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 (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: 675117 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 675117 B. Wing A. Building (X3) DATE SURVEY COMPLETED 08/15/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Runningwater Draw Care Center Inc 800 W 13th St Olton, TX 79064 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)