Pine Meadows Ranch.

“Based on record review, documentation review, and interview, the manager failed to ensure a caregiver's skills and knowledge were verified and documented before providing physical health services and according to policies and procedures, for three of four caregivers reviewed. The deficient practice posed a health and safety risk. Findings include: 1. A review of E2's, E3's, and E4's personnel records revealed no documentation of verification of the employees' skills and knowledge. 2. A documentation review of the Policy and Procedures revealed a policy titled "Skills and Knowledge Policy and Procedures." The document states: "VERIFICATION PROCESS: Skills and knowledge will be verified by Manager/Designee on date of hire through practical assessment and demonstrate their understanding by checking, sign and dated the caregiver skills and knowledge documentation before they are permitted to provide services to the residents. The signed document will be included in the employee's file. REGULAR AUDITS: Caregiver skills and knowledge documentation is completed accurately and thoroughly before the employee provides services to residents. Any lapses on verification process must be address promptly and perform a regular performance review to implement continuous education as part of the in service or refresher course training." 3. In an interview, E1 acknowledged that E2, E3, and E4 did not have documentation of the skills and knowledge in their personnel record. 4. In an exit interview, the information was reviewed with E1; no other documentation was provided.”

“Based on record review and interview, the manager failed to ensure a resident's written service plan included the frequency of assisted living services being provided to the resident for three of the three residents reviewed. The deficient practice posed a risk as the service plans did not reinforce and clarify the services to be provided to a resident. Findings include: 1. A review of R1's medical record revealed a current service plan dated October 9, 2025. This service plan did not include the frequency of assistance with dressing, bathing, or showering, grooming, incontinence care, and medication administration. 2. A review of R2's medical record revealed a current service plan dated June 4, 2025. This service plan did not include the frequency of assistance with dressing, bathing or showering, grooming, and medication administration. 3. A review of R3's medical record revealed a current service plan dated December 12, 2024. This service plan did not include the frequency of assistance with dressing, bathing or showering, grooming, and medication administration. 4. In an interview, E1 acknowledged that the service plans did not include the frequency of services for R1, R2, and R3. 5. In an exit interview, the findings were reviewed with E1, and no additional information was provided.”