Rinaldi Convalescent Hospital

During a review of Resident 75`s Order Summary Report (OSR) as of 3/29/26, the OSR indicated the following prescribed medications that were administered by LVN 6 to Resident 75: 1.Metoclopramide Oral Tablet 5 mg, give 1 tablet by mouth before meals for nausea and vomiting. 2.

Omeprazole 20 mg cap, give 1 capsule by mouth two times a day for gastroesophageal reflux disease (GERD). 3.

Creon Oral Capsule 24000-76000 Unit, give 24000 unit by mouth with meals for pancreatic enzyme replacement therapy give with meals. 4.

Famotidine Oral Tablet 20 mg, give 1 tablet by mouth two times a day for GERD.

During a review of the facility`s Policy and Procedure (P&P) titled Resident Rights, last reviewed on 1/29/2026, the P&P indicated that Employees shall treat all residents with kindness, respect, and dignity.be informed of, and participate in, his or her care planning and treatment.

055906 03/29/2026

Rinaldi Convalescent Hospital 16553 Rinaldi St Granada Hills, CA 91344

During a review of Resident 11's Minimum Date Set (MDS- a standardized assessment and care screening tool) dated 1/1/2026, the MDS indicated Resident 11's cognition (a mental process involved in knowing, learning, and understanding things) was moderately impaired.

The MDS indicated Resident 11 required substantial/maximal assistance (staff does more than half the effort) with eating and personal hygiene and was dependent (staff does all of the effort) on staff with oral care and toileting hygiene.

During an observation on 3/28/2026 at 8:30 a.m., in Resident 11's room, observed Resident 11 in bed, with the call light not within the resident's reach.

Observed Resident 11's call light tucked in between Resident 11's mattress and pillow.

During a concurrent observation and interview on 3/28/2026 at 8:48 a.m., with the RN Case Manager (RNCM), in Resident 11's room, observed Resident 11 in bed with the call light not within the resident's reach.

Observed Resident 11's call light tucked in between Resident 11's mattress and pillow.

Observed RNCM place the call light within Resident 11' s reach, next to Resident 11's right hand and stated Resident 11' s call light was not within reach.

The RNCM continued to state that the call light should always be next to the resident so that the resident can call for assistance and for Resident 11's safety.

During a review of the facility's policy and procedure (P&P) titled, Answering the Call Light, last reviewed on 1/29/2026, the P&P indicated the purpose of this procedure is to ensure timely responses to the resident's request and needs.

The P&P further indicated staff must ensure the call light is accessible to the resident when in bed.

055906 03/29/2026

Rinaldi Convalescent Hospital 16553 Rinaldi St Granada Hills, CA 91344

honored.During a review of the facility's Policy and Procedure (P&P) titled, Advance Directives, last

accordance with state law and facility policy.

Prior to or upon admission of a resident the social

representative, about the existence of any written advanced directives.

The resident or representative is provided with written information concerning the right to refuse or accept medical or surgical treatment and to formulate an AD if he or she chooses to do so. If the resident is incapacitated and unable to receive information about his or her right to formulate an AD, the information may be provided to the resident`s legal representative.

Nursing staff will document in the medical record the offer to assist and the resident`s decision to accept or decline assistance.

055906 03/29/2026

Rinaldi Convalescent Hospital 16553 Rinaldi St Granada Hills, CA 91344

During a review of Resident 15's admission Record, the admission Record indicated the facility originally admitted the resident on 7/01/2025 and readmitted the resident on 12/17/2025 with diagnosis including, muscle weakness and hypertension (high-blood pressure).

During a review of Resident 15's Minimum Data Set (MDS-a standardized assessment and care screening tool) dated 3/02/2026, the MDS indicated the resident had the ability to make self-understood and the ability to understand others.

The MDS indicated that Resident 15 required partial/moderate assistance (helper does more than half the effort) from staff for oral hygiene, upper body dressing and substantial/maximal assistance (helper does more than half the effort) with toileting, shower and personal hygiene. b.

During a review of Resident 82's admission Record, the admission Record, indicated the facility originally admitted the resident on 8/23/2023 with diagnosis including history of falling and hypertension (high-blood pressure).

During a review of Resident 82's MDS dated [DATE], the MDS indicated the resident had the ability to sometimes make self-understood and the ability to sometimes understand others.

