the city, county, or city and county fire department or district providing fire protection services, or the State Fire Marshal: (2) Bedridden persons This requirement is not met as evidenced by: Deficient Practice Statement Based on client record review, the licensee did not comply with the section cited above, as two out of 6 residents are deemed to be BEDRIDDEN, per MD reports, but facility is not approved for bedridden residents and does not maintain fire clearance for bedridden clients. This poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 01/03/2024 Plan of Correction Plan of correction to be submitted to CCLD BY DUE DATE.

Official classification

Type A

Official code

87355(e)(3)

Regulation authority

CCR

What the official deficiency says

(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: (3) Request a transfer of a criminal record clearance as specified in Section 87355(c) or This requirement is not met as evidenced by: Deficient Practice Statement Based on staff record review, the licensee did not comply with the section cited above, as night staff #2 does not have criminal record clearance associated to this facility. This poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 01/03/2024 Plan of Correction Criminal record clearance transfer request for staff #2 to be submitted to CCLD with photo ID BY DUE DATE, or transfer of clearance to be done in Guardian.

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 staff record review, the licensee did not comply with the section cited above, as health screening and/or TB test results are not maintained for staff 2, #4, #6, which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 01/16/2024 Plan of Correction Proof of health screenings and /or TB test results for S2, S4, S6 will be sent to CCLD BY DUE DATE

Official classification

Type B

Official code

87411(c)(1)

Regulation authority

CCR

What the official deficiency says

(1) Staff providing care shall receive appropriate training in first aid from persons qualified by such agencies as the American Red Cross. This requirement is not met as evidenced by: Deficient Practice Statement Based on staff record review, the licensee did not comply with the section cited above, as staff #2, #3, #6 do not have proof of current first-aid training, which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 01/16/2024 Plan of Correction Proof of valid first aid training for S2, S3, S6 will be submitted to CCLD BY DUE DATE

Official classification

Type B

Official code

1569.69(b)

Regulation authority

HSC

What the official deficiency says

(b) Each employee who received training and passed the examination required in paragraph (5) of subdivision (a), and who continues to assist with the self-administration of medicines, shall also complete eight hours of in-service training on medication-related issues in each succeeding 12-month period. This requirement is not met as evidenced by: Deficient Practice Statement Based on staff record review, the licensee did not comply with the section cited above, as medication staff #4 has not received annual medication training since 2/2022, which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 01/16/2024 Plan of Correction Proof of current medication training for staff #4 will be sent to CCLD BY DUE DATE

Official classification

Type B

Official code

87507(a)

Regulation authority

CCR

What the official deficiency says

(a) The licensee shall complete an individual written admission agreement, as defined in Section 87101(a), with each resident or the resident's representative, if any. This requirement is not met as evidenced by: Deficient Practice Statement Based on client record reviews, the licensee did not comply with the section cited above, as admission agreements for all clients are missing or incomplete, which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 01/16/2024 Plan of Correction Completed admission agreements will be maintained on file for all residents, and administrator or designee will submit certification to CCLD BY DUE DATE that agreements are maintained on file

Official classification

Type B

Official code

87465(h)(5)

Regulation authority

CCR

What the official deficiency says

(h) The following requirements shall apply to medications which are centrally stored: (5) Each resident's medication shall be stored in its originally received container. No medications shall be transferred between containers. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, the licensee did not comply with the section cited above, as clients' medications are pre-poured 10 days in advance. Seven-day pill organizers are observed, as well as plastic baskets containing small plastic cups for each clients' AM, PM, BT medications for 3 additional days. This practice poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 01/16/2024 Plan of Correction This practice must CEASE IMMEDIATELY, and proof/certification of correction to be submitted to CCLD BY DUE DATE

Official classification

Type B

Official code

1569.625(b)(2)

