A list of the most recent deficiencies for Moraga Post Acute. The list is based on the information provided by CMS from both standard inspections and from complaints filed by residents.
| Deficiency | Type of Deficiency | Deficiency Date | Date Corrected | Resulted from a Complaint? |
|---|---|---|---|---|
| Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted | Health | 2023-08-01 | 2023-09-25 | Y |
| Provide appropriate treatment and care according to orders, resident?s preferences and goals. | Health | 2023-08-01 | 2023-09-25 | Y |
| Provide appropriate treatment and care according to orders, resident?s preferences and goals. | Health | 2022-08-15 | 2022-10-31 | Y |
| Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | Health | 2022-02-24 | 2022-05-13 | Y |
| Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | Health | 2021-07-09 | 2021-08-20 | N |
| Provide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM and/or mobility, unless a decline is for a medical reason. | Health | 2021-07-09 | 2021-08-20 | N |
| Provide enough food/fluids to maintain a resident's health. | Health | 2021-07-09 | 2021-08-20 | N |
| Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures. | Health | 2021-07-09 | 2021-08-20 | N |
| Employ sufficient staff with the appropriate competencies and skills sets to carry out the functions of the food and nutrition service, including a qualified dietician. | Health | 2021-07-09 | 2021-08-20 | N |
| Provide sufficient support personnel to safely and effectively carry out the functions of the food and nutrition service. | Health | 2021-07-09 | 2021-08-20 | N |
| Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature. | Health | 2021-07-09 | 2021-08-20 | N |
| Ensure each resident receives and the facility provides food that accommodates resident allergies, intolerances, and preferences, as well as appealing options. | Health | 2021-07-09 | 2021-08-20 | N |
| Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | Health | 2021-07-09 | 2021-08-20 | N |
| Provide and implement an infection prevention and control program. | Health | 2021-07-09 | 2021-08-20 | N |
| Conduct risk assessment and an All-Hazards approach. | Fire Safety | 2021-07-15 | 2021-08-03 | N |
| Establish policies and procedures for medical documentation. | Fire Safety | 2021-07-15 | 2021-08-03 | N |
| Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system. | Fire Safety | 2021-07-15 | 2021-08-03 | N |
| Install corridor and hallway doors that block smoke. | Fire Safety | 2021-07-15 | 2021-08-03 | N |
| Have generator or other power source capable of supplying service within 10 seconds. | Fire Safety | 2021-07-15 | 2021-08-03 | N |
| Ensure proper usage of power strips and extension cords. | Fire Safety | 2021-07-15 | 2021-08-03 | N |
| Develop and maintain an Emergency Preparedness Program (EP). | Fire Safety | 2019-09-09 | 2019-10-10 | N |
| Include a process for Emergency Preparedness collaboration. | Fire Safety | 2019-09-09 | 2019-10-10 | N |
| Address subsistence needs for staff and patients. | Fire Safety | 2019-09-09 | 2019-10-10 | N |
| Establish policies and procedures for volunteers. | Fire Safety | 2019-09-09 | 2019-10-10 | N |
| List the names and contact information of those in the facility. | Fire Safety | 2019-09-09 | 2019-10-10 | N |
| Provide a means of sharing information on occupancy/needs. | Fire Safety | 2019-09-09 | 2019-10-10 | N |
| Properly select, install, inspect, or maintain portable fire extinguishes. | Fire Safety | 2019-09-09 | 2019-10-10 | N |
| Install corridor and hallway doors that block smoke. | Fire Safety | 2019-09-09 | 2019-10-10 | N |
| Have approved installation, maintenance and testing program for fire alarm systems. | Fire Safety | 2018-11-13 | 2018-12-11 | N |
| Have generator or other power source capable of supplying service within 10 seconds. | Fire Safety | 2018-11-13 | 2018-12-11 | N |
| Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | Health | 2018-09-12 | 2018-10-12 | N |
| Reasonably accommodate the needs and preferences of each resident. | Health | 2018-09-12 | 2018-10-12 | N |
| Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | Health | 2018-09-12 | 2018-10-12 | N |
| Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | Health | 2018-09-12 | 2018-10-12 | N |
| Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | Health | 2018-09-12 | 2018-10-12 | N |
| Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures. | Health | 2018-09-12 | 2018-10-12 | N |
| Ensure medication error rates are not 5 percent or greater. | Health | 2018-09-12 | 2018-10-12 | N |
| Ensure meals and snacks are served at times in accordance with resident?s needs, preferences, and requests. Suitable and nourishing alternative meals and snacks must be provided for residents who want to eat at non-traditional times or outside of scheduled meal times. | Health | 2018-09-12 | 2018-10-12 | N |
| Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | Health | 2018-09-12 | 2018-10-12 | N |
| Designate a qualified infection preventionist to be responsible for the infection prevent and control program in the nursing home. | Health | 2022-07-06 | Not Fixed | N |
