Health inspection·April 22, 2021

F 0880 Provide and implement an infection prevention and control program. Level of Harm - Minimal harm or potential for actual harm Based on observation, interview, and record review, the facility failed to implement their infection prevention policy and procedures when: Residents Affected - Some 1. CNA 1 did not perform hand hygiene when donning and doffing gloves. 2. CNA 2 improperly transported soiled linens. 3. RNA 1 did not perform hand hygiene when assisting multiple residents and handling food. These failures had the potential to spread infection among facility residents. Findings: 1. During a concurrent observation and interview on 4/21/21, at 9:27 a.m., with Certified Nursing Assistant (CNA) 1, CNA 1 was observed transporting Resident 22 via wheelchair into their room. CNA 1 donned gloves and assisted Resident 22 from wheelchair into bed. CNA 1 removed gloves and pushed wheelchair out of the room, into outside storage area. CNA 1 stated hand hygiene needs to be performed, Every time we touch the resident and after. CNA 1 further states, I just forgot to perform hand hygiene when assisting residents and before donning and doffing gloves. During a review of the facility's policy and procedure (P&P) titled, Handwashing/Hand Hygiene, dated 10/2020, the P&P indicated, Perform hand hygiene before applying non-sterile gloves and after removing gloves. P&P further indicates, The use of gloves does not replace hand washing/hand hygiene. Integration of glove use along with routine hand hygiene is recognized as the best practice for preventing healthcare-associated infections. 2. During a concurrent observation and interview on 4/21/21, at 9:47 a.m., with Certified Nursing Assistant (CNA) 2, CNA 2 was observed coming out of a resident room carrying soiled linens with bare hands and placing them in soiled linen bin at end of hallway. CNA 2 stated she bundled soiled linens so the outside where she touched was clean. During an interview on 4/22/21, at 11:40 a.m., with Director of Nursing (DON), DON stated staff are to place soiled linens in a bag while in residents' room, then bring bag to soiled linen bin in hallway. During a review of the facility's policy and procedure (P&P) titled, Laundry and Bedding, Soiled, dated 10/2020, the P&P indicated, Place contaminated laundry in a bag or container at the location where it is used and do not sort or rinse at the location of use. Page 1 of 4 555461 555461 04/22/2021 Marina Garden Nursing Center 3201 Fernside Blvd. Alameda, CA 94501

F 0880 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some 3. During a concurrent observation and interview on 4/21/21, at 10:19 a.m., with Restorative Nursing Assistant (RNA) 1, RNA 1 brought a pudding cup from snack cart into Resident 76's room, opened pudding cup and fed Resident 76. RNA 1 left the room, pushed snack cart to another room, poured hot water and juice, opened packet of crackers and gave them to Resident 17. RNA 1 left the room and assisted Resident 19 from hallway into bed. RNA 1 poured juice, opened packet of crackers and gave the the crackers to Resident 19. RNA 1 stated she keeps a bottle of hand sanitizer in her pocket, but stated, she forgot, when asked about performing hand hygiene between care of multiple residents and handling food. During a review of the facility's policy and procedure (P&P) titled, Handwashing/Hand Hygiene, dated 10/2020, the P&P indicated, Use an alcohol-based hand rub containing at least 62% alcohol; or, alternatively, soap (antimicrobial or non-antimicrobial) and water for the following situations: before and after direct contact with residents, before and after eating or handling food, before and after assisting a resident with meals. 555461 Page 2 of 4 555461 04/22/2021 Marina Garden Nursing Center 3201 Fernside Blvd. Alameda, CA 94501

F 0912 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some Provide rooms that are at least 80 square feet per resident in multiple rooms and 100 square feet for single resident rooms. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation and interview, the facility had 15 resident (Rt) rooms (Rooms 1, 2, 3, 4, 5, 6, 7, 8, 10, 11, 12, 14, 15, 16, and 17) with multiple beds that provided less than 80 square feet (sq. ft) per resident who occupied these rooms. This deficient practice had the potential to result in inadequate space for the delivery of care to each of the residents in each room, or for storage of the residents belongings. Findings: During an observation on 4/19/21, at 9:42 a.m., the following rooms and corresponding square footage (sq. ft) per bed were identified. Room Activity Room Size Floor Area (sq. ft. per Resident) 1 Rt room [ROOM NUMBER]'3x 11'4.5 69.67 sq. ft/bed 2 Rt room [ROOM NUMBER]'4x 12'4.5 70.13 sq. ft/bed 3 Rt room [ROOM NUMBER]'2x 11'5 69.45 sq. ft/bed 4 Rt room [ROOM NUMBER]'3x 12'5 69.84 sq. ft/bed 5 Rt room [ROOM NUMBER]'6x 12'3 70.44 sq. ft/bed 6 Rt room [ROOM NUMBER]'5x 11'6 71.40 sq. ft/bed 7 Rt room [ROOM NUMBER]'6x 12'2.5 70.20 sq. ft/bed 8 Rt room [ROOM NUMBER]'3x 11'5.5 70.18 sq. ft/bed 10 Rt room [ROOM NUMBER]'5x 11'3.5 70.10 sq. ft/bed 11 Rt room [ROOM NUMBER]'2.5x 11'5.5 69.94 sq. ft/bed 12 Rt room [ROOM NUMBER]'5 x 11'1.5 69.07 sq. ft/bed 14 Rt room [ROOM NUMBER]'2.5x 11'5.5 69.94 sq. ft/bed 15 Rt room [ROOM NUMBER]'5.5x 11'3.5 70.34 sq. ft/bed 16 Rt room [ROOM NUMBER]'6x 12'2.5 70.20 sq. ft/bed 17 Rt room [ROOM NUMBER]'5 x 11'6 77.67 sq. ft/bed During random observations of care and services from 4/19/21 to 4/22/21, there was sufficient space 555461 Page 3 of 4 555461 04/22/2021 Marina Garden Nursing Center 3201 Fernside Blvd. Alameda, CA 94501

F 0912 Level of Harm - Minimal harm or potential for actual harm for the provision of care for the residents in all rooms. There was no heavy equipment kept in the rooms that might interfere with residents care and each resident had adequate personal space and privacy. There were no complaints from the residents regarding insufficient space for their belongings. There were no negative consequences attributed to the decreased space and/or safety concerns in the 15 rooms. Granting of room waiver is recommended. Residents Affected - Some 555461 Page 4 of 4