Health inspection·October 1, 2024

F 0684 Provide appropriate treatment and care according to orders, resident’s preferences and goals. Level of Harm - Minimal harm or potential for actual harm Based on observation, interview, and record review, the facility failed to ensure one of three residents, (Resident 1) received treatment and care in accordance with professional standards of practice, when: Residents Affected - Few 1. A Certified Nursing Assistant (CNA 1) left Resident 1 in bed naked and uncovered with the curtain halfway open. 2. A CNA (CNA 2) took a long time in attending to Resident 1 for a change. These failures had the potential to cause Resident 1 a psychological effect for maintaining respect and dignity. Findings: During a review of Resident 1 ' admission Record (general demographics) on September 11, 2024, the document indicated Resident 1 was admitted to the facility on November August 29, 2024, with diagnoses internal right hip prosthesis (a condition with hip replacement), heart failure (a condition that develops when your heart does not pump enough blood for the body needs), and hypertension (a condition with a high blood pressure). A review of Resident 1 ' s care plan dated, August 29, 2024, indicated, Focus: ADL (Activities of daily living) self-care performance deficit r/t (related to) limited mobility. Goal: Will safely perform bed mobility, transfers, eating, dressing, grooming, toilet use and personal hygiene with modified independence . Interventions: . Promote dignity by ensuring privacy. 1. During an interview on September 11, 2024, at 1:25 PM, with CNA 1, the CNA 1 stated, I usually provide residents with privacy during care I forgot to cover the resident with a sheet before leaving the room. During an interview on September 11, 2024, at 3:10 PM, with the Administrator regarding CNA 1, the Administrated stated, The CNA 1 should have covered the resident with sheets during care and before leaving the room. The Administrator further stated, the CNA did not follow the facility policy and procedure. 2. During a phone interview on September 30, 2024, at 2:10 PM, with CNA 2, the CNA 2 was asked about taking long time to attend to Resident 1 for a change. The CNA 2 stated, I am usually attending to Page 1 of 2 055374 055374 10/01/2024 Upland Rehabilitation and Care Center 1221 E Arrow Hwy Upland, CA 91786

F 0684 residents at that and might have taken too long with cleaning her up. Level of Harm - Minimal harm or potential for actual harm During a phone interview on September 30, 2024, at 4:27 PM, with the Director of Nursing (DON) regarding CNA 2, the DON stated, The CNA should have requested for assistance so she could attend to the resident with the changing. The DON further stated the CNA 2 did not follow facility policy and procedure. Residents Affected - Few A review of the facility ' s policy and procedure (P&P), titled, Resident Rights dated, January 2022, indicated, .It is the policy of this facility that all resident rights be followed per state and federal guidelines as well as other regulative agencies. The Resident has the right: 1. To be treated with consideration, respect, and full recognition of his or her dignity and individuality . 055374 Page 2 of 2