Inspection·December 13, 2024

F 0837 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Establish a governing body that is legally responsible for establishing and implementing policies for managing and operating the facility and appoints a properly licensed administrator responsible for managing the facility. Based on interview and record review, the facility failed to follow its policy and procedure when staff in-service training records were incomplete. This failure resulted in incomplete training records and the potential for staff to be inadequately trained to care for residents. Findings: During a concurrent interview and record review on 12/13/24 at 12:44 p.m. with Director of Staff Development (DSD), three in-service training logs were reviewed. In-service training log one had three staff signatures and in-service training log two had one staff signature, both training logs did not contain a date, start time, end time, in-service course title, instructor name and instructor signature. In-service training log three contained the signature of five staff but did not contain the start time, end time, instructor name and instructor signature. DSD stated the in-service training logs must contain the date, the time the in-service started and ended, the topic and name and signature of the person giving the lesson to be complete. During a concurrent interview and record review on 12/13/24 at 1:24 p.m. with Director of Nursing (DON), DON reviewed the in-service training logs. DON stated the in-service training logs were not complete. During a review of the facility's policy and procedure (P&P) titled, Recordkeeping, Staff Development dated 2/08, the P&P indicated, An individual training record for each employee will be maintained. This record will be filed in the employee's personnel record or training record. Training records include, as a minimum.date of each training class attended.subject of class.class length.instructor of each class.individual training records are completed by the in-service training coordinator and/or department supervisor. 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: 555125 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 555125 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/13/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Linwood Meadows Care Center 4444 West Meadow Visalia, CA 93277 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)