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F0584
D

Failure to Maintain Safe and Homelike Resident Room Environment

El Monte, California Survey Completed on 07-10-2025

Penalty

Fine: $20,490
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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

A deficiency was identified when a resident's bedroom wall was found to be missing part of the baseboard, exposing drywall and peeling paint. This condition was observed during a survey in the resident's room, specifically behind the bed. The resident had a history of sepsis, lack of coordination, and dysphagia, and was assessed as having moderately impaired cognition. The resident used a walker and required setup or clean-up assistance with toileting hygiene. The missing baseboard and exposed wall were confirmed by both the Director of Nursing (DON) and the Maintenance Supervisor (MS) during interviews and observations, with both acknowledging that the area should not be left in that condition. The facility's policies and procedures for housekeeping and maintenance were reviewed and indicated that the environment should be kept clean, comfortable, homelike, and sanitary, and that the building and equipment should remain safe, clean, and functional for residents, staff, and visitors. The failure to maintain the resident's room in accordance with these policies resulted in a living area that was not safe, clean, or homelike, as required.

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