Health inspection·June 25, 2024

F 0726 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on interviews and record reviews, the facility failed to ensure one of four nursing staff reviewed had the required continuing education and state certifications for working with the facilty resident population. This failure placed up to 11 residents at risk for harm due to a lack of required education related to patient care. Findings: On [DATE] an unannounced visit was made to the facility in response to a Facility Reported Incident. On [DATE], at 10:24 A.M., a record review of a facility Performance Improvement Plan (PIP), dated [DATE], and interview was held with the Director of Nursing, (DON), and the Administrator (ADM). The PIP reflected a Certified Nursing Assistant (CNA 1) had an expired license as of [DATE], but had been working full time assisting residents and providing care. The ADM stated that there was a lapse in checking licenses; the current Director of Staff Development (DSD) was transferred from another position and was unaware of the cancelling of the COVID blanket waiver that allowed a CNA to work for a period of time without a license due to delays in issuing licenses. On [DATE] at 10:44 A.M., a record review of CNA 1's personnel file was held with the DSD. CNA 1's employment application, dated [DATE], reflects CNA license number 0120xxxx. CNA 1's CNA license was issued [DATE], and expired [DATE]. The last employee review, dated [DATE] reflected that CNA 1 needed to attend required trainings and complete the CNA renewal. Also, CNA 1 had a position change, effective [DATE], from CNA to Direct Care Partner (DCP). On [DATE] at 10:58 the Director of Nursing (DON) was interviewed regarding the differences between a CNA and a DCP. The DON stated the DCP does not involve patient care. DCP tasks would be to assist with interviews, do paperwork, fetch tissues, any non-care task; a DCP could not assist with dressing, feeding, brushing hair or teeth, or any other resident care. The DON also stated that CNA 1 was utilized as a CNA, providing care, until [DATE]. The DON stated there was an unawareness of the change in status for CNA 1 from CNA to DCP in [DATE]. On [DATE] at 12:15 P.M., an interview was held with the DSD. The DSD confirmed that CNA 1 still does not have a new license. The DSD stated she is now aware that CNA 1 should not have been on the schedule to work with a resident providing care. Page 1 of 2 055964 055964 06/25/2024 Friendship Manor Nursing & Rehab Center 902 South Euclid Avenue National City, CA 91950

F 0726 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few On [DATE] at 2:03 P.M. a second interview was held with the DON and the ADM. The ADM stated having unlicensed staff giving direct care could cause harm to residents; not enough training for the requirements needed to care for the residents. The DON stated for patient safety, personnel need to have knowledge to take care of the resident's medical needs. The document, Duties and Responsibilities of the In-Service Director/Educator (DSD), dated 2003, reflected Administrative Functions include: .Assist licensed nursing personnel (i.e. RNs, LVNs, and Nurse Aides) in obtaining in-service training to keep their license current in accordance with state law. 055964 Page 2 of 2