Inspection·July 18, 2025

F 0600 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on interview and record review the facility failed to ensure one of three sampled residents (Resident 1) was free from abuse as stated in the facility's policy and procedure (P&P) when a nursing student witnessed Certified Nurse Assistant (CNA 1) used verbally abusive words to Resident 1. This failure had the potential to result in Resident 1 having emotional harm such as feeling unsafe, loss of trust, and can lead to behavioral issues.Findings: An unannounced visit was conducted to the facility on July 18, 2025, for investigation of a facility reported incident of abuse. During a review of Resident 1's Face Sheet (FS- a document containing patient demographics) the FS indicated, Resident 1 was admitted to the facility on [DATE]. A review of Resident 1's Progress Note - Physician (PN- A document containing the progression of the residents and past medical history), dated July 16, 2025, indicated Resident 1 has a history of extreme prematurity (baby born before 28 weeks), short gut (a condition that occurs when the small intestine is damaged or shortened) and is gastrostomy tube (G tube-a tube inserted through stomach to provide nutrition, food, and medication) dependent (someone who relies on G tube). During an interview on July 18, 2025, at 12:25 PM, with Resident 2's mother, Resident 2's mother stated that she has seen CNA 1 be very rough when turning Resident 2. Resident 2's mother further stated that she has brought it up to management before and management stated they would talk to CNA 1. During an interview on July 18, 2025, at 12:45 PM, with CNA 2, CNA 2 stated that she has seen CNA 1 give an attitude to other staff members. During an interview on July 18, 2025, at 1:40 PM, with Resident 1's father, Resident 1's father stated, that the facility called him to let him know that one of the staff members was telling his son Bad things and that they sent that staff member home. Resident 1's father further stated, he is concerned for his son's safety. A review of nursing student's statement Notes, dated July 8, 2025, indicated on July 8, 2025, I went into Resident 1's room with my assigned nurse and witnessed Resident 1 run away from the CNA 1 and grab my nurse's leg. CNA 1 said you better get back in that damn bed and when the CNA 1 checked on another patient, the CNA 1 again said get back in the f****ng bed.During a concurrent interview and record review, on July 18, 2025, at 2:44 PM, with the HR Director (HRD), the employee separation report (document used for termination of an employee), dated July 16, 2025, was reviewed. The employee separation report indicated, [CNA 1] was witnessed verbally abusing a patient in the subacute department [provides level of care between hospital care and skilled nursing care] which is called for immediate termination. The HRD stated that CNA 1 did not sign the document. A review of notice of disciplinary action (document that contains unsatisfactory performance given to staff for them to sign), dated May 27, 2025, in CNA 1's file, indicated there must be immediate improvement in: polite and professional interactions with other at all times. Your negative interactions can cause disruption and jeopardize safe care for our children. During an interview on July 18, 2025, at 3:46 PM, with the Chief Nursing Officer (CNO), the CNO stated verbal abuse is anything that can be intimidating to (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: 555587 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 555587 B. Wing A. Building (X3) DATE SURVEY COMPLETED 07/18/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Totally Kids Rehabilitation Hospital - D/P Snf 1720 Mountain View Loma Linda, CA 92354 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)