Health inspection·May 22, 2025

F 0908 Keep all essential equipment working safely. Level of Harm - Minimal harm or potential for actual harm Based on observation, interview, and record review, the facility failed to perform timely maintenance on the ventilators (a breathing machine or breathing device that helps a resident breath when they cannot do it on their own) for two (2) of five (5) sampled residents (Residents 1 & 2). Residents Affected - Few This failure has the potential to cause malfunctions of the ventilators, which may place the health of clinically compromised Residents 1 and 2 at risk. Findings: During an observation on 5/22/2025, at 12:43 p.m. in the Subacute Unit, with the respiratory therapist (RT 1) and the Assistant Director of Nursing (ADON), it was noted that the two ventilators currently in use for Resident 1 and Resident 2 were overdue for service maintenance. The maintenance sticker observed for both ventilators indicated the following: a. For Resident 1 - preventative maintenance was due on June 17, 2023. b. For Resident 2 - preventative maintenance was due on September 20, 2024. The ADON and RT 1 acknowledged that preventive maintenance for both ventilators is already past due. During a concurrent interview and review of the policy and procedure (P&P) titled Maintenance Service, on 5/22/2025, at 1:31 p.m. with the ADON, the ADON was inquired about the procedures for scheduling maintenance on ventilators. ADON stated respiratory therapist informs her when maintenance is required for a ventilator, and she will then contact the outside company for scheduling. A continued review of the policy and procedure titled Maintenance Service, dated December 2009, with the ADON, the P&P indicated .Providing routinely scheduled maintenance service of equipment according manufacturer ' s guidelines or other facility needs that may become necessary or appropriate . When the ADON was asked if this policy was being followed, the ADON replied, No. During a concurrent interview and record review on 5/22/2025, at 1:49 p.m. with the Respiratory Therapist (RT 2), RT 2 stated the RT in charge of the department is responsible to inform the ADON and Director of Nursing (DON) about any ventilator that requires servicing or are nearing their service due date. The ADON or DON will then contact an outside company to arrange for the servicing of those ventilators. The P&P titled Maintenance Service, dated December 2009, was also reviewed with RT 2. RT 2 was asked if this policy was being followed, RT 2 replied, No. (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: 555435 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 555435 B. Wing A. Building (X3) DATE SURVEY COMPLETED 05/22/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE The Canyons Post-Acute 1350 Reche Canyon Rd Colton, CA 92324 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)