Royal Living Homes LLC

During a monitoring visit on 6/25/24 it was identified that relief caregiver Charles Weru Githui CPR/first aid training certificate was not available for review.

Copy printed out to file and email to licensor on 6/26/24.  Doer not affect other residents will keep copy in file to ensure it doesnt happen again.

During a monitoring visit on 6/25/2024 it was idenfied that relief caregivers Richard Larus and Charles Weru Githui  were on duty/ in charge.  The following exclusion was not available to verify: Richard Larus: SAM exclusion Charles Weru Githui: SAM exclusion

Have completed the SAM exclusion and emailed SAM to licensor   This doesn't affect other residents.  Have been filed to ensure its not repeated.

During a monitoring visit on 6/25/2024 it was identified that relief caregivers Richard Larus and Charles Weru Githui were on duty/ left in charge. Both caregivers did not have records that they were oriented to the adult foster home.

This has been printed out of the electronic record put in file and emailed to licensor.  Ir doesnt affect the residents hence wont be reported.

During a monitoring visit to this adult foster home on 6/25/2024 at aproximately 12:45PM, it was identifed that relief caregivers Richard Larus and Charles Weru Githui were on duty/ in charge.  The following sections of the Department's Caregiver Preparatory workbook was incomplete: Richard  Larus: Page 29 ( question #85), certificate Charles Weru Githui: certificate

Question 85 redone, in place in workbook.  Certificates printed and in file. This does not affect other residents will remain in file hence wont be repeated.

During a monitoring visit on 6/25/2024 the Pre-Admission Screening for Resident #2 was not available for review.

Pre-Admission screening printed and given to licensor.  This does not affect other residents.  Its in file now so wont reoccur.

During a monitoring visit on 6/25/2024 the following resident narrative documentation was identified: Resident #1: last narrative entry available for review was dated 5/13/24. Resident #2: last narrative entry available for review was dated 5/13/24. Resident #3: last narrative entry available for review was dated 2/27/24.

Narrative completed and in file.  This does not affect other residents will be done timely

During a monitoring visit on 6/25/2024 it was identified that Resident #3 careplan was not updated at least once every six months; that careplan update was dated 5/11/2023.

Care plan updated  and printed and put in file.  This doesn't affect other residents .  It will be done in a timely manner in future.

On 6/25/2024 at approximately 12:45PM the following prescribed medications were not initialed as given: Resident #1: Viewing the June 2024 Medication Administration Record (MAR) , there were 73 medications times not initialed as given. Resident #2: Viewing the June 2024 Medication Administration Record ( MAR), there were 213 medications times not initialed as given. Resident #3: Viewing the December 2023 Medication Administration Record (MAR), there were 26 medication times not initialed as given; viewing the June 2024 Medication Administration Record (MAR) , there were 23 medicatoin times not initialed as given. A total of 335 medication times were not initialed as prescribed medications administered.

This was completed and in file.  It does't affect other resident.  Must be completed in a timely manner in future.  This has been carefully reviewed , documented and corrected.  It doesnt affect other resident.  Will be  carefully documented  in future as soon as medications are given.  It will be observed by both administrators to ensure it does not occur .  Corrected documents emailed to licensor.

During a monitoring visit on 6/25/2024 at approximately 12:45PM it was identified, according to the June 2024 medication administration record,  that Resident #2 was administered an 'as needed' medication and there was no time, dose, reason and outcome given.

Documentation completed and filed  as late entry.  This doesn't affect other residents.  Will be renewed  by both administrators to ensure it doesn't occur.

Adult Foster Homes must operate and provide services in compliance with all applicable State and local laws, regulations and codes. This report reflects the findings of an unannounced monitoring visit conducted on 06/25/2024 . The adult foster home was evaluated for compliance with Oregon Administrative Rule 411, Divisions 049, 050, 051, and 052.  The following deficiency was identified:

Based on observation, interview and record review, it was determined the licensee failed to meet this rule as evidenced by: Resident 1 was admitted to the house on 1/25/2023. At the time of LLA arrival on 1/27/2023, the screening for the resident was not in the resident's file. The provider was able to produce the screening on the computer that showed that the resident is a full assist in all ADLS. As a class 2 home, the provider is only able to accept resident's in the home that have 3 or few full assist. The provider did not submit any documentation requesting a variance for resident before the resident moved into the house. At the time of the visit, the provider was able to complete the variance form but has not completed the fire drill or the care plan required to be submitted with the variance request. The provider also needs to submit a new weekly plan of operations that shows an RN on shift 24/7- 7 days a week which will be required to approve the variance. THIS DEFICIENCY MUST BE CORRECTED BY 2/03/2023

Licensee's Statement as written: This documents have been submitted to licensing office. A variance form has been filled, careplan completed, fire drill completed with a weekly plan of operations on 1/27/2023. Accepted C.Hartman 2/01/2023

Based on observation, interview and record review, it was determined the licensee failed to meet this rule as evidenced by: Resident 1 was admitted to the house on 1/25/2023. At the time of LLA arrival on 1/27/2023, the screening for the resident was not in the resident's file. The provider was able to produce the screening on the computer that showed that the resident is a full assist in all ADLS. As a class 2 home, the provider is only able to accept resident's in the home that have 3 or few full assist. The provider did not submit any documentation requesting a variance for resident before the resident moved into the house. At the time of the visit, the provider was able to complete the variance form but has not completed the fire drill or the care plan required to be submitted with the variance request. The provider also needs to submit a new weekly plan of operations that shows an RN on shift 24/7- 7 days a week which will be required to approve the variance. THIS DEFICIENCY MUST BE CORRECTED BY 2/03/2023