The MDS indicated that Resident 82 required substantial/maximal assistance (helper does more than half the effort) with toileting hygiene, shower, upper body dressing, lower body dressing and personal hygiene.

During an observation onˆ3/28/2026 at 9:01 a.m., in Resident 15 and Resident 82's room, observed both residents sleeping in their bed.

Observed the room's sliding door screen with a tear measuring approximately 24 inches.During a concurrent observation and interview on 03/28/2026 at 9:35ˆa.m. with the Director of Nursing (DON) in Resident 15 and 82`s room, the DON confirmed the observation of the torn screen door.

The DON stated that the resident`s room must be sealed from the outside by a screen to prevent small insects from entering the room.

The DON stated the torn screen posed a health and safety risk to residents, as it had the potential to allow entry of insects that may transmit infection.

During a review of the facility`s policy and procedures (P&P) titled, Homelike Environment,, the P&P indicated that Residents are provided with a safe, clean, comfortable and homelike environment and encouraged to use their personal belongings to the extent possible.clean, sanitary and orderly environment. ˆ ˆ ˆ ˆ ˆ ˆ ˆ ˆ ˆ ˆ ˆ ˆ

055906 03/29/2026

Rinaldi Convalescent Hospital 16553 Rinaldi St Granada Hills, CA 91344

During a review of the facility's policy and procedure (P&P)ˆtitled, Care Plans,ˆComprehensive Person Centered, last reviewed and revised on 1/29/2026, the P&P indicatedˆCPsˆinclude measurable objectives and timetables to meet the resident's physical, psychological and functional needsˆis developed and implemented for each resident.ˆˆ b.

During a review of Residentˆ5's admission Record, the admission Record indicated the resident wasˆreadmitted to the facility on ˆˆ3/9/2026ˆwith diagnoses that includedˆend stage renal disease (ESRD-ˆirreversible kidney failure)ˆand dependence on renal dialysisˆ(a life-sustaining medical treatment that filters waste products, toxins, and excess fluids from the blood when the kidneys are failing).ˆ During a review of Residentˆ5's MDS dated [DATE], the MDS indicated Residentˆ5's cognition (a mental process ofˆacquiringˆknowledge and understanding through thought experience and the sense) was moderately impaired.

The MDS indicated Residentˆ5ˆrequiredˆsupervision or touchingˆassistanceˆ(helperˆprovides cuesˆand/or touching/steadyingˆassistance)ˆwith eating and oral hygiene,ˆrequiredˆ partial/moderateˆassistanceˆ(helper does less than half the effort) with personalˆhygiene andˆrequiredˆsubstantial/maximalˆassistanceˆ(helper does more than half the effort)ˆwith toileting.ˆˆ During a review ofˆResident 5's Order SummaryˆReport, the Order Summary Report indicated an order dated 3/9/2026 for ˆLiberal Renal (a specialized eating plan for people with kidney disease that limits specific minerals and fluidsˆto reduce strain on the kidneys and prevent waste buildup)- No Added Salt (NAS) dietˆfor ESRD.ˆˆ During an interview and concurrent record review onˆ3/29/2026, at 9:50ˆa.m. with theˆDesk Nurse (DN), theˆDNˆreviewed Residentˆ5'sˆcare plansˆandˆstatedˆthat there was no care planˆcreatedˆaddressingˆResident 5'sˆrenal diet.

TheˆDNˆstatedˆthatˆResident 5 should have aˆspecificˆcare planˆfor Resident 5'sˆrenal diet because a care planˆwill provide interventionsˆfor Resident 5 specific to a renal diet.

The DNˆstatedˆthat all staffˆare responsible forˆinitiatingˆdiet care plans.

The DN furtherˆstatedˆthat care plans are important because care plans are a form of communicationˆfor the interdisciplinary team to help provide quality of care.ˆˆ During a review of the facility's policy and procedure (P&P)ˆtitled, Care Plans,ˆComprehensive Person Centered, last reviewed and revised on 1/29/2026, the P&P indicatedˆCPsˆinclude measurable objectives and timetables to meet the resident's physical, psychological and functional needsˆis developed and implemented for each resident.ˆˆ

055906 03/29/2026

Rinaldi Convalescent Hospital 16553 Rinaldi St Granada Hills, CA 91344

During a review of the facility`s Policy and Procedure (P&P) titled Care Plans, Comprehensive Person-Centered, last reviewed on 1/29/2026, the P&P indicated assessments of residents are ongoing and care plans are revised as information about the residents and the resident`s conditions changed.

