Health inspection·April 9, 2024

F 0600 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. Based on observation, interview, and record review, the facility failed to ensure one of two sampled residents (Resident 1 and Resident 2) were free from verbal abuse. This failure resulted in Activity Assistant (AA) verbally abused Resident 1 and Resident 2 during activities and had the potential to cause emotional harm. Findings: During a concurrent observation and interview on 4/9/24 at 4:03 p.m. with Resident 1 in the dining room, Resident 1 had his eyebrows folded and moved his head side to side (right to left) and stated, I was in shock. He [AA] yelled and cursed at him and Resident 2 during activities on 4/7/24. Resident 1 stated AA lead activities at the facility and activities were supposed to be fun and it wasn't that day [4/7/24]. During a review of Resident 1's History and Physical (H&P), dated 10/24/23, the H&P indicated, Resident 1 had the mental capacity to make medical decisions. During a review of Resident 1's Weekly Summary Note (WSN), dated 4/25/24, the WSN indicated, Resident is alert and oriented, able to verbalize needs. During a concurrent observation and interview on 4/9/24 at 4:05 p.m. with Resident 2 in the dining room, Resident 2 had watery eyes with raised eyebrows and stated during activities on 4/7/24, AA picked up my popcorn and threw it at me. Resident 2 stated AA yelled at her and I was terrified and I am afraid he [AA] will come back. During a review of Resident 2's MDS, dated 1/21/24, the MDS indicated, Section C- Cognitive Patterns. C0500. BIMS Summary Score 13 [score 13 is cognitively intact]. During a review of Resident 2's PN, dated 4/7/24, the PN indicated Resident 2 and Resident 1 were both yelled at during activities by AA, Resident 2 was scared and her popcorn was thrown on the floor. During an interview on 4/9/24 at 4:10 p.m. with Administrator, Administrator stated on 4/7/24, Receptionist called him and informed him AA yelled at Resident 1 and Resident 2 during activities. Administrator stated he was the facility abuse coordinator, and the expectation was all staff Cannot yell and mistreat them [residents]. Administrator stated AA was verbally abusive during activities to Resident 1 and Resident 2. Administrator stated, shouldn't have happened and verbal abuse is not tolerated. Page 1 of 2 555170 555170 04/09/2024 Arvin Post Acute 323 Campus Drive Arvin, CA 93203

F 0600 Level of Harm - Minimal harm or potential for actual harm During an interview on 4/9/24 at 6:18 p.m. with AA, AA stated on 4/7/24 at approximately 11 a.m., during activities I yelled at them [Resident 1 and Resident 2] and lost my cool. AA stated he raised his arms up at Resident 2 and I told her [Resident 2] if you don't want to be here then leave. AA stated, Yeah I might of said a few curse words to Resident 1 and Resident 2. AA stated, I know that I should not have done what I did, it was verbal abuse. AA stated he should not yell at the residents. Residents Affected - Few During a concurrent interview and record review on 4/9/24 at 7 p.m. with Receptionist, Receptionist written incident statement (WIS) dated 4/7/24 was reviewed. The WIS indicated, [AA] threw [Resident 2's] popcorn from the table to the floor. Receptionist stated AA yelled at Resident 1 and Resident 2 Get the Fuck out of the dining room you guys are getting me upset. Receptionist stated, He [AA] was screaming at them [Resident 1 and Resident 2] very bad. Receptionist stated the facility staff are expected to treat them [residents] with respect and the same way you want to be treated. During a review of the facility's policy and procedure (P&P) titled, Abuse Prevention, dated 12/31/15, the P&P indicated, Each resident has the right to be free from verbal, sexual, physical, and mental abuse. Residents must not be subjected to abuse by anyone, including, but not limited to, facility staff. Purpose To ensure the resident's rights are protected. SECTION 2: DEFINITIONS. VERBAL ABUSE: Verbal abuse is defined as the use of oral, written or gestured language that willfully includes disparaging and derogatory terms to residents or their families, or within their hearing distance, regardless of their age, ability to comprehend or disability. 555170 Page 2 of 2