Health inspection·January 6, 2025

F 0880 Provide and implement an infection prevention and control program. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interview, and record review, the facility failed to ensure infection control practices were implemented in four out of six shower rooms when: Residents Affected - Some 1. Shower room [ROOM NUMBER] had a brown substance on the floor; 2. Shower room [ROOM NUMBER] had cotton swabs and a shaver cover on the floor drain; 3. Shower room [ROOM NUMBER] had a used white towel on the shower handlebar, and 4. Shower room [ROOM NUMBER] had a used shaver, toilet tissue, wheelchair footrests, and socks in the bathtub. These failures could result in the spread of infection and cross-contamination that could affect staff, visitors, and the 194 residents who reside in the facility. Findings: 1. During a concurrent observation and interview on 12/4/2024 at 10:12 a.m., with the Maintenance Director (MD), there was a brown substance on the floor in shower room [ROOM NUMBER]. The MD confirmed the brown substance was feces (bodily waste discharged from the bowels after food has been digested). The MD further stated staff should clean and disinfect after they use the shower rooms. 2. During a concurrent observation and interview on 12/4/2024 at 10:16 a.m., with the MD, there were cotton swabs and a shaver cover on the floor drain in shower room [ROOM NUMBER]. The MD confirmed this observation and stated staff should throw away these items after they are used on the residents. 3. During a concurrent observation and interview on 12/4/2024 at 10:20 a.m., with the MD, there was a used white towel on the shower handlebar in shower room [ROOM NUMBER]. The MD confirmed this observation and stated the shower room should be left clean for the next resident to use. 4. During a concurrent observation and interview on 12/4/2024 at 10:22 a.m., with the MD, there was a used shaver, toilet tissue, wheelchair footrests, and socks in the bathtub in shower room [ROOM NUMBER]. The MD confirmed this observation and stated items should be removed and the shower room should be left clean for the next resident to use. During an interview with the Director of Nursing (DON) on 12/4/24 at 2:48 p.m., the DON Page 1 of 2 056082 056082 01/06/2025 Canyon Springs Post-Acute 180 North Jackson Avenue San Jose, CA 95116

F 0880 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some acknowledged the above observations and stated the shower rooms should not be left dirty and should be cleaned after use for the next resident to prevent infection. During a review of the facility's policy and procedure (P&P) titled, Cleaning and Disinfection of Environmental Surfaces, revised 2022, the P&P indicated, Environmental surfaces will be cleaned and disinfected according to current CDC recommendations for disinfection of healthcare facilities and the OSHA bloodborne Pathogens Standards. During a review of the facility's policy and procedure (P&P) titled, Bathrooms, revised 2020, the P&P indicated, 2. Bathroom, including showers, sink, commodes are cleaned and disinfected daily in accordance with our established procedures. During a review of the facility's policy and procedure (P&P) titled, Policies and Practices-Infection Control, revised 2018, the P&P indicated, This facility's infection control policies and practices are intended to facilitate maintaining a safe, sanitary and comfortable environment and to help prevent and manage transmission of disease and infections. 2. the objective of our infection control policies and practices are to: b. Maintain a safe, sanitary, and comfortable environment for personnel, residents, visitors, and the general public. 056082 Page 2 of 2