Health inspection·May 8, 2023

F 0550 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on interview and record review, the facility failed to ensure one resident (Resident 1) was treated with dignity and respect when Certified Nursing Assistant (CNA) 1 put her hand towards her face. This had the potential to result in a decline in her physical, emotional and psychosocial well being. Findings: On 3/10/23 at 3:40 pm, the California Department of Public Health received a report (via phone) that Resident 1 alleged CNA 1 called her disrespectful and put her hand up to her face. A follow up written report was faxed on 3/10/23 at 5:06 pm. A review of Resident 1's record indicated she was admitted on [DATE], with diagnoses that included a stroke, morbid (severe) obesity, hemiplegia (inability to move one side of the body), diabetes, and anxiety disorder. During an interview on 3/16/23 at 11:20 am, Resident 1 stated CNA 1 was across the hall helping another resident and she waved at her to get her attention because she needed to go to the bathroom. She said when CNA 1 came in the room she told me not to disrespect her that way then she waved her hand in my face. She said CNA 1 did not touch her face but her hand was right up in her face and she told CNA 1 to stop and started yelling for the nurse. Further review of the record included an Interdisciplinary Team (IDT-group of healthcare disciplines that meet to discuss resident care needs) note, dated 3/14/23, which indicated on 3/10/23, Resident 1 reported a verbal altercation with CNA 1. The night shift nurse had over heard the altercation and removed CNA 1 from the room. Per policy, CNA 1 would receive appropriate disciplinary action and re-training. During an interview on 4/27/23 at 12:45 pm, CNA 1 confirmed she wrote a statement on 3/9/23 at 11:48 pm. She said she asked Resident 1 to try not to wave and holler. CNA 1 said she stuck her hand out and said stop and did not realize her hand was in Resident 1's face who then swatted her hand away. During an interview on 3/20/23 at 1:15 pm, Licensed Nurse (LN) 1 said she heard Resident 1 yelling so she went into the resident's room. Resident 1 said CNA 1 pulled on her and put her hand toward her face. LN 1 said she asked CNA 1 to leave the room and had another CNA take over that room. The investigative report report provided by the adminstrator concluded there was not abuse but CNA 1 was unprofessional. (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: 555356 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 555356 B. Wing A. Building (X3) DATE SURVEY COMPLETED 05/08/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Quartz Hill Post Acute 2120 Benton Drive Redding, CA 96003 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)