Regulation authority

HSC

What the official deficiency says

(b) (1) The department shall adopt regulations to require staff members of residential care facilities for the elderly who assist residents with personal activities of daily living to receive appropriate training. This training shall consist of 40 hours of training. A staff member shall complete 20 hours, including six hours specific to dementia care, as required by subdivision (a) of Section 1569.626 and four hours specific to postural supports, restricted health conditions, and hospice care, as required by subdivision (a) of Section 1569.696, before working independently with residents. The remaining 20 hours shall include six hours specific to dementia care and shall be completed within the first four weeks of employment. The training coursework may utilize various methods of instruction, including, but not limited to, lectures, instructional videos, and interactive online courses. The additional 16 hours shall be hands-on training. (2) In addition to paragraph (1), training requirements shall also include an additional 20 hours annually, eight hours of which shall be dementia care training, as required by subdivision (a) of Section 1569.626, and four hours of which shall be specific to postural supports, restricted health conditions, and hospice care, as required by subdivision (a) of Section 1569.696. This training shall be administered on the job, or in a classroom setting, or both, and may include online training. This requirement is not met as evidenced by: Deficient Practice Statement Based on review of staff training, the licensee did not comply with the section cited above, as there is no evidence of required 20 hours of staff training for staff 1, 2, 3, 4, 6, including 8 hours of dementia training and 4 hours specific to postural supports, restricted health conditions and hospice care. This poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 01/16/2024 Plan of Correction Proof of required staff training for S1, S2, S3, S4, S6 will be submitted to CCLD BY DUE DATE.

Official classification

Type B

Official code

87608(a)

Regulation authority

CCR

What the official deficiency says

POSTURAL SUPPORTS A written order from a physician indicating the need for the postural support shall be maintained in the resident’s record. The licensing agency shall be authorized to require other additional documentation if needed to verify the order. This requirement is not met as evidenced by: Deficient Practice Statement Based on client record review, the licensee did not comply with the section cited above, as ALL residents have bed rails--hospice client #4 has FULL bed rails. There are no MD orders for half bed rails and hospice care plan for client #4 does not include full bed rails. This poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 01/16/2024 Plan of Correction Proof of correction to be submitted to CCLD BY DUE DATE.

Official classification

Type A

Official code

87307(d)(6)

Regulation authority

CCR

What the official deficiency says

PERSONAL ACCOMMODATIONS SERVICES All outdoor and indoor passageways and stairways shall be kept free of obstruction. This requirement is not met, as exit door from private bathroom in room #1--which is identifed by sign and included on facility sketch--cannot be fully opened because of ramp railing. One cannot exit down ramp because ramp is too narrow. Licensee failed to ensure that exit can be used for exiting., which poses an immediate health and safety risk for clients in care.

Official plan of correction

Proof of correction to be sent to CCLD BY DIUE DATE

Deadline recorded: Oct 24, 2022. 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

PERSONAL RIGHTS OF RESIDENTS IN ALL FACILITIES Residents in all RCFEs shall have the personal right to be accorded safe, healthful and comfortable accommodations, furnishings and equipment. This requirement is not met, as protocols for COVID screening of visitors, staff and clients is not in place. Visitors are not screened & asked for contact number, daily record of COVID screening/temp checks for staff and clients is not maintained. Licensee failed to ensure that COVID safety protocols are maintained, which poses an immediate health, safety or personal rights risk to clients in care.

Official plan of correction

Visitor log shall include contact numbers & results of COVID screening/temp checks. Logs shall be maintained for daily COVID symptom screening/temp checks for staff and residents. Proof of correction to be sent to CCLD BY DUE DATE

Deadline recorded: Oct 24, 2022. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87411(a)

Regulation authority

CCR

What the official deficiency says

ADMINISTRATOR QUALIFICATIONS DUTIES Facility personnel shall at all times be sufficient in numbers, and competent to provide the services necessary to meet resident needs. . This requirement was not met, as 3 staff present upon LPA's arrival were unable to find PPE, client files, emergency contacts. Licensee failed to ensure that staff is competent to meeet the needs of clients, which poses an immediate health, safety, or personal rights risk to clients in care.

Official plan of correction

Proof of correction to be submitted to CCLD BY DUE DATE

Deadline recorded: Oct 24, 2022. A deadline is not proof that correction was completed.