Ridgecrest I

Based on record review, observation, and interview, the manager failed to ensure a written order verifying the verbal order was obtained from the medical practitioner within 14 calendar days after receipt of the verbal order, for one of two residents sampled. Findings include: 1. A review of R1's medical record revealed a current written service plan dated June 1, 2024, for directed care services. The service plan indicated R1 received medication administration. 2. A review of R1's medical record revealed a verbal medication order from a registered nurse dated June 3, 2024. The order stated "Lorazepam 0.05 mg oral take 1/2 tab in AM and 1 tab at bedtime." R1's medical record contained evidence of documentation the medication was being administered as ordered, however, there was no documentation to indicate a written order was obtained from the medical practitioner within 14 days of the verbal order. 3. In an interview, E1 reported the Lorazepam administered to R1 was administered per the verbal order. E1 acknowledged a written order verifying the verbal order was not obtained from R1's medical practitioner within 14 calendar days after receipt of the verbal order.

Based on record review and interview, the manager failed to ensure a written service plan was updated at least once every three months, for one of two directed care residents sampled. Findings include: 1. A review of R1's medical record revealed a service plan for directed care services dated January 26, 2023. However, evidence of an updated service plan prior to May 9, 2023, was not available for review. 2. In an interview, E2 acknowledged R1 received directed care services and the service plan was not updated at least once every three months.

Based on document review, observation, and interview, the manager failed to ensure there was a means of exiting the facility that provided access to an outside area which controlled or alerted employees to the egress of a resident from the facility. The deficient practice posed a risk if the facility was unaware of the general or specific whereabouts of a resident receiving directed care services. Findings include: 1. A review of facility documentation revealed the facility was licensed at Directed Care level. 2. During a tour of the facility, the Compliance Officer observed no less than two ambulatory residents. The Compliance Officer also observed a room off the kitchen utilized as an office space. The room had a back door leading outside the facility, which was equipped with an alarm designed to alert employees of egress from the facility. However the alarm was turned off. The doorway also contained a steel security door which was equipped with a deadbolt requiring a key to unlock, however the deadbolt was not engaged and the Compliance Officer was able to open the security door with minimal effort. 3. In an interview E3 acknowledged the alarm attached to the office door providing egress from the facility was turned off.

Based on observation and interview, the manager failed to ensure hot water temperatures were maintained between 95 \'baF and 120 \'baF in areas of an assisted living facility used by residents. Findings include: 1. The Compliance Officer observed the water temperature, in a community bathroom used by residents, to be 135.1 \'baF. 2. In an interview, E3 acknowledged the hot water was not maintained between 95 \'baF and 120 \'baF in areas of an assisted living facility used by residents.