Health inspection·August 15, 2023

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 establish and maintain an infection prevention and control program designed to provide a safe, sanitary, and comfortable environment and to help prevent the development and transmission of communicable diseases and infection for 3 (CNA, NA in Training and Special Care Aide) of 7 employees observed during lunch dining observation. Residents Affected - Some CNA did not disinfect hands between feeding 4 residents. NA in Training touched her face and then delivered a resident tray without sanitizing hands. NA in Training carried 2 resident plates on one tray and delivered plates to different tables in the dining room without sanitizing hands between plates. Special Care Aide put hands in pockets and then delivered a resident tray without sanitizing hands. Special Care Aide carried 2 resident plates on one tray and delivered plates to different tables in the dining room without sanitizing hands between plates. This failure could place residents at risk of transmission of a communicable disease or infection. Finding included: In an interview on 8/15/23 at 10:38AM DON stated that she conducted in-services regarding hand hygiene and infection control about every 2 weeks. DON stated that she had done skills training with all staff on hand hygiene and had posters which indicated proper hand hygiene techniques and infection control procedures, placed around the building. DON stated that all newly hired employees had to pass a skills-based training on hand hygiene and infection control before they were allowed to work with residents. On 8/15/23 at 11:44AM during observation of lunch service, CNA prepared a dietary supplement drink for 4 residents and used the same spoon for all 4 drinks. CNA picked up the same spoon and fed one resident, set the spoon down, touched her pant leg and then proceeded to pick up another spoon to feed another resident. CNA did not sanitize her hands throughout the lunch service observation. On 08/15/23, during multiple observations during lunch service, NA in Training was observed to touch her face and then pick up a resident tray. NA in Training failed to sanitize hands between each resident tray delivery. NA in Training was observed carrying 2 plates of resident food on one tray and delivered both plates to different tables in the dining room without sanitizing her hands between plates. Special Care Aide was observed to put his hands in his pockets and then pick up a resident tray. Special Care Aide was observed carrying 2 plates of resident food on one tray and delivered both Page 1 of 2 675117 675117 08/15/2023 Runningwater Draw Care Center Inc 800 W 13th St Olton, TX 79064

F 0880 plates to different tables in the dining room without sanitizing his hands between plates. Level of Harm - Minimal harm or potential for actual harm On 8/15/23 at 12:35PM while this surveyor was reviewing policies and procedures and in-services, DON stated that she witnessed a break in hand hygiene during the lunch service. DON stated she had worked with the dietary staff to ensure everyone practiced proper hand hygiene when working with resident food. DON stated that she would conduct an in-service with the 3 employees, before the next meal service. Residents Affected - Some In an interview on 8/15/23 at 12:51PM NA in Training stated that she was nervous because this surveyor was in the dining room and forgot to sanitize her hands between trays. NA in Training stated that she should have sanitized her hands between every resident tray. NA in Training stated that she should not put 2 resident plates on the same tray. NA in Training stated that the negative outcome of not sanitizing hands between plates and trays would be that the residents could become sick. In an interview on 8/15/23 at 12:57PM Special Care Aide stated that he should sanitize his hands between the delivery of every resident tray. Special Care Aide stated that he should not put 2 resident plates on the same tray. Special Care Aide stated that the negative outcome of not sanitizing hands between plates and trays would be that the residents could become sick. In an interview on 8/15/23 at 4:04PM CNA stated that she should sanitize her hands between feeding residents. CNA stated that feeding 4 residents at the same time was not hard and that she did not need any assistance in feeding those 4 residents. CNA stated that the negative outcome would be cross-contamination between the residents and residents could become sick. Record Review of Infection Control Policies and Procedures and Infection Control in-services revealed that in-services regarding infection control and hand hygiene were conducted on 5/30/23 and 8/8/23. 675117 Page 2 of 2