Health inspection·August 9, 2023

F 0921 Level of Harm - Minimal harm or potential for actual harm Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public. Based on observation, interview, and record review, the facility failed to routinely check and record resident room temperatures, resident bathroom water temperatures, call lights, and resident equipment. Residents Affected - Some This failure had the potential for residents to be uncomfortable or at risk for accidents related to unidentified hazards. Findings: On 8/4/23 an unannounced visit was made to the facility due to a complaint of hot, uncomfortable resident room temperatures within the facility. The hallway temperature thermometers read 72 degrees Fahrenheit (F). Standing electrical fans were in the hallway of Station 3 and a portable air conditioning unit was in the north hallway of Station 3. On 8/4/23 at 2:02 P.M., an interview was conducted with Resident 4 outside of her room. Resident 4 stated her room was too cold and she had to sleep with several blankets at night. Resident 2 asked if the temperature in her room could be adjusted. On 8/4/23 at 2:15 P.M., an interview was conducted with the Interim Maintenance Director (I-MD). The I-MD stated the previous MD left on 7/6/23, and he took over the role on 7/7/23. The I-MD stated sometime in July 2023, the air conditioning unit for Station 3 stopped working, which covered the North hallway of Station 3. The air conditioning unit was repaired 3 days later. The I-MD stated he did not perform room or hallway temperature checks during the three-day period of the air conditioner being down. The I-MD stated he has not performed any room temperature, water, or equipment checks since taking over the position. The I-MD stated he did not know it was part of his job duties as I-MD. On 8/4/23 at 2:20 P.M., room temperature checks were performed on 12 resident rooms in Stations 3, rooms 300-400. The highest temperature was 75.6 F., and the lowest temperature was 66.0 F. On 8/4/23 at 2:29 P.M., the Housekeeping Supervisor (Hskp-S) produced two black binders for room temperatures and hot water temperature checks. The binders were reviewed with the I-MD. Resident room temperature checks were performed for 19 room on July 2-July 6, 2023, and on July 9, 2023. No room temperature checks had been performed since 7/9/23. Resident room hot water temperature checks had not been conducted since December 30, 2022. There was also no documented evidence rooms were routinely inspected for call light or equipment failures. On 8/4/23 at 2:35 P.M., an interview was conducted with the Director of Nursing (DON). The DON (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: 056040 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 056040 B. Wing A. Building (X3) DATE SURVEY COMPLETED 08/09/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Escondido Post Acute 421 E Mission Ave Escondido, CA 92025 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)