Health inspection·July 26, 2023

F 0921 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public. Based on observation, record review, interview, and facility policy review, the facility failed to ensure the physical environment was maintained in a clean and sanitary manner. This affected three residents (#28, #31 and #52) and had the potential to affect additional residents residing on the Over the Falls, Sycamore, and Pier units. The facility census was 56. Findings include: On 07/26/23 environmental observations revealed the following: a. On 07/26/23 at 9:30 A.M. observation of Resident #28 and #52's room revealed the floor was dirty and sticky with visible track marks from Resident #52's power wheelchair. Observation revealed dirty linen, clothes, trash, food, and debris on the floor, on the resident's bed, under the bed, and at the entrance of the doorway. Interview on 07/26/23 at 9:35 A.M. with Staff Member (SM) #800 confirmed the condition of Resident #28 and #52's room as noted above. During the interview, SM #800 revealed the dirt on the floor came from the wheels of Resident #52 wheelchair. SM #800 verified the open boxes of cereal had been spilled onto the floor, old food boxes and food had likely been on the floor for days, and the presence of dirty and soiled linen piled on the bed and under the bed. Resident #52 bed had a small spot clear of debris for sleeping. b. On 07/26/23 at 9:45 A.M. observation of the second floor shower room located on the Sycamore unit, revealed dirty linen with visible brown stains on the washcloths and brown substance smeared on the floor, an open bag of dirty linen spilling onto the floor, and trash and debris. This shower room was noted to be used for resident showers. Interview on 07/26/23 at 9:45 A.M. with SM #801 confirmed the above findings of the shower room. SM #801 also indicated staff had assigned rooms to clean, but due to how staff were scheduled, some rooms/areas had not been cleaned for the prior two days. c. On 07/26/23 at 9:51 A.M. observation of Resident #31's room, located on the Over the Falls unit, revealed the floor was dirty and sticky with open and crushed grape jelly packets into the floor, and a soiled brief on the floor adjacent to the bed. Interview on 07/26/23 at 9:52 A.M. with SM #802 confirmed the condition of Resident #31's room as noted above. Page 1 of 2 365594 365594 07/26/2023 Gardens of Euclid Beach 16101 Euclid Beach Blvd Cleveland, OH 44110

F 0921 Level of Harm - Minimal harm or potential for actual harm d. Observation on 07/26/23 at 10:00 A.M. of the carpet located in the hallway of the second-floor unit, The Pier, revealed the carpet was dirty with various stains. There were multiple stains throughout the unit including one big black spot and multiple other spots that varied in color. Interview on 07/26/23 at 10:02 A.M. with SM #801 confirmed the carpet condition located on The Pier unit. Residents Affected - Some Review of the resident council meeting minutes from the meetings held 04/26/23, 05/30/23, 06/27/23, and 07/25/23 revealed residents present generated concern forms for the maintenance, housekeeping, and laundry departments. Review of the concern log dated April, May, and June 2023 revealed a concern was voiced during the resident council meeting dated 04/26/23 that resident rooms, dining room, and restorative were not cleaned. Review of the facility undated document titled Cycle Cleaning revealed the facility had a policy in place to identify the functional areas in the facility that require cleaning and to use cycle cleaning schedules to outline the frequencies and maintain regularly scheduled environmental service tasks. This deficiency represents non-compliance investigated under Complaint Number OH00144809. This deficiency is also an example of continued non-compliance to the survey dated 04/06/23 and 06/22/23. 365594 Page 2 of 2