Surprise Valley Community Hospital D/p Snf
Inspection Findings
F-Tag F0609
F 0609 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few
FORM CMS-2567 (02/99) Previous Versions Obsolete
12/18/25 at 2:15 pm, with Licensed Vocational Nurse (LN) A in the conference room, LN A stated, I made a mistake. I did not report the allegation when it initially was reported to me [by CNA C]. I should have reported the allegation when it occurred. I do not recall when it occurred but it was awhile back. During an
interview on 12/18/25 at 2:45 pm, with CNA C in the conference room, CNA C stated they informed LN A of
the abuse allegation from Resident 1 regarding an incident in the shower, but they did not follow up and make sure the LN Ae formally reported the allegation. CNA C could not recall when the allegation was made but thought perhaps it was at the end of October 2025.During an interview on 12/19/25 at 7:40 am, with DON in the conference room, DON confirmed staff did not report the abuse allegation in accordance with the facility's Abuse Policy. The DON confirmed the notification of alleged abuse was made late to CDPH.
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SURPRISE VALLEY COMMUNITY HOSPITAL D/P SNF in CEDARVILLE, CA 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 CEDARVILLE, CA, (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 SURPRISE VALLEY COMMUNITY HOSPITAL D/P SNF or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.