The interdisciplinary team reviews and updates the care plan when there has been a significant change in the resident`s condition, when the desired outcome is not met, when the resident has been readmitted to the facility from a hospital stay, at least quarterly, in conjunction with the quarterly MDS assessments.

055906 03/29/2026

Rinaldi Convalescent Hospital 16553 Rinaldi St Granada Hills, CA 91344

During a review of Resident 65's Minimum Date Set (MDS- a standardized assessment and care screening tool) dated 2/11/2026, the MDS indicated Resident 65's cognition (a mental process of acquiring knowledge and understanding through thought experience and senses) was severely impaired.

The MDS indicated Resident 65 was independent with eating, required partial/moderate assistance (helper does less than half the effort) with oral hygiene, and required substantial/maximal assistance (helper does more than half the effort) with toileting and personal hygiene.

During an observation on 3/28/2026 at 10:05 a.m., in Resident 65's room, observed Resident 65's fingernails to be long, untrimmed, and unkempt.

During a concurrent observation and interview on 3/29/2026 at 10:01 a.m. with the Desk Nurse (DN), in Resident 65's room, the DN observed Resident 65's fingernails.

The DN stated that Resident 65's fingernails are long and unclean.

The DN stated that Resident 65's fingernails should be kept trimmed and clean.

During an interview on 3/29/2026 at 10:14 a.m. with the Director of Staff Development Assistant (DSDA), the DSDA stated that Certified Nursing Assistants (CNAs) are responsible for keeping residents' nails clean and trimmed.

The DSDA stated that when CNAs see that residents' nails are long it is the CNAs responsibility to trim the residents' fingernails.

The DSDA stated that there is no specific schedule for trimming the residents' nails.

During a follow up interview on 3/29/2026 at 10:15 a.m. with the DN, the DN stated that residents' nails should be kept short and clean to promote personal hygiene, infection control and dignity.

During a review of the facility's policy and procedure (P&P) titled Fingernails/Toenails, Care of, reviewed on 1/29/2026, the P&P indicated the purpose of the procedure are to clean the nail bed, to keep nails trimmed, and to prevent infections.

The P&P indicated under general guidelines, the P&P indicates nail care includes daily cleaning and regular trimming.

055906 03/29/2026

Rinaldi Convalescent Hospital 16553 Rinaldi St Granada Hills, CA 91344

risk for developing new pressure injury.

During an interview on 3/30/2026 at 4:50 p.m., with the

bilateral heel protectors as ordered by the physician.

The DON stated the potential outcome is skin

facility`s Policy and Procedure (P&P) titled Prevention of Pressure Injuries, last reviewed on 1/29/2026, the P&P indicated that review and select medical devices with consideration to the ability to minimize tissue damage, including size, shape, its application and ability to secure the devise, monitor regularly for comfort and signs of pressure related injury.

For prevention measures associated with specific devices, consult clinical practice guidelines.

055906 03/29/2026

Rinaldi Convalescent Hospital 16553 Rinaldi St Granada Hills, CA 91344

Assistive Devices and Equipment, reviewed on 1/29/2026, the P&P indicated that the facility

for residents.

055906 03/29/2026

Rinaldi Convalescent Hospital 16553 Rinaldi St Granada Hills, CA 91344

During a concurrent interview and record review on 3/28/2026 at 6:52 p.m. with the facility`s Assistant Director of Nursing (ADON), Resident 12's physician order summary report, COC and post fall review forms dated 1/29/2026 were reviewed.

The ADON stated That Resident 12 had a fall on 1/29/2026, and one of the IDT recommendations was to apply landing pads at the resident`s bedside.

The ADON stated Resident 12`s physician ordered to apply landing pads on both sides of the resident`s bedside on 1/29/2026, however, staff failed to place landing pads at Resident 12`s bedside.

The ADON stated the potential outcome is increased risk of injury if fall occurs.

During an interview on 3/29/2026 at 5:04 p.m. with the Director of Nursing (DON), the DON stated that staff are required to implement physician orders for fall precautions.

