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F0584
D

Failure to Complete Resident Personal Belongings Inventory at Admission and Discharge

Pleasant Hill, California Survey Completed on 01-05-2026

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 complete a personal belongings inventory for one sampled resident, resulting in an inaccurate record of the resident's possessions. The resident was admitted with diagnoses including nonrheumatic tricuspid valve disorder and later discharged home. A review of the admission record showed that, at the time of admission, the Inventory of Personal Effects form for this resident was not filled out. During an interview and concurrent record review, the Administrator confirmed that the Inventory of Personal Effects form for this resident had not been completed. Further review of the Inventory of Personal Effects form showed that the section listing the resident's personal belongings was blank, and the Certification of Receipt sections for both admission and discharge contained no signatures from the resident or resident representative, nor from a facility staff representative. Review of the facility's policy and procedure titled "Resident's Personal Property" indicated that personnel are required to identify and record resident belongings upon admission, list all items on the Inventory of Personal Effects form, keep the form in the clinical chart, add any additional items brought in after admission, and obtain signatures from the resident or representative and an employee at admission and again at discharge. These required steps were not carried out for this resident.

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