Based on observation, interview and record review, it was determined the licensee failed to meet this rule as evidenced by: Due to resident #1's care needs, this home must have an RN on staff at all time 24/7. An updated weekly plan of operations needs to be submitted to support resident's care needs including 2 AM medications. THIS DEFICIENCY MUST BE CORRECTED BY 2/03/2023

Licensee's Statement as written: A weekly plan of operations is attached to ensure there a nurse on sight 24/7. 1/27/2023 Accepted C.Hartman 2/01/2023

Based on observation, interview and record review, it was determined the licensee failed to meet this rule as evidenced by: Due to resident #1's care needs, this home must have an RN on staff at all time 24/7. An updated weekly plan of operations needs to be submitted to support resident's care needs including 2 AM medications. THIS DEFICIENCY MUST BE CORRECTED BY 2/03/2023

Based on observation, interview and record review, it was determined the licensee failed to meet this rule as evidenced by: At the time of visit on 1/27/2023 at 12:05 PM,  medications that were required to be administeted on 1/26/2023 were not inititaled on the MARS which are the following: Budes/Formot AER-4.5- 5:00PM Calcium Carb SUS 1250/5ML 12:00 PM & 5:00 PM Chlorhex Glu Sol 0.12% 2:00PM, 5:00 PM, 8:00 PM Eliqus 5MG Tab 5:00 PM Gabapentin SOL 250/5ML 5:00 PM Insulin Glar SOL 100U/ML 8:00 PM Ipratoprium SOL Albuter 8:00 AM, 2:00PM, 8:00 PM Melatonin 5:00 PM Nystatin Powder 5:00 PM Prampexole Tab 0.125 MG 8:00 PM Vitamin D3 8:00 AM Medications that were required to be administeted on 1/27/2023 before the LLA arrival were not inititaled on the MARS which are the following: Amiodarone Tab 200 MG 8:00 AM Atrovastatin Tab 40 MG 8:00 AM Budes/Formot AER-4.5 8:00 AM Calcium Carb SUS 1250/5ML 8:00 AM Chlorex Glu Sol 0.12 % 2:00 AM and 8:00 AM Duloxetine CAP 60 MG 8:00 AM Eliqus 5MG Tab 8:00 AM Gabapentin SOL 250/5ML 8:00 AM Lisinopril Tab 10 MG 8:00 AM Nystatin powder 15 GM 8:00 AM Senna-Docusate 8.6-50 MG Tab 8:00AM THIS DEFICIENCY MUST BE CORRECTED BY 2/03/2023

Licensee's Statement as written: All medications have been signed. If other residents are admitted their medications will be signed on time-immediately after giving them. Action is taken to sign medications inmmediately after administration. Completed on 1/27/2023 Accepted C.Hartman 2/02/2023

Based on observation, interview and record review, it was determined the licensee failed to meet this rule as evidenced by: At the time of visit on 1/27/2023 at 12:05 PM,  medications that were required to be administeted on 1/26/2023 were not inititaled on the MARS which are the following: Budes/Formot AER-4.5- 5:00PM Calcium Carb SUS 1250/5ML 12:00 PM & 5:00 PM Chlorhex Glu Sol 0.12% 2:00PM, 5:00 PM, 8:00 PM Eliqus 5MG Tab 5:00 PM Gabapentin SOL 250/5ML 5:00 PM Insulin Glar SOL 100U/ML 8:00 PM Ipratoprium SOL Albuter 8:00 AM, 2:00PM, 8:00 PM Melatonin 5:00 PM Nystatin Powder 5:00 PM Prampexole Tab 0.125 MG 8:00 PM Vitamin D3 8:00 AM Medications that were required to be administeted on 1/27/2023 before the LLA arrival were not inititaled on the MARS which are the following: Amiodarone Tab 200 MG 8:00 AM Atrovastatin Tab 40 MG 8:00 AM Budes/Formot AER-4.5 8:00 AM Calcium Carb SUS 1250/5ML 8:00 AM Chlorex Glu Sol 0.12 % 2:00 AM and 8:00 AM Duloxetine CAP 60 MG 8:00 AM Eliqus 5MG Tab 8:00 AM Gabapentin SOL 250/5ML 8:00 AM Lisinopril Tab 10 MG 8:00 AM Nystatin powder 15 GM 8:00 AM Senna-Docusate 8.6-50 MG Tab 8:00AM THIS DEFICIENCY MUST BE CORRECTED BY 2/03/2023

Adult Foster Homes must operate and provide services in compliance with all applicable State and local laws, regulations and codes. This report reflects the findings of the unannounced on-site complaint inspection conducted 1/27/2023. The adult foster home was evaluated for compliance with Oregon Administrative Rule 411, Divisions 049, 050, 051, and 052.

Adult Foster Homes must operate and provide services in compliance with all applicable State and local laws, regulations and codes. This report reflects the findings of the unannounced on-site complaint inspection conducted 1/27/2023. The adult foster home was evaluated for compliance with Oregon Administrative Rule 411, Divisions 049, 050, 051, and 052.