The DON stated Resident 12 had a physician order for landing pads on both sides of the bed, which was not implemented by staff.

The DON stated the potential outcome is increased risk of injuries in the event of a fall.

During a review of the facility's policy and procedure(P&P) titled, Falls and Fall Risk, Managing, last reviewed on 1/19/2026,the P&P indicated that the IDT team with the input of the attending physician, will implement a resident-centered fall prevention plan to reduce the specific risk factor(s) for falls for each resident at risk or with a history of falls. In conjunction with the attending physician, licensed staff will identify and implement relevant interventions (e.g., low bed position, floor pad) to try to minimize serious consequences of falling.

055906 03/29/2026

Rinaldi Convalescent Hospital 16553 Rinaldi St Granada Hills, CA 91344

During an interview onˆ3/29/2026ˆatˆ5:11ˆp.m., with theˆDirector of Nursing (DON), the DONˆstatedˆthatˆlicensed staffˆare requiredˆtoˆimplement residents` care plan interventionsˆand monitor for effectiveness of the interventions.

The DONˆstatedˆlicensed staffˆare required toˆmonitorˆtheˆresidentsˆwithˆanˆindwelling catheterˆfor sign and symptoms of infection,ˆprovide indwelling catheter care,ˆandˆdocument their monitoringˆand careˆin the residents` medical record.ˆThe DONˆstatedˆthat licensed staff did notˆimplementˆResident 99`s care plan interventions for the indwelling catheterˆandˆfailed toˆmonitorˆthe residentˆforˆside effectsˆassociated with having anˆindwelling catheter.

The DONˆstatedˆthe potential outcome is increased risk of UTI and inability toˆidentifyˆand report complications to the physician.ˆ Duringˆaˆreview of the facility`s Policy and Procedure (P&P) titled CatheterˆCare,ˆUrinary last reviewed on 1/29/2026, the P&Pˆindicatedˆthatˆthe purpose of this policy is toˆpreventˆcatheter-associated urinaryˆtract infections.ˆReview the resident`s care plan toˆassessˆany special needs of the resident.ˆObserved the resident for complications associated with urinary catheters.

Report unusual findings to the physician or supervisorˆimmediately.ˆThe following information should be recorded in the resident`s medical record: the date and time that catheter care was given, the name and title of the individual giving the catheter care, all assessment data obtained when giving catheter care,ˆcharacter of urine such as color ( straw-colored, dark, or red), clarity (cloudy, solid particles, or blood) and odor,ˆhow the resident tolerated the procedure and if the resident refused the procedure, the reason why and the interventions taken.ˆ

055906 03/29/2026

Rinaldi Convalescent Hospital 16553 Rinaldi St Granada Hills, CA 91344

During a review of Resident 43's Minimum Data Set (MDS-a resident assessment tool) dated 12/23/2025, the MDS indicated the resident had the ability to make self-understood and the ability to understand others.

The MDS indicated that Resident 43 required substantial/maximal assistance (helper does more than half the effort) from staff for oral hygiene, toileting hygiene, upper body dressing, lower body dressing, and personal hygiene.

During an observation on 3/28/2026 at 9:05 a.m., observed Resident 43 in her room sleeping.

Upon checking the resident`s environment, observed a G-tube feeding pump turned off at the time and the feeding bottle formula (Isosource 1.5 calories) hanging on the G-tube pole had no written tube feeding order in the label.

During a concurrent observation and interview on 3/28/2026 at 9:32 a.m., with Licensed Vocational Nurse 7 (LVN 7), in Resident 43`s room, observed Resident 43's G-tube feeding pump turned off at this time and the feeding bottle formula (Isosource 1.5 calories) hanging on the G-tube pole with no written tube feeding order on the label. LVN 7 stated that the nurse that hung the feeding formula bottle should have transcribed on the label the rate of infusion or feeding rate order in order to ensure the physician`s ordered rate is accurately reflected in the label.

LVN 7 stated if there is no feeding rate on the label, it may result in inaccurate delivery of the amount of formula the resident will receive which could result in unintended weight loss.

During a concurrent interview and record review on 3/28/2026 at 10:00 a.m., with LVN 7, reviewed Resident 43's physician`s order dated 3/25/2026 for enteral feeding Isosource 1.5 via G-tube at 50 milliliter/hour (ml- [unit of measurement]/hr) for 20 hrs., off at 8 a.m. and on at 12 noon or until dose is met to provide 1000 ml volume/1500 kilocalories (kcal- a unit of energy).

