Health inspection·February 24, 2026

F 0908 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some stated he received a phone call from a staff member on 2/21/26 around 10:00 a.m. and was notified there was no hot water in stations 1 and 2. The MS stated he came into the facility and checked the boiler and found the fan to the boiler igniter was not working because the motor was frozen. The MS stated he called the VDR repairman and they came to the facility around 12:00 p.m. The MS stated he was informed the motor would have to be replaced and was told it was the weekend so the part to repair the boiler would not be available until Monday or Tuesday. The MS stated on Saturday 2/21/26 he had checked the sink water temperatures at Stations 1 and 2 by running hot water and putting his hand under it. The MS stated he did not use a thermometer to check the temperatures, but the water was cold to touch. The MS stated the main areas affected were stations 1 and 2 nurses' station, shower rooms and resident rooms. The MS stated he checked the other stations (stations 3, 4, 5 and 6) and there was no hot water in their shower rooms, resident rooms or nurses station sinks. The MS stated the laundry room had hot water because it was on a separate boiler. The MS stated he notified the ADM that stations 1 and 2's hot water was not working but did not report the other stations because the other sinks weren't as cold as stations 1 and 2, but the water was not getting hot. The MS stated the boiler does not receive routine service from an outside vendor and they are called only when there is an issue. The boiler to the main section of the facility was observed in an outside closet near the kitchen. There were two boilers in the closet, the MS stated they worked as one to heat the facility's water. The MS pointed to a large cover on the side of the main boiler and stated the motor that was replaced was under the cover, it was not visible. The second boiler was a tankless water heater in a closet outside the laundry room. The MS stated the boiler only heats the water for the laundry room and was not affected.During an interview on 2/24/26 at 4:04 p.m. with the Director of Nursing (DON), the DON stated she received a text on Saturday 2/21/26 that stations 1 and 2 did not have hot water. The DON stated she was told the laundry room was on a separate boiler and had hot water that the staff could use to provide bed baths. The DON stated her expectation to test water temperatures was to use a thermometer to get an accurate reading. The DON stated it was important for the facility to have hot water to shower the residents to prevent skin issues, infection control and for proper hand hygiene when hand sanitizers were not appropriate to use.During an interview on 2/24/26 at 4:30 p.m. with the ADM, the ADM stated when the MS called on Saturday 2/21/26, he was not informed there was no hot water to stations 3, 4, 5, and 6, so he did not realize how widespread the issue was. The ADM stated his expectations for accurate water temperature readings was for a thermometer to be used. During a review of the Service Work Order, dated 2/24/26, from the VDR, the work order indicated, . Returned and arrived at 11:30 AM and installed the new motor and had hot water running by 11:45 AM. 2/24/26. Tested system and system is operating properly at this time. Replace . Combustion Motor.During a review of the facility's P&P titled Maintenance Service, dated 12/2009, the P&P indicated, . maintenance department is responsible for maintaining the buildings, grounds, and equipment in a safe and operable manner at all times. Functions of maintenance personnel include. maintaining the building in compliance with current federal, state, and local laws, regulations and guidelines. maintaining the heat/cooling system, plumbing fixtures. in good working order. Maintenance director is responsible for developing and maintaining a schedule of maintenance service to assure that the buildings, grounds, and equipment are maintained in a safe and operable manner . During a review of the facility's policy and procedure (P&P) titled Water Temperatures, Safety of, dated 12/2009, the P&P indicated, . Tap water in the facility shall be kept within a temperature range to prevent scalding of residents. Maintenance staff is responsible for checking thermostats and temperature controls in the facility and recording these checks in a maintenance log. Maintenance staff shall conduct (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 055147 If continuation sheet Page 2 of 3 Printed: 05/15/2026 Form Approved OMB No. 0938-0391 Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER: (X2) MULTIPLE CONSTRUCTION 055147 B. Wing A. Building (X3) DATE SURVEY COMPLETED 02/24/2026 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Madera Rehabilitation & Nursing Center 517 South A Street Madera, CA 93638 For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)

F 0908 periodic tap water temperature checks and record water tempers in a safety log. If at any time water temperatures feel excessive to the touch. staff will report this finding. Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 055147 If continuation sheet Page 3 of 3