Health inspection·January 16, 2026

F 0584 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely. Based on observation, interview, and record review, the facility failed to maintain a safe, comfortable, and sanitary environment when: 1.One of the shower rooms, Room A729, was found with broken tiles and an exposed wall cavity. This failure had the potential to result in exposing residents to pests and contaminants, compromising the hygiene and safety of a medically vulnerable population of 107 residents.2. The shared bathroom for one of 24 sampled resident's (Resident 39) and one unsampled resident (Resident 34), had a large, unsealed hole located directly above the toilet. This failure resulted in Resident 39 and Resident 34 feeling stress and discomfort with the disrepair (poor condition of a building) and had the potential to result in injuries or infections from dust, insulation, or debris falling from an unsealed ceiling. Findings: 1.During a concurrent observation and interview on 1/15/2026 at 11:20 a.m. with the Charge Nurse (CN), in shower room A729, there were broken tiles and an exposed wall cavity. The CN stated shower room A729 was one of two in the whole facility used by residents. The CN stated the broken tiles should have been reported for repair to plant operations. During a concurrent interview and record review on 1/15/2026 at 11:57 a.m. with the Staff Service Manager (SS), the documents' titled, Environmental Rounds, dated February 2025 to January 2026 were reviewed. The Environmental Rounds indicated broken tiles were noted and recommended for repair and replacement on the following dates: 2/12/2025, 4/23/2025, 7/3/2025, 10/22/2025, and 1/9/2026. The SS stated the broken tiles were unsafe and should have been repaired. During a review of a Work Order, #24_094880, dated 10/23/2024, the work order indicated tile repair was needed in the shower room A729 for broken tiles. Further review of the work order indicated the work order was created back on 10/23/2024 and was left opened with no repair date and no completion date.During an interview on 1/15/2026 at 12:30 p.m. with the Building Maintenance Worker (BMW), the BMW stated it was not safe for the shower disrepair to be left like that. During a follow up interview on 1/15/2026 at 4:38 p.m. with the SS, the SS stated the broken tiles and an exposed wall cavity measured at 5.5 inches by 16 inches (unit of measurement). During a review of the facility's policy and procedure (P&P) titled, Environment of Care Rounds, dated 10/9/2025, the P&P indicated, Any safety issues will .require that immediate action be taken to prevent harm to resident, staff, or visitors. During a review of the facility's policy and procedure (P&P) titled, General Maintenance, dated 5/1/2025, the P&P indicated, All building, fixtures, equipment, and spaces will be maintained in operable conditions. Maintenance of [the facility], including the grounds, in a clean and sanitary condition and in good repair at all times was to ensure the safety and well-being of residents, staff, and visitors. 2. During a concurrent observation and interview on 1/15/2026 at 11:46 a.m. with Resident 39, in the resident's room, there was a large, unsealed hole observed in the bathroom ceiling located directly above the toilet. Resident 39 stated, I don't like the hole; it feels like the devil would come out. During an interview on 1/15/2026 at 12:30 p.m. with the Building Maintenance Worker (BMW), the BMW stated it was not safe for the (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 4 Event ID: 555795 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 555795 B. Wing A. Building (X3) DATE SURVEY COMPLETED 01/16/2026 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Veterans Home of California - Chula Vista 700 East Naples Court Chula Vista, CA 91911 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)