Haven Of Sandpointe, Llc
Inspection Findings
F-Tag F0600
F 0600 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few
FORM CMS-2567 (02/99) Previous Versions Obsolete
stated that Resident #3 was pushing his wheelchair into the dining room and walked past Resident #2 who was already sitting in the dining room. Resident #2 said something to Resident #3 that did not make sense, and Resident #3 acknowledged Resident #2, but then Staff #50 stated that she saw that Resident #2 got up and punched Resident #3 in the upper back between the shoulder blades. Staff #50 stated that then, she saw that Resident #3 reacted and punched Resident #2 in the upper chest region toward the front of the resident's shoulder area. Staff #50 stated that she intervened and separated the residents, and then Resident #3 apologized and stated that his punch was just a reaction. Staff #50 stated that when she saw Resident #2 punch Resident #3, that Resident #2 looked angry and that the punch was aggressive in nature. Staff #50 stated that after the incident, she assessed the residents for injury and did not see any, and then notified the Director of Nursing (DON) and Administrator, and that she wrote a progress note in
the medical record that accurately described the incident. Staff #50 stated that this is not the first time Resident #2 has been physically aggressive toward other residents.An interview was conducted with the Director of Nursing (DON / Staff #1) on September 16, 2025, at 12:27 P.M. The DON stated that her expectation for staff to prevent resident to resident altercations would be to know the residents well enough to identify changes in behavior and triggers. Regarding the incident between Resident #3 and Resident #2
on September 2, 2025, the DON stated that her understanding of the incident was that Resident #2 had tried to talk to Resident #3 and when he did not respond, Resident #2 became agitated and struck Resident #3, and then Resident #3 struck Resident #2 back. The DON stated that she did not know the location on
the body where Resident #3 or Resident #2 were struck. The DON stated that in the case where one resident hits another resident, that would be considered abuse.An interview was conducted with the Administrator (Staff #66) on September 16, 2025, at 12:24 A.M. Staff #66 stated that physical abuse is when a person is intentionally trying to cause harm to a resident, and examples of physical abuse included hitting or pinching. Staff #66 stated that his understanding of the incident was that Resident #3 was walking down the hallway pushing his wheelchair and Resident #2 may have said something to Resident #3. Staff #66 stated that then, Resident #3 felt something on his back and turned around and pushed Resident #2.
Then, Staff #66 stated that the nurse intervened and separated the residents. Regarding the question if Staff #66 believed that physical abuse occurred in the incident, Staff #66 did not answer the question directly, but Staff #66 did state that he did not believe that Resident #2 was trying to hurt Resident #3.A telephonic interview was conducted with a family member of Resident #3 on September 16, 2025, at 2:14 P.M. Resident #3's family stated that after the incident occurred on September 2, 2025, that the nurse (Staff #50) called the family to notify the family of the incident. Resident #3's family stated that the nurse stated that a resident went up to Resident #3 and hit him as hard as she could and then Resident #3 turned around and punched the other resident in the chest.Review of the policy titled Resident Rights/Dignity: Abuse, Neglect, Exploitation and Misappropriation Prevention Program, dated January 1, 2024, revealed that residents have the right to be free from abuse, neglect, misappropriation of resident property and exploitation. This includes but is not limited to freedom from corporal punishment, involuntary seclusion, verbal, mental, sexual or physical abuse, and physical or chemical restraint not required to treat the resident's symptoms.
Event ID:
Facility ID:
If continuation sheet
HAVEN OF SANDPOINTE, LLC in YUMA, AZ inspection on recent inspection.
Found 0 violation(s). Severity: Standard violations. Status: 0 corrected, 0 pending.
Frequently Asked Questions
- What is an F-tag violation?
- F-tags are federal deficiency codes used by CMS to categorize nursing home violations. Each F-tag corresponds to a specific federal regulation (42 CFR Part 483). For example, F607 relates to abuse prevention policies, F880 relates to infection control.
- Were these violations corrected?
- Facilities must submit plans of correction and implement changes within required timeframes. CMS conducts follow-up inspections to verify corrections. Check the inspection report for specific correction dates and follow-up verification status.
- How often do nursing home inspections happen?
- CMS conducts unannounced inspections of all Medicare/Medicaid-certified nursing homes at least once per year. Additional inspections may occur based on complaints, facility-reported incidents, or follow-up to verify previous violations were corrected.
- What should families do about these violations?
- Families should: (1) Review the full inspection report for details, (2) Ask facility administration about specific corrective actions taken, (3) Check if this represents a pattern by reviewing prior inspections, (4) Compare with other facilities in YUMA, AZ, (5) Report new concerns to state authorities.
- Where can I see the full inspection report?
- Complete inspection reports are available on Medicare.gov's Care Compare website (www.medicare.gov/care-compare). You can also request copies directly from HAVEN OF SANDPOINTE, LLC or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.