During a review of the facility's policy and procedure (P&P) titled, Enteral Tube Feedings via Continuous Pump Gastrostomy Tube., last reviewed on 1/29/2026, the P&P indicated, The purpose of this procedure is to provide a guideline for the use of a pump for enteral feedings .check the enteral nutrition label against the order before administration, check the following information:A.

Resident name, ID and room number;B.

Type of formula;C.

Date and time formula was prepared;D.

Route of delivery;E.

Access site;F.

Method (pump, gravity, syringe) andG.

Rate of administration (mL/hr.).

055906 03/29/2026

Rinaldi Convalescent Hospital 16553 Rinaldi St Granada Hills, CA 91344

During a review of Resident 11's Minimum Data Set (MDS- a resident assessment tool) dated 1/1/2026, the MDS indicated Resident 11's cognition (a mental process of acquiring knowledge and understanding through thought experience and the sense) was moderately impaired.

The MDS indicated Resident 11 required substantial/maximal assistance (staff does more than half the effort) with eating and personal hygiene and was dependent (staff does all of the effort) on staff with oral care and toileting hygiene.

During a review of Resident 11's Order Summary Report, the Order Summary Report indicated an order to administer oxygen at two (2) LPM via nasal canula continuously to keep oxygen saturation (a measure of how much oxygen is in your blood) >90%, dated 10/28/2025.

During an observation on 3/28/2026 at 8:40 a.m., in Resident 11's room, observed Resident 11 in bed with their mouth open with the oxygen nasal canula in Resident 11's mouth.

During a concurrent observation and interview on 3/28/2026 at 8:46 a.m., with the Registered Nurse Case manager (RNCM) in Resident 11's room, observed Resident 11's mouth open with the oxygen nasal canula in Resident 11's mouth.

Observed the RNCM fix Resident 11's nasal cannula and placed Resident 11's nasal canula prongs into Resident 11's nostrils.

The RNCM stated that Resident 11's nasal canula was not in place and should not be in Resident 11's mouth.

The RNCM stated the nasal canula prongs should be in Resident 11's nostrils.

During an interview on 3/28/2026 at 5:12 p.m., with the Assistant Director of Nursing (ADON), the ADON stated that it is important for the nasal canula to be properly placed in resident's nostrils to ensure residents are getting the oxygen per facility policy and per physician's order.

The ADON stated that potential negative outcomes that a resident may experience if not getting the ordered oxygen could be dizziness, tachycardia (increase heart rate), and shortness of breath.

During a review of the facility's P&P titled, Oxygen Administration, reviewed on 1/29/2026, the P&P indicated oxygen therapy is administered by way of an oxygen mask, nasal cannula, and/or nasal catheter.

The nasal cannula is a tube that is placed approximately one-half inch into the resident's nose.

055906 03/29/2026

Rinaldi Convalescent Hospital 16553 Rinaldi St Granada Hills, CA 91344

During a review of Resident 99`s physician History and Physical (H&P) dated 3/27/2026, the H&P indicated that the resident did not have the capacity for medical decision making.

During a review of Resident 99's Physician Order Summary Report dated 3/25/2025, the Order Summary Report indicated that Resident 99 was prescribed Enoxaparin Sodium injection solution 40 milligrams (mg- a unit of measure of mass)/0.4 milliliters (ml- a unit of measure of volume), inject one dose subcutaneously (applied under the skin) every 24 hours for Deep Vein Thrombosis (DVT- when a blood clot forms in one or more of the deep veins in the body, usually in the legs) prophylaxis (preventive treatment).

During a review of Resident 99's Medication Administration Record (MAR - a daily documentation record used by a licensed nurse to document medications given to a resident) for March 2026, the MAR indicated that Resident 99 was administered enoxaparin sodium injections on 3/26/2026 and 3/27/2026.

The MAR contained no documentation of monitoring for signs and symptoms of bleeding or bruising related to the use enoxaparin sodium.

During a concurrent interview and record review on 3/28/2026 at 6:40 p.m., with Assistant Director of Nursing (ADON), Resident 99`s Physician Order Summary report and MAR for March 2026 were reviewed.

