Health inspection·January 22, 2025

F 0921 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation and interview, the facility failed to provide a safe, clean, and home like environment to the 8 of 9 residents living in the affected rooms. These failures had the potential to result in unsanitary living conditions and accidental falls and injuries. Findings: a). During an observation on 1/22/2025 at 10:00 a.m., in activity room, where (unidentified) residents were observed watching televisionand drinking coffee, two ceiling vents (grilles) by the entrance of the activity room were observed full of dusts, with strands of dust hanging over the vents. The back and right-side walls were also observed with dried food spots. b). During an observation on 1/22/2025 at 10:15 a.m. in residents ' rooms 12A, 18A, 21A, 22B, 36B, 44A, 49C, the walls behind the residents ' headboard had white paints falling off from the wall. c). During an observation on 1/22/2025 at 10:35 a.m. in resident ' s room [ROOM NUMBER]C. The side wall was observed with black and white dried food spots. The ceiling vent was observed with strands of dusts. d). During an observation on 12/22/2025 at 10:40 a.m. in resident ' s room [ROOM NUMBER]C, a plastic baseboard (a narrow wooden board running along the base of an interior wall) was observed sticking out from the wall. During an interview on 1/22/2024 at 2;00 p.m. with Housekeeping (HK), the HK stated deep cleaning (a thorough cleaning that eliminates visible dirt, bacteria, and germs) were done to each room once a month. The HK stated deep cleaning included moving furniture, beds, cleaningthe windows and walls. The HK stated, if the walls were dirty, it should have been cleaned. The HK stated if there were parts in a resident ' s room that were broken, or paints were peeling off from the wall is falling, we inform the supervisor. The HK stated the janitor is in charge to clean the ceiling vents. The HK stated the supervisor was informed around December 2024 about the plastic baseboard in room [ROOM NUMBER]C coming off the wall. The HK stated it is important to keep rooms clean and fix broken things for residents ' safety and hygiene. During an observation and interview on 1/22/2025 at 2:34 p.m. with Maintenance Assistance (MA), the MA confirmed the ceiling vents in the activity room were dirty, full of dust strands. The MA stated Page 1 of 2 055737 055737 01/22/2025 Sunny Hills Post Acute 12200 LA Mirada Blvd. LA Mirada, CA 90638

F 0921 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some it was important to clean the ceiling vents, so the dusts won ' t fall on residents ' food while eating and for infection control. During an interview on 1/22/2024 at 2:57 p.m. with Maintenance Supervisor (MS), the MS stated the paints in some of the rooms (unidentified), were coming off. The MS stated it was not acceptable to keep the plastic baseboards loose, as they were not safe and could cause the residents to fall. The MS stated the walls should be cleaned every day. The MS stated the facility is the residents ' home, and the facility must ensure a home like environment are being provided to the residents. During an interview on 1/22/2025 at 4;10 p.m. with Director of Nursing (DON), the DON stated dirty walls must be cleaned by housekeeping to prevent any infections and provide the residents a homelike environment. During a review of the facility ' s policies and procedures (P&P) titled, Safe and Homelike Environment, dated, 12/19/2022, the P&P indicated, the facility must provide a safe, clean, comfortable and homelike environment. The P&P indicated housekeeping and maintenance services will be provided as necessary to maintain a sanitary, orderly, and comfortable environment. During a review of the facility ' s P&P titled, Preventative Maintenance Program, dated 12/19/2022, the P&P indicated, a Preventative Maintenance Program shall be implemented to ensure the provision of a safe, functional, sanitary, and comfortable environment for residents, staff, and the public. 055737 Page 2 of 2