The Canyons Post-acute
Inspection Findings
F-Tag F0695
F 0695
Provide safe and appropriate respiratory care for a resident when needed.
Level of Harm - Minimal harm or potential for actual harm
Based on observation, interview, and record review, the facility failed to ensure that respiratory therapists were available for 41 residents when there was no respiratory therapist on duty for approximately seven (7) hours during the night shift of October 12, 2025.This failure had the potential to place clinically compromised residents' health and safety at risk by not having a respiratory therapist available to provide appropriate care when necessary.Findings:During an interview on 10/14/2025, at 3:00 PM, with one of the residents (Resident 1), Resident 1 stated, two nights ago, there was no RT (Respiratory Therapist) at all.
The nurses do not know how to operate the machine; I just stayed off the machine. I was suctioned before
the RT left.During an interview on 10/14/2025, at 3:50 PM, with Respiratory Therapist (RT 1), RT 1 stated, I came early Monday [10/13/2025] at 5:00 AM, I clocked in before 5:00 AM, there was no RT on duty. RT 1 indicated that the scheduled RT called off, and another RT, who lacks work permit, did not report to work.
To address the situation, an RT from the day shift extended his hours and remained on duty until 10:00 PM that shift.During an interview on 10/15/2025, at 12:44 PM, with Respiratory Therapist (RT 2), RT 2 stated, .They could not find anybody and there was no RT on the floor, I left at 10:00 PM, there was no RT when I left. There was two scheduled, [Name of two RTS], they called off.During an interview on 10/28/2025, at 12:40 PM, with Registered Nurse (RN ), RN stated, There was no RT, the young lady [Name of staff], is not
a registered therapist, there was no cover, the scheduled RT called off. RN confirmed she was working on
the floor that night.During record review of respiratory therapist time sheet dated October 12, 2025, the timesheet indicated Respiratory Therapist (RT 3) did not work on the night shift on October 12, 2025. Also,
the timesheet showed that RT 2 clocked out at 10:10 PM on October 12, 2025, and RT 1, clocked in at 4:55 AM on October 13, 2025. The timesheet illustrates that between 10:10 PM on October 12, 2025, and 4:55 AM on October 13, 2025, there was no respiratory therapist on duty at the facility.During a concurrent
interview and record review on 11/04/2025, at 3:38 PM, with the Director of Nursing (DON) the facility policy and procedure (P&P) titled, Staffing, was reviewed dated, October 2017. The P&P indicated, Our facility provides sufficient numbers of staff with the skills and competency necessary to provide care and services for all residents in accordance with resident care plans and the facility assessment. When the DON was asked if they facility followed this policy she stated, No.
Residents Affected - Few
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
Event ID:
The Canyons Post-Acute in Colton, 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 Colton, 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 The Canyons Post-Acute or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.