Health inspection·July 23, 2024

F 0814 Dispose of garbage and refuse properly. Level of Harm - Minimal harm or potential for actual harm Based on observation, interview, and record review, the facility failed to dispose of garbage and refuse properly for a census of 92 when the garbage dumpster was found with garbage bags rising out of the top with the lid not properly closed. Residents Affected - Some This failure had the potential to attract pests to the facility. Findings: During an observation on 7/23/24 at 2:17 p.m. at the garbage disposal area outside the facility, six trash bins and one biohazard bin were observed. One of the trash bins was observed with black trash bags rising out of the bin and the lid was not fully closed. During a concurrent observation and interview on 7/23/24 at 2:36 p.m. with Housekeeping Staff (HS) inside the laundry room, HS was observed holding a fly swatter and stated, There are a lot of flies here, it could be maybe from the garbage out there. During an interview on 7/23/24 at 3:03 p.m. with the Administrator (ADM), when a picture of the trash bin was shown to him, the ADM confirmed the trash bin was not properly closed and bag was propped open, and contacted the Maintenance Director (MTD). The ADM stated, There were residents leaving the door opened .Flies are coming from the outside .Spreading of infection and diseases is the biggest risks for having those things in the facility. During an interview on 7/23/24 at 4:08 p.m. with the MTD, the MTD confirmed the trash bin was not properly closed. During a review of the US FDA 2022 Food Code, section 5-501.15, titled, Outside Receptacles, 1/18/23 version, indicated, (A) Receptacles and waste handling units for REFUSE, recyclables, and returnables used with materials containing FOOD residue and used outside the FOOD ESTABLISHMENT shall be designed and constructed to have tight-fitting lids, doors, or covers. During a review of the facility's policy and procedure (P&P) titled, Pest Control, revised 4/2008, the P&P indicated, 5. Garbage and trash are not permitted to accumulate and are removed from the facility daily. During a review of the facility's P&P titled Garbage and Refuse Disposal, revised 12/2022, the P&P indicated, 2. All garbage and refuse containers are provided with lids or covers and must be kept covered when stored or not in continuous use .4. Garbage and refuse containing food wastes will be stored in a manner that prevent pests .6. Outside dumpsters provided by garbage pickup services will be Page 1 of 4 056243 056243 07/23/2024 Western Slope Health Center 3280 Washington Street Placerville, CA 95667

F 0814 kept closed. Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some 056243 Page 2 of 4 056243 07/23/2024 Western Slope Health Center 3280 Washington Street Placerville, CA 95667

F 0925 Make sure there is a pest control program to prevent/deal with mice, insects, or other pests. Level of Harm - Minimal harm or potential for actual harm Based on observation, interview, and record review, the facility failed to maintain an effective pest control program for a census of 92 when flies were observed in hallways and in Resident 1's room. Residents Affected - Some This failure had the potential to spread infections and diseases among the residents, staff and visitors. Findings: During a concurrent observation and interview on 7/23/24 at 1:39 p.m. with Resident 1 in his room, flies were observed moving around the room, on Resident 1's blanket, and on the curtains. Resident 1 stated, Everybody complains about the flies, and I complained too .They put a blanket on me, so I don't feel the flies. During an interview on 7/23/24 at 1:47 p.m. with Licensed Nurse (LN 1), LN 1 stated, I know you noticed the flies, the rooms are so smelly .we have lights outside the rooms, but they are not effective. During a concurrent observation and interview on 7/23/24 at 2:02 p.m. with LN 2 in Resident 1's room, LN 2 confirmed the presence of flies inside the room, on Resident 1's blanket and on the curtains. LN 2 stated, We have infestation of flies here, they put the lights but it's not effective. During a concurrent observation and interview on 7/23/24 at 2:06 p.m. with LN 3 in the hallway, LN 3 was observed clearing away flies using hands while being interviewed. LN 3 stated, I have seen a lot of flies, they have machine lights, but residents open the door frequently .I should add it in the maintenance log, there's a lot of flies here .it's an infection control issue and dignity issue. During a concurrent observation and interview on 7/23/24 at 2:36 p.m. with Housekeeping Staff (HS) inside the laundry room, HS was observed holding a fly swatter and stated, There are a lot of flies here, it could be maybe from the garbage out there. During an interview on 7/23/24 at 2:44 p.m. with the Maintenance Director (MTD), the MTD stated, We had a lot of trouble with flies, it's because of a lot of traffic .They come from outside . During an interview on 7/23/24 at 2:53 p.m. with the Director of Nursing (DON), the DON stated, I did notice flies around the facility .flies can get in food, everywhere, that's a huge infection control issue. When pictures of flies were shown, the DON stated, That's not good, we should do something about it. During an interview on 7/23/24 at 3:03 p.m. with the Administrator (ADM), the ADM stated, There were residents leaving the door opened .flies are coming from the outside .spreading of infection and diseases are the biggest risks for having those things in the facility. During a review of the facility's policy and procedure (P&P) titled, Physical Environment and Accommodations Policy, undated, the P&P indicated, (a) The facility shall be clean, safe, sanitary and in good repair at all times. Maintenance shall include provision of maintenance services and procedures for the safety and well-being of residents, employees and visitors. 056243 Page 3 of 4 056243 07/23/2024 Western Slope Health Center 3280 Washington Street Placerville, CA 95667

F 0925 Level of Harm - Minimal harm or potential for actual harm During a review of the facility's P&P titled Pest Control, revised 4/2008, the P&P indicated, Our facility shall maintain an effective pest control program .1. This facility maintains an on-going pest control program to ensure that the building is kept free of insects and rodents. Residents Affected - Some 056243 Page 4 of 4