Inspection·November 21, 2025

F 0755 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. Based on observation, interview, and record review, the facility failed to ensure expired medical food and dressing change supplies were not stored in the medication storage areas, and readily available for use.This failure had the potential for residents to receive ineffective medical food supplements and medical supplies.Findings:On November 20, 2025, at 1:12 p.m., a medication storage inspection was conducted with the Registered Nurse Supervisor (RNS). The following expired items were found stored and readily available for use:a. Two sterile central line (a long, thin tube [catheter] inserted into a large vein in the neck, chest, or groin, with its tip ending in or near the heart) dressing change trays containing one each of the following outdated components:- Medium Aloe Vinyl Examination gloves with expiration date of 5/28/2025 (May 28, 2025) (4/30/2025 [April 30, 2025] - date on the insert);- Stabilization PICC (peripherally inserted central catheter- a type of central line) Statlock (brand of suture free medical stabilization device) with an expiration date of 08/28/2025 (August 28, 2025); and- Aegis CHG disk (a foam disc impregnated with CHG [chlorhexidine gluconate - an antiseptic, antibacterial solution] that is used to cover and protect the insertion sites of medical devices like central lines to prevent infection), with an expiration date of 10/18/2025 (October 18, 2025).The sticker label attached to the kits indicated, .UPON OPENING THE PACK, REMOVE AND DESTROY THE EXPIRED COMPONENT-THE REMAINDER OF THE ITEMS ARE SAFE FOR USE.In a concurrent interview with the RNS, the RNS stated the above items were expired and should have been removed from storage, so as not to be used on the residents.A review of the facility's policy and procedure titled, STERILE EQUIPMENT STORAGE AND EXPIRATION DATE, revised March 2021, indicated, .Purpose.To establish standardized procedures for sterile equipment storage and shelf life.Items purchased as sterile will follow manufacturers expiration.b. 18 outdated Prostat concentrated liquid protein (brand of protein nutritional supplement), 15 grams (unit of measurement) in one fluid ounce (unit of measurement) packets with expiration dates as follows:- seven packets with expiration dates of 10/10/2025 (October 10, 2025);- six packets with expiration dates of 8/13/2025 (August 13, 2025); and- five packets with expirations dates of date 6/17/2025 (June 17, 2025).In a concurrent interview with the RNS, the RNS stated the Prostat were expired and should have been removed from storage, so as not to be given to the residents.A review of the facility's policy and procedure titled, EXPIRED/RECALLED PRODUCTS, dated May 2024, indicated .Purpose.To develop a mechanism designed to ensure the retrieval and safe disposal of expired and recalled nutrition products to reduce the potential of adverse reactions to inferior products.Outdated and recalled nutrition products will not be provided to patients.Discard outdated or recalled products immediately or return them to the manufacturer for credit. 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: 555623 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 555623 B. Wing A. Building (X3) DATE SURVEY COMPLETED 11/21/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Hemet Valley Healthcare Center 371 North Weston Pl Hemet, CA 92543 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)