F 0583
Keep residents' personal and medical records private and confidential.
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 the right to personal privacy for one of
five sampled residents (Resident 1), when patient care was provided to Resident 1 without privacy being
provided.
Residents Affected - Few
This failure had the potential to cause distress and embarassment for Resident 1 by having other residents
watching and knowing her
medical problems.
Findings:
A review of the facility's, policy titled Restorative Nursing Services, dated July 2017 indicated, 5. Restorative
goals may include, but are note limited to supporting and assisting the resident in: c. Maintaining his/her
dignity .
A review of Resident 1's admission Record , indicated Resident 1 was admitted to the facility on [DATE],
with diagnoses including dementia (loss of memory and ability to make sound decisions), cognitive
communication deficit (an impairment in thought organization, attention, memory, problem solving, and
safety awareness), and diabetes (high sugar in the blood).
During an observation on 1/17/25 at 12:08 PM in the dining room, Licensed Nurse A (LN A) entered the
resident's dining room and checked Resident 1 ' s blood sugar by pricking her finger and using a
glucometer (a devise used to measure blood sugar level) at the dining table, while other residents were at
the table.
During an observation on 1/17/25 at 12:13 PM in the dining room, LN A entered the dining room and gave
Resident 1 an insulin (a biological product to treat blood sugar disease) shot at the dining table, with other
residents at the table.
During an interview on 1/23/25 at 11:32 AM, with the Infection Control Nurse (IP), the IP confirmed that
checking blood sugar and giving insulin in the dining room did not meet the facility ' s standard practices for
ensuring patient privacy and dignity.
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 3
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
01/23/2025
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)
F 0812
Level of Harm - Minimal harm
or potential for actual harm
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve
food in accordance with professional standards.
Based on observation, interview, and record review, the facility failed to ensure food safety and sanitation
requirements were met in accordance with professional standards for food service safety when:
Residents Affected - Many
1. Dietary Manager (DM) was not wearing a hair net in the kitchen.
2. Food was not properly covered, labeled and dated.
These failures created a potential risk for exposure to foodborne illnesses in a medically vulnerable
population of 110 residents who received food prepared in the kitchen.
Findings:
1. During review of facility Policy & Procedure (P&P) titled Kitchen Cleaning Policy and Procedures,
4/20/23, the P&P indicated food employees shall wear hair restraints such has hair nets.
During concurrent observation and interview with the DM on 1/16/25 at 10:20 AM, the DM was not wearing
a hair net in the kitchen. The DM confirmed that she should be wearing a hair net while in the kitchen.
2. During review of facility Policy & Procedure (P&P) titled, Procedure for Refrigerated Storage, no date, the
P&P indicated food items will be covered, labeled, and dated.
During concurrent observation and interview with DM on 1/16/25 at 10:23 AM, in the walk-in refrigerator the
DM confirmed that there were two pans containing cranberry bars which were not covered, labeled, and
dated.
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
555356
If continuation sheet
Page 2 of 3
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
01/23/2025
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)
F 0880
Provide and implement an infection prevention and control program.
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 infection control measures were
adhered to when Licensed Nurse A (LN A) provided patient care in the dining room without following
infection control policy and procedures. These failures had the potential to cause the spread of infection and
disease to other residents in the dining room.
Residents Affected - Few
Findings:
A review of the facility's, policy titled, Infection Prevention and Control Program dated August 2016
indicated a. Important facets of infection prevention include: (2) instituting measures to avoid complications
or dissemination (spread) and .adhere to proper techniques and procedures.
A review of Resident 1's admission Record , indicated Resident 1 was admitted to the facility on [DATE],
with diagnoses including dementia (loss of memory and ability to make sound decisions), cognitive
communication deficit (an impairment in thought organization, attention, memory, problem solving, and
safety awareness), diabetes (high sugar in the blood).
During an observation on 1/17/25 at 12:08 PM, in the dining room, LN A entered the dining room and
checked Resident 1 ' s blood sugar by pricking her finger with a lancet (a small, sharp needle used to prick
the skin to obtain a blood sample) and using a glucometer (a devise used to measure blood sugar level) at
the table.
During an observation on 1/17/25 at 12:13 PM, in the dining room, LN A entered the dining room and gave
Resident 1 insulin (a biological product to treat blood sugar disease) using an insulin syringe (a short thin
needle used to inject insulin into the body) at the table.
During an interview on 1/23/25 at 11:32 AM, with the Infection Control Nurse (IP), the IP confirmed that
checking blood sugar and giving insulin in the dining room did not meet the facility ' s infection control policy
or standard practices.
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
555356
If continuation sheet
Page 3 of 3