F 0947
Level of Harm - Minimal harm
or potential for actual harm
Residents Affected - Few
Ensure nurse aides have the skills they need to care for residents, and give nurse aides education in
dementia care and abuse prevention.
**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on
interview and record review, the facility failed to provide in-service training (training intended for those
actively engaged in a profession or activity) as indicated by the facility's in-service calendar for Certified
Nursing Assistants (CNA) regarding behavioral health for two of two sampled CNAs (CNA 2 and CNA 3).
This deficient practice has the potential to place residents who have a behavioral health diagnosis at risk for
improper care and avoidable incidences.
Findings:
During a review of the facility's Facility assessment dated [DATE], the Facility Assessment indicated under
Common Diagnosis/Conditions: Psychiatric (branch of medicine concerned with the study, diagnosis, and
treatment of mental illness)/Mood Disorders (mental health condition that primarily affects your emotional
state). Common diagnosis: Psychosis (severe mental disorder in which thought and emotions are so
impaired that contact is lost with external reality), impaired cognition (the process of acquiring knowledge
and understanding through thought, experience, and the senses), mental disorder (referred to as a mental
illness or mental health condition, is a pattern of behavioral or mental symptoms that cause significant
distress or impair an individual's ability to function in daily life), depression (mood disorder that causes a
persistent feeling of sadness and loss of interest), bipolar disorder (mental disorder that causes unusual
shifts in mood, energy, activity levels, concentration, and the ability to carry out day-to-day tasks),
schizophrenia (a mental illness that is characterized by disturbances in thought), post-traumatic stress
disorder (PTSD - a disorder in which a person has difficulty recovering after experiencing or witnessing a
traumatic event), anxiety disorder (intense, excessive, and persistent worry and fear about everyday
situations), behavior that needs interventions Services Provided Based on Resident Need: Mental health
and behavior. Under specific Care or Practices: Manage the medical conditions and medication related
issues causing psychiatric symptoms and behavior identify and implement interventions to help support
individuals with issues such as dealing with anxiety, care of someone with cognitive impairment, care of
individuals with depression, trauma/PTSD, other psychiatric diagnosis, intellectual or developmental
disabilities.
During a review of the facility's Annual In-service Calendar 2025, the facility's Annual In-service Calendar
2025 indicated under March: Behavioral Health Training: Care of Resident with Dementia (decline in
memory or other thinking skills severe enough to reduce a person's ability to perform everyday activities),
Mental, Psychosocial and Substance Abuse Disorder (chronic brain disease characterized by compulsive
drug seeking and use, despite harmful consequences), PTSD, Trauma, and Trigger Management (All Staff).
(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:
055906
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
055906
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
04/30/2025
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Rinaldi Convalescent Hospital
16553 Rinaldi St
Granada Hills, CA 91344
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)
F 0947
Level of Harm - Minimal harm
or potential for actual harm
Residents Affected - Few
During an interview on 4/29/2025 at 4:10 p.m., with Certified Nursing Assistant 2 (CNA 2), CNA 2 stated
that no formal in-service or training was given to him for behavior management.
During an interview on 4/30/2025 at 9:38 a.m., with CNA 3, CNA 3 stated that CNA 3 was not given a
formal in-service, education, or training for behavior management. CNA 3 stated that she would like formal
education for behavior management, so she knows how to deal with residents' behaviors.
During a concurrent interview and record review on 4/30/2025 at 10:30 a.m., with the Director of Staff
Development (DSD), reviewed the facility's Annual In-service Calendar 2025. The DSD stated that she did
not provide the scheduled March 2025 in-service for Behavioral Health Training: Care of Resident with
Dementia, Mental, Psychosocial and Substance Abuse Disorder, PTSD, Trauma, and Trigger Management.
The DSD further stated that she was recently employed by the facility (started March 2025), and was not
sure if the in-services for Behavioral Health Training: Care of Resident with Dementia, Mental, Psychosocial
and Substance Abuse Disorder, PTSD (Post Traumatic Stress Disorder), Trauma, and Trigger Management
were provided to the facility's CNAs in March 2025 by the previous DSD. The DSD stated that Behavioral
Health Training is important to provide to CNA staff because CNA staff are on the front line of providing
care for residents and should be aware of behavioral health.
During a concurrent interview and record review on 4/30/2025 at 10:36 a.m., with the DSD, reviewed the
personal files of CNA 2 and CNA 3. The DSD stated that there was no documented evidence of behavioral
health training found in the CNA 2 and CNA 3's file.
During a review of the facility's policy and procedure titled, In-Service Training, Nurse Aide, revised date
8/2022, the policy indicated annual in-services: d. address the special needs of the residents, as
determined by the facility assessment. Required training topics for all staff (including nurse aides) include:
g. behavioral health. Training curricula includes learning objectives, performance standards and evaluation
criteria. Nurse aides are evaluated based on individual performance when appropriate. Competency may
also be demonstrated through written exam or by consistently applying the interventions necessary to meet
the needs of the residents as identified in the facility assessment.
During a review of the facility's policy and procedure titled, In-Service Training, All Staff, revised date
8/2022, the policy indicated required training topics include the following: d. Behavioral Health. Training
requirements are met prior to staff providing services to residents, annually, and as necessary based on the
facility assessment.
During a review of the facility's policy and procedure titled, On-the-Job Training, revised date 1/2008, the
policy indicated on-the-job training programs will be conducted when necessary to assist employee in
performing their assigned tasks.
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
055906
If continuation sheet
Page 2 of 2