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F0558
D

Failure to Provide Communication Accommodations for LEP Resident

Laguna Hills, California Survey Completed on 10-10-2025

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 provide reasonable accommodations for a resident with limited English proficiency (LEP) who primarily spoke Cantonese and Vietnamese. Despite facility policies requiring language assessments, notification of language access coordinators, and provision of communication aids such as interpreters and communication boards, the resident was not provided with effective means to communicate daily needs. Observations and interviews revealed that the resident could not effectively communicate with staff due to the absence of staff who spoke her language, lack of a communication board in her room, and no use of telephone translation services by staff. The resident's medical records indicated she was alert, oriented, and had moderate cognitive impairment, with a stated preference for communication in Cantonese and a need for an interpreter. During interviews, the resident reported having to wait for family members to communicate her needs, as staff did not use available translation resources. Staff members, including an LVN and CNA, were unable to locate a communication board in the resident's room and demonstrated a lack of knowledge regarding the use of language line services. The Director of Staff Development also failed to show that communication aids were available for the resident. Family members expressed concern about the resident's ability to have her needs met, especially during times when family was not present. They confirmed that staff had not used communication boards or translation services during the resident's stay. The facility's failure to provide these accommodations had the potential to negatively impact the resident's psychosocial well-being and could result in delayed provision of care, as the resident's needs may not have been effectively communicated or addressed.

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