The ADON stated Resident 99's order summary report did not include any physician order for monitoring the side effects (unwanted or dangerous medication effects) of enoxaparin sodium such as bleeding and bruising.

The ADON stated licensed staff did not obtain physician order to monitor Resident 99 for side effects of Enoxaparin Sodium.

The ADON stated licensed staff are required to obtain a physician order to monitor residents on anticoagulants for side effects, ensuring the residents do not experience bleeding.

The ADON stated licensed staff did not monitor Resident 99 for the side effects of enoxaparin sodium and the potential outcome is to cause bleeding of the resident.

During an interview on 3/29/2026 at 5:15 p.m., with the Director of Nursing (DON), the DON stated residents receiving anticoagulants should be monitored for bleeding, as it is a known side effect of these medications.

The DON stated Resident 99 was prescribed enoxaparin and that monitoring for bleeding during its use was important to ensure any bleeding would be identified and addressed.

During a review of the facility's policy and procedures (P&P) titled, Anticoagulation-Clinical Protocol, last reviewed on 1/29/2026, the P&P indicated that assess for any signs and symptoms related to adverse drug reactions due to the medication alone or in combination with other medications.

The staff and physicians will monitor for possible complications in individuals who are being anticoagulated and will manage related problems. If an individual on anticoagulation therapy shows signs of excessive bruising, hematuria (blood in urine), or any other evidence of bleeding, the nurse will discuss the situation with the physician before giving the next scheduled dose of anticoagulant.

055906 03/29/2026

Rinaldi Convalescent Hospital 16553 Rinaldi St Granada Hills, CA 91344

During a review of Resident 40's Minimum Data Set (MDS- a resident assessment tool) dated 1/15/2026, the MDS indicated Resident 40 could make himself understood and understand others and required partial assistance (helper dose less than half the effort) for oral hygiene and personal hygiene and was dependent (helper does all the work) on staff for toileting, showering, lower body dressing and putting off/on footwear.

During a review of Resident 40's Order Summary Report, the Order Summary Report indicated an order for clonidine transdermal (on the skin) patch weekly 0.2 milligram (mg- unit of measurement)/24 hour.

Apply one patch transdermally every Saturday for hypertension.

Please alternate/rotate site.

Ordered 1/11/2026.

During a review of Resident 40's Medication Administration Record (MAR, a report detailing the medications administered to a resident by the licensed nurse in the facility) from 2/1/2026 to 3/29/2026, the MAR indicated the following for clonidine transdermal patch:- On 2/14/2026 removed from right arm- On 2/14/2026 placed on right arm- On 2/21/2026 removed from left arm- On 2/21/2026 placed on left arm- On 3/14/2026 removed from right arm- On 3/14/2026 placed on right arm During a concurrent interview and record review on 3/29/2026 at 9:40 a.m., with Licensed Vocational Nurse 4 (LVN 4), reviewed Resident 40's MAR from 2/1/2026 to 3/29/2026. LVN 4 stated on 2/14/2026, 2/21/2026, and 3/14/2026, Resident 40's clonidine transdermal patch should have been rotated, and it was not.

LVN 4 stated it is important to rotate the site because licensed nurses should follow the doctors' orders and it could irritate the resident's skin.

During a concurrent interview and record review on 3/29/2026 at 11:06 a.m., with the Assistant Director of Nursing (ADON), reviewed Resident 40's MAR from 2/1/2026 to 3/29/2026.

The ADON stated clonidine patches must be rotated to avoid harm to the skin.

During a review of the facility's policy and procedure (P&P) titled, Medication Administration - General Guidelines, last reviewed and revised on 1/29/2026, the P&P indicated medications are administered as prescribed in accordance with good nursing principles and practice.

During a review of the facility-provided manufacturer's guideline on the use of Catapres (brand name for clonidine) patch patient instructions, undated, the guideline indicated after one week, remove the old patch and discard it and after choosing a different site, place the new patch.

055906 03/29/2026

Rinaldi Convalescent Hospital 16553 Rinaldi St Granada Hills, CA 91344

During an interview on 3/29/2026 at 12:16 p.m., with the Assistant Director of Nursing (ADON), the ADON stated correct temperature is very important to the integrity of medication, especially those that require refrigeration.

The ADON stated licensed nurses must check and record the temperature of each refrigerator twice a day to ensure they are in good working order to keep the medications safe for use on the residents.

