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F0883
D

Failure to Document and Administer Influenza and Pneumococcal Vaccines

Anaheim, California Survey Completed on 04-14-2025

Penalty

No penalty information released
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The penalty, as released by CMS, applies to the entire inspection this citation is part of, covering all citations and f-tags issued, not just this specific f-tag. For the complete original report, please refer to the 'Details' section.

Summary

The facility failed to ensure that two of five sampled residents received appropriate influenza and pneumococcal immunizations as required by facility policy. For one resident, the medical record indicated a refusal of the pneumococcal vaccine, but the consent/declination form was undated, and there was no documentation of additional attempts to offer the vaccine. The Infection Preventionist (IP) confirmed that the resident's record lacked a date for the refusal and did not show further efforts to administer the vaccine. For another resident, the immunization record documented a refusal of the influenza vaccine, but no date was provided for the refusal. Additionally, the vaccine consent/declination form was signed by the resident's responsible party, but there was no evidence in the medical record that the influenza vaccine was administered. The IP verified the absence of documentation regarding the administration of the influenza vaccine for this resident.

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