Health inspection·July 8, 2025

F 0921 Level of Harm - Minimal harm or potential for actual harm Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public. Based on interview and record review, the facility failed to ensure a safe water system was in place for 44 residents when: Residents Affected - Few 1. The high temperature alarm (a mechanism to alert the staff when water temperatures exceed 120 degrees Fahrenheit [°F]) was not working. This failure had the potential to place the residents at risk of scalding from high temperature water. 2. The facility did not monitor hot water temperature for three out of 12 days for the month of June 2025. This failure had the potential to contribute to unsafe conditions without timely staff awareness. Findings: 1. On July 3, 2025, at 10:30 a.m., during an interview with the Maintenance Supervisor (MS). The MS stated, the facility's procedure was to monitor hot water temperatures daily. The MS stated, the high temperature alarm was used to ensure that water used by residents did not exceed 120°F. The MS further stated, the high temperature alarm at the nurses station was currently not working. On July 3, 2025, at 1:30 p.m., during an interview with the Administrator (ADM), the ADM stated to ensure resident safety, the MS was responsible for daily hot water monitoring and the high temperature alarm should be functioning. 2. A review of facility document titled, Daily Hot Water Temperature Record, Month of June 2025, indicated blank entries on the following dates: - June 1, 2025; - June 6, 2025; and - June 7, 2025. On July 3, 2025, at 10:30 a.m., during a concurrent interview and record review with the Maintenance Supervisor (MS), the MS stated no hot water temperature checks were performed on June 1, June 6, and June 7, 2025. The MS stated, it should have been checked, since it's a risk not knowing if the Page 1 of 2 555383 555383 07/08/2025 Blythe Post Acute LLC 285 West Chanslor Way Blythe, CA 92225

F 0921 water may be too hot, which may place residents at risk of burning themselves. Level of Harm - Minimal harm or potential for actual harm A review of facility's policy and procedure titled, Water Supply, revised November 2009, indicated, .Tap water in the facility shall be kept within a temperature range to prevent scalding of residents .Water heaters that service resident rooms, bathrooms, common areas, and tub/shower areas shall be set to temperatures of no less than 105°F and no more than 120°F . Maintenance staff shall conduct periodic tap water temperature checks and record the water temperatures in a safety log . Residents Affected - Few 555383 Page 2 of 2