Health inspection·January 3, 2025

F 0602 Protect each resident from the wrongful use of the resident's belongings or money. 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 that one of three sampled residents (Resident 1) was free from financial exploitation (taking advantage of a resident for personal gain, through the use of manipulation, intimidation, threats, or coercion) by a staff member. Residents Affected - Few This failure had the potential to cause significant emotional and financial harm to Resident 1 and had the potential to place other residents at risk of abuse, neglect and exploitation. Findings: During a review of Resident 1 ' s Face Sheet (a document containing clinical and demographic information), it indicated Resident 1 was admitted to the facility on [DATE], with diagnoses which included depression (feeling sad and low motivation), anxiety (feeling restless), and colonostomy status (an opening in the abdominal wall to allow waste to exit the body through the colon). During a review of the State of California Form 341 REPORT OF SUSPECTED DEPENDENT ADULT/ELDER ABUSE, dated December 5, 2024, it indicated Resident 1 came into activities dining room [ROOM NUMBER]/4 (December 4, 2024) to paint her nails well we were seating down she asked me how my thanksgiving was I told her that it was nice but quiet, she then stating saying if I ever need anything to let her know, that she had 2,300 ($ 2,300) on her card and was able to help Employee 1 because she was able to make Thanksgiving happen to year . During an interview with Resident 1, on December 6, 2024, at 9:35 AM, Resident 1 stated that three days before Thanksgiving, Employee 1 told her she needed items for her family's Thanksgiving dinner. Resident 1 stated she voluntarily gave Employee 1 her EBT (Electronic Benefits Transfer- used in California for the delivery, redemption, and reconciliation of issued public assistance benefits) card and PIN with the condition that the total purchase does not exceed $600.00. Resident 1 further stated Employee 1 copied her EBT card number and PIN onto her phone and used it to make purchases through an online grocery delivery application. Resident 1 further stated that most items purchased were kept by Employee 1. During a concurrent phone interview and record review with the Administrator (Admin), on December 6, 2024, at 10:40 AM, the Receipts print out [name of supermarket] dated December 4, 2024, at 8:21 PM was reviewed. The receipts indicated two transactions as follows: a. November 17, 2024, a total purchase of $436.51. b. November 21, 2024, a total purchase of $225.70. (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: 555089 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 555089 B. Wing A. Building (X3) DATE SURVEY COMPLETED 01/03/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Meadows Ridge Care Center 1700 E Washington St Colton, CA 92324 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)