BELLEROSE SENIOR LIVING

Official classification

Type A

Official code

87211(a)(2)

Regulation authority

CCR

What the official deficiency says

(a) Each licensee shall furnish to the licensing agency such reports as the Department may require, including, but not limited to, the following:(2) Occurrences, such as epidemic outbreaks, poisonings, catastrophes or major accidents which threaten the welfare, safety or health of residents, personnel or visitors, shall be reported within 24 hours either by telephone or facsimile to the licensing agency and to the local health officer when appropriate. This requirement was not met as evidenced by: Based on interview, record review, and observation the licensee did not ensure to report their infectious disease outbreak to the Department within 24 hours which poses/posed an immediate health, safety, and personal rights risk to persons in care.

Official plan of correction

Licensee will submit a written plan regarding reporting infecious disease outbreaks to the Department by POC due date of 09/23/2023.

Deadline recorded: Sep 23, 2023. A deadline is not proof that correction was completed.

Official classification

Type A

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 observation, interview, and record review the licensee did not ensure 3 out of 5 residents obstained a health screening report prior and after employment which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 09/23/2023 Plan of Correction Licensee has secured a local clinic to perform the health screening for staff. Licensee will submit a scheduled date and time for each of the missing personnel to LPA Dolores by 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 observation, interview, and record review the licensee did not ensure staff for each shift were provided quarterly drills which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 09/29/2023 Plan of Correction Licensee will submit the signed in-service drill for each employee for each shift to LPA Dolores by POC due date.