Health 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. Page 1 of 2 055448 055448 01/03/2024 Dinuba Healthcare 1730 South College Ave. Dinuba, CA 93618

F 0880 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few During an interview on 1/3/24 at 2:31 p.m. with Infection Preventionist (IP), IP stated BP machine and BP cuff should be sanitized before and after each use. During a review of the facility's policy and procedure (P&P) titled, Cleaning and Disinfection of Environmental Surfaces, dated October 2021, the P&P indicated, The following categories are used to distinguish the level of sterilization/disinfection necessary for items used in resident care and those in resident's environment.c. Non-Critical items are those that come in contact with intact skin but not mucous membranes.(2) Most non-critical items can be decontaminated where they are used.2. Non- critical surfaces will be disinfected with an EPA- registered intermediate or low-level hospital disinfectant according to the label's safety precautions. 2.During an observation on 1/3/24 at 2:12 p.m. CNA 1 exited Resident 1's room after taking Resident 1's BP and did not sanitize her hands. CNA 1 walked down Hallway A and entered Resident 2's room without sanitizing her hands. CNA 1 proceeded to check Resident 2's BP. During an observation on 1/3/24 at 2:15 p.m. CNA 1 exited Resident 2's room and did not sanitize her hands upon exiting the room. During an observation on 1/3/24 at 2:19 p.m. CNA 1 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 perform hand hygiene before or after providing care to 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 perform hand hygiene before or after providing care to Resident 4. During an interview on 1/3/24 at 2:25 p.m. with CNA 1, CNA 1 was asked when should hand hygiene be performed. CNA 1 stated, I should do it more often. CNA 1 was made aware of the observations and stated, Yeah, I should have sanitized my hands. During an interview on 1/3/24 at 2:33 p.m. with IP, IP stated hand hygiene should be performed before and after touching residents. IP stated it is also expected to use hand sanitizer before entering and after leaving all resident rooms. During a review of the facility's P&P titled, Handwashing/Hand Hygiene, dated March 2020, the P&P indicated, This facility considers hand hygiene the primary means to prevent the spread of infections.2. All personnel shall follow handwashing/ hand hygiene procedures to help prevent the spread of infections to other personnel, residents, and visitors.7. Handwashing: soap (antimicrobial or non-antimicrobial) and water for the following situations: a. Before and after coming on duty; b. Before and after direct contact with residents.i. After contact with resident's intact skin.l. After contact with objects (e.g., medical equipment) in the immediate vicinity of the resident. 055448 Page 2 of 2