Health inspection·July 24, 2024

F 0880 Provide and implement an infection prevention and control program. Level of Harm - Potential for minimal harm Based on observation, interview, and facility P&P review, the facility failed to ensure the infection control practices were implemented to help prevent development and transmission of diseases and infections for two of four sampled residents (Residents 3 and 4) and six of six nonsampled residents (Residents 5, 6, 7, 8, 9, and 10). Residents Affected - Some * The facility failed to properly store and label two bedpans and a basin observed on a handrail in Room A's restroom occupied by Residents 5 and 6. * The facility failed to properly store and label a basin found in Room B's restroom occupied by Residents 3, 7, 8 and 9. * The facility failed to properly store and label a urinal found on top of a toilet tank in Room C occupied by Residents 4 and 10. These failures had the potential for cross contamination and spread of infections. Findings: Review of the facility's P&P titled Infection Prevention and Control Program revised 9/18/24, showed an infection prevention and control program is established and maintained to provide a safe, sanitary and comfortable environment and to help prevent the development and transmission of communicable diseases and infections. Review of the facility's P&P titledResident's Personal Property revised 8/25/21, showed the facility should protect the resident's rights to retain his/her personal belongings and preserve the resident's individuality and dignity. 1. During an initial tour on 7/24/24 at 0829 hours, there were two unlabeled bedpans and one unlabeled basin in Room A's restroom. Room A was occupied by Residents 5 and 6. 2. On 7/24/24 at 0905 hours, an observation was conducted in Room B. Resident 3 was in Room B with Residents 7, 8 and 9. There was an unlabeled basin touching the clean toilet paper seat dispenser. 3. On 7/24/24 at 1050 hours, an observation was conducted in Room C. Room C wasoccupied by Residents 4 and 10. There was anunlabeled urinal placed on top of the toilet tank. On 7/24/24 at 1130 hours, an observation and concurrent interview was conducted with the DON. The DON verified all the findings and stated all bedpans, basins, and urinals should be properly stored Page 1 of 2 055653 055653 07/24/2024 South Coast Post Acute 1030 W Warner Ave Santa Ana, CA 92707

F 0880 and labeled to avoid cross contamination. Level of Harm - Potential for minimal harm Residents Affected - Some 055653 Page 2 of 2