Inspection·January 3, 2024

F 0880 Provide and implement an infection prevention and control program. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interview, and record review, the facility failed to implement infection prevention and control practices when: Residents Affected - Few 1. One of three sampled Certified Nursing Assistant's (CNA 1) failed to sanitize blood pressure (BP) cuff (an inflatable cuff, which measures the systolic (the measure of pressure within the arteries while the heart beats) and diastolic pressure (the measure of pressure your blood is exerting against the artery walls while the heart muscle is resting) after use. 2. One of three sampled CNA's (CNA 1) did not perform hand hygiene after providing resident care. These failures had the potential to result in the transmission of infection and communicable diseases to residents and staff. Findings: 1. During an observation on 1/3/24 at 2:10 p.m. CNA 1 entered room Resident 1's room with a BP machine and stated I'm gonna check your blood pressure. During an observation on 1/3/24 at 2:12 p.m. CNA 1 exited Resident 1's room with BP machine, walked down hallway A and entered Resident 2's room [ROOM NUMBER]. CNA 1 did not sanitize the BP cuff prior to placing the BP cuff on Resident 2's left arm. CNA 1 did not sanitize to BP cuff after use on Resident 2. During an observation on 1/3/24 at 2:19 p.m. CNA 1 took the BP machine out of Resident 2's room and walked into the dining room in hallway B where residents were partaking in different activities (coloring, bingo, and movies). CNA 1 walked over to Resident 3 who was watching a movie and informed Resident 3 that she was going to check his BP. CNA 1 did not sanitize the BP cuff prior to placing it on Resident 3's right arm. CNA 1 did not sanitize the BP cuff after the use on Resident 3 During an observation on 1/3/24 at 2:22 p.m. CNA 1 walked over to Resident 4 who was sitting in the dining room playing bingo and informed her that she was going to check her BP. CNA 1 did not sanitize the BP cuff prior to placing the BP cuff on Resident 4's left arm. CNA 1 did not sanitize the BP cuff after the use on Resident 4. During an interview on 1/3/24 at 2:25 p.m. with CNA 1, CNA 1 stated the BP machine and BP cuff are sanitized once per shift. (continued on next page) Any deficiency statement ending with an asterisk (*) denotes a deficiency which the institution may be excused from correcting providing it is determined that other safeguards provide sufficient protection to the patients. (See instructions.) Except for nursing homes, the findings stated above are disclosable 90 days following the date of survey whether or not a plan of correction is provided. For nursing homes, the above findings and plans of correction are disclosable 14 days following the date these documents are made available to the facility. If deficiencies are cited, an approved plan of correction is requisite to continued program participation. LABORATORY DIRECTOR'S OR PROVIDER/SUPPLIER REPRESENTATIVE'S SIGNATURE TITLE (X6) DATE FORM CMS-2567 (02/99) Previous Versions Obsolete Facility ID: If continuation sheet Page 1 of 2 Event ID: 055448 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 055448 B. Wing A. Building (X3) DATE SURVEY COMPLETED 01/03/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Dinuba Healthcare 1730 South College Ave. Dinuba, CA 93618 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)