During a review of the facility's P&P titled, Medication Labeling and Storage, reviewed on 1/29/2026, the P&P indicated the facility must store all medications and biologicals in locked compartments under proper temperature, humidity and light controls.

The P&P indicated medications requiring refrigeration are to be stored in a refrigerator located in the medication room.

055906 03/29/2026

Rinaldi Convalescent Hospital 16553 Rinaldi St Granada Hills, CA 91344

During an interview on 3/30/2026 at 5:00 p.m., with the Director of Nursing (DON), the DON stated that the facility is responsible for ensuring that residents` medical record were complete and accurate, including documentation of all current diagnoses.

The DON stated that the potential outcome of not including Resident 36`s anxiety disorder in the current diagnoses list is an increased risk of the resident not receiving appropriate care due to an inaccurate medical record.

During review of facility`s Policy and Procedure (P&P) titled Charting and Documentation, last reviewed on 1/29/2026, the P&P indicated that all services provided to the resident, progress toward the care plan goals, or any changes in the resident`s medical, physical, functional, or psychosocial condition shall be documented in the resident`s medical record.

The medical record should facilitate communication between the interdisciplinary team regarding the resident`s condition and response to care.

055906 03/29/2026

Rinaldi Convalescent Hospital 16553 Rinaldi St Granada Hills, CA 91344

During a review of the facility's hospice contract titled, Hospice- Skilled Nursing Facility Agreement, undated, the facility's hospice contract indicated under training, education and assessment: Hospice shall provide orientation and training for all personnel, including but not limited to the staff specific job duties, and hospice's philosophy, policies and procedures regarding methods of comfort, pain control, and symptom management, as well as principles about death and dying, individual responses to death, patient rights, appropriate forms, and record keeping requirements. In addition, hospice shall assess the skills and competence of all personnel, and, as necessary, provide in service training and education programs where required.

Hospice shall have written policies and procedures describing its method(s) of assessment of competency and maintain a written description of the in-service training provided during the previous 12 month period.

055906 03/29/2026

Rinaldi Convalescent Hospital 16553 Rinaldi St Granada Hills, CA 91344

During a review of the facility's P&P titled, Infection Control, last reviewed and revised on 1/29/2026, the P&P indicated the facility must maintain practices to facilitate a safe, sanitary and comfortable environment to help prevent and manage transmission of disease and infections.

055906 03/29/2026

Rinaldi Convalescent Hospital 16553 Rinaldi St Granada Hills, CA 91344

During a review of the Request for Room Size Waiver letter dated 3/29/2026, submitted by the Administrator (ADM), the Request for Room Size Waiver letter indicated the rooms (Rooms 101,102,104,105, and 107) did not meet the 80 square feet requirement per federal regulation.

The letter indicated the residents' beds were in accordance with the special needs of the residents and will not adversely affect the residents' health and safety and do not impede the ability of the residents in that room to obtain their highest practicable well-being.

The following rooms provided less than 80 square feet per resident:Rooms # Beds Floor Area Sq. Ft. Sq. Ft/Resident101 2 149.6 74.8102 2 149.6 74.8103 3 214.5 71.5104 3 220 73.3105 3 220 73.3The minimum square footage for a 2-bed room should be 160 sq. ft.

The minimum square footage for a 3-bed room should be 240 sq. ft During the Resident Council meeting on 3/28/2026 at 2:00 p.m., no concerns were brought up by the residents regarding the size of the rooms.

During the general observation of the residents' rooms on 3/28/2026 and 3/29/2026, the residents had ample space to move freely inside the rooms.

There was sufficient space to provide freedom of movement for the residents and for nursing staff to provide care for the residents.

There was also sufficient space for beds, side tables, and resident care equipment.

During interviews with staff on 3/29/2026 at 2:36 p.m., there were no concerns regarding the size of rooms 101, 102, 103, 104, and 105.

The facility submitted a written request for continued waiver.

During a review of the facility-provided policy and procedure (P&P) titled, Bedrooms, last reviewed on 1/29/2026, the P&P indicated that all residents are provided with clean, comfortable, and safe bedrooms that meet federal and state requirements.

Bedrooms measure at least 80 square feet of space per resident in double rooms, and at least 100 square feet of space in single room.