Health inspection·June 30, 2025

F 0584 Level of Harm - Minimal harm or potential for actual harm Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely. Based on observation, interview, and record review, the facility failed to ensure the facility's South Side dining room was safe and clean as evidenced by: Residents Affected - Few 1. A wet and dirty plastic container, surrounded by flying insects (fruit flies), was underneath the sink while ten residents were inside the dining room eating lunch. 2. Next to the sink was a trash can surrounded by flying insects (flies). 3. The corner next to the sink was dirty and the walls had food particles adhered to the wall. 4. The sink had been nonfunctional since 6/1/25, was not covered and without any signage indicating the sink was not working. 5. The dining room floor has broken tiles in multiple areas. 6. The dining room had lots of dark stains especially around the corners. These facility failures exposed residents to risks of contamination, cross-contamination, illness, infection, and injuries from tripping and falling. Findings: 1. A review of the facility's policy and procedure titled Safe, Clean, Comfortable, and Home like Environment, dated 6/2023, indicates In accordance with Residents Rights, the facility will strive to provide a safe, clean .environment . Housekeeping and maintenance services will be provided as necessary to maintain a sanitary, orderly and comfortable environment . The facility will strive to maintain/enhance a safe, clean, comfortable environment by engaging in the following general practices and considerations: k. Promptly reporting issues to maintenance department, such as: issues with pest or vermin. During a concurrent tour of the South Side dining room and interview with the shift coordinator (SC) on 6/24/25 at 12:12 p.m., a wet and dirty plastic container was surrounded by flying insects (fruit flies) was observed underneath the sink while 10 residents were inside the dining room. Flies were Page 1 of 3 555163 555163 06/30/2025 Shoreline Care Center 5225 South J Street Oxnard, CA 93033

F 0584 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few flying in front of the residents' faces, but the residents were not coherent enough to notice the flies. The SC confirmed the observation and stated Yes, those are fruit flies. I did not see this (container with dirty plastic) before. This should not be here. However, the SC didn't remove the container. The container remained underneath the sink. During a concurrent observation of the container with the dirty plastic inside underneath the sink and interview with nursing supervisor (NS) on 6/24/25 at 12:45 p.m., the NS confirmed the observation and stated Yes, I see what you mean. The container is surrounded with the fruit flies and the residents are here eating. This is not good . 2. A review of the facility policy and procedure titled Resident Room Cleaning and Disinfection, dated 2021, indicates It is the policy of this facility to ensure the provision of routine cleaning and disinfection in order to provide a safe, sanitary environment and to prevent the development of transmission of infections to the extent possible. During a concurrent observation of the South Side dining room trash can, next to the sink, the trash can was surrounded by flying insects (flies) and interview with nursing supervisor (NS) on 6/24/25 at 12:45 p.m., the NS confirmed the corner was dirty and the trash can was surrounded by insects. NS stated, I agree the corner is dirty, there are fruit flies flying around the trash can and the residents are eating here now. 3. A review of the facility policy and procedure titled Resident Room Cleaning and Disinfection, dated 2021, indicates Consistent surface cleaning and disinfection will be conducted with a detailed focus on high touch areas . cleaning of walls . will be conducted when visibly soiled. During a concurrent observation of the South Side dining room corner and interview with the infection preventionist (IP) on 6/24/25 at 1:02 p.m., the dining room corner, next to the sink, and the corner's walls and floor were dirty. One wall had food particles adhered to the wall. Another wall had liquid stains like some liquid had been splashed, drops got on the wall and the liquid ran down the wall. The floor had dark stains, especially at the corners of the floor. The IP confirmed the observation and stated, I agree, this area (corner) is dirty. I heard about the flies around the bucket. I agree, this is an infection control problem. 4. According to the centers for disease control (CDC) 2024, in the section Construction, Renovation, Remediation, Repair, and Demolition indicates Implement infection-control measures relevant to construction ., maintenance ., and repair. Establish and maintain surveillance for airborne environmental disease (e.g., aspergillosis) as appropriate during .repair activities to ensure the health and safety of patients. During a concurrent observation of the South Side dining room sink and interview with the IP on 6/24/25 at 1:02 p.m., the cabinet door where the sink was mounted, had been removed, and an open pipe was exposed, and the sink had not been functional since 6/1/25. The IP indicated making rounds daily however had not seen the sink cabinet door missing, and was not aware the sink was not functioning. The area where the sink was located was not isolated or covered with a barrier to ensure the area was separated from the area where the residents were eating or congregating. The IP agreed and confirmed the sink area was not isolated or covered with a barrier to ensure the residents were not exposed to possible contaminants from the opened pipe, and repair activities. During a concurrent observation of the South Side dining room sink and interview with the director 555163 Page 2 of 3 555163 06/30/2025 Shoreline Care Center 5225 South J Street Oxnard, CA 93033

F 0584 Level of Harm - Minimal harm or potential for actual harm of maintenance, & housekeeping (DMH) on 6/24/25 at 12:26 p.m., the cabinet where the sink was mounted, door had been removed, an open pipe was exposed, and the sink had not been functional since 6/1/25. The DMH confirmed the sink being under repairs, the cabinet door was removed and the cabinet (including the pipe) left exposed or uncovered. Furthermore, agreed there was no signage indicating the sink was under repair. Residents Affected - Few 5. A review of the facility policy and procedure titled Safe, Clean, Comfortable, and Home like Environment, dated 6/2023, indicates .Maintenance services will be provided as necessary to maintain a sanitary, safe, orderly, and comfortable environment. ED, DON, and/or Maintenance/Housekeeping supervisor should conduct regular facility rounds and provide general monitoring/oversight of efforts to maintain a safe, clean, comfortable, environment. During a concurrent observation of the South Side dining room floor and interview with the DMH on 6/24/25 at 12:49 p.m., approximately 12 floor tiles were noted with cracks on tiles, some cracks were larger than others. One tile between the sink and the table where residents were eating was noted to have a large crack with pieces of the tile detached and floating around the area. The DMH reported not being aware of the cracked floor tiles and the staff had not notified him of the tiles needing repair. The DMH confirmed the numerous floor tiles being cracked, and agreed the residents might trip and fall with the tile between the sink and the table where residents seat to each. 6. A review of the facility policy and procedure titled Housekeeping Services, dated 2012, indicates Thorough scrubbing will be used for all environmental surfaces that are being cleaned in resident care areas. During a concurrent observation of the South Side dining room floor and interview with the infection preventionist (IP) on 6/24/25 at 1:02 p.m., the dining room floor was noted to have numerous areas with dark stains on the floor, especially around the corners of the dining room. The IP acknowledged the observation and stated, I agree the floor is dirty with stains. The IP was asked how often the floor was buffed and/or waxed. The IP stated No, I don't know . On 6/24/25 at 1:50 pm., the nursing supervisor (NS) was asked to provide logs or documentation indicating when the dining room floor was buffed/waxed. The NS requested such documentation from the DMC. The NS reported that according to the DMC, the facility does not have any documentation or logs indicating when or how often the dining room floor is being buffed or waxed. 555163 Page 3 of 3