Alhambra Healthcare: Consent Form Left Incomplete - CA
The lapse surfaced during a complaint inspection at Alhambra Healthcare & Wellness Centre on November 25, 2025. Inspectors reviewed a consent form dated October 21, 2025, and found it incomplete. The licensed vocational nurse who handled the consent, identified in inspection records as LVN 1, was straightforward about what happened. "I forgot to write FM 1's name on the verification of informed consent form," she told inspectors. "The consent form was incomplete."
That admission was the beginning and the end of the explanation.
The consent had been obtained over the phone from the resident's responsible party, a family member. Under the facility's own documentation standards, the nurse was expected to do two things after that call: complete the consent form with the family member's name, and write a progress note documenting the discussion. Neither was done.
The director of nursing reviewed the same form with inspectors at 4:14 that afternoon and confirmed both failures. The licensed staff, the DON said, should have completed the informed consent after obtaining it over the phone. The staff member should also have documented the discussion in the nurse's progress notes. There was no note. There was no name.
Four minutes later, inspectors sat with the DON again and went through the facility's own policy on documentation, a procedure titled "Completion & Correction" that the facility last revised in January 2012. The policy is not ambiguous. It calls for entries that are "complete, legible, descriptive and accurate." The DON looked at the incomplete form and said what the record already showed: if the licensed staff did not have complete and accurate documentation, the licensed staff did not follow the facility's policy.
Inspectors tagged the violation as F0842, covering medical record accuracy and completeness. The level of harm was recorded as minimal, or potential for actual harm, affecting a few residents.
What the inspection report does not say is whether anyone contacted the family member again, whether the form was ever corrected, or whether the progress note was ever written. The record reviewed by inspectors on November 25 showed a consent form from five weeks earlier, still missing the name of the person who gave consent.
A consent form exists to document that someone with authority over a resident's care agreed to something, and that the agreement was real, informed, and recorded. When the name of the person who consented is absent, the form documents nothing verifiable. The phone call happened, or it didn't. The family member agreed, or they didn't. Without the name and without the progress note, the medical record cannot answer either question.
The facility's documentation policy has been in place, in its current form, for more than thirteen years.
Full Inspection Report
The details above represent a summary of key findings. View the complete inspection report for Alhambra Healthcare & Wellness Centre, Lp from 2025-11-25 including all violations, facility responses, and corrective action plans.
Additional Resources
Data source: This article is based on inspection data downloaded directly from the Centers for Medicare & Medicaid Services (CMS) via Medicare.gov. CMS releases inspection reports in bulk; we publish the findings as documented by state surveyors in the official Form CMS-2567 Statement of Deficiencies.
Plan of correction: The CMS report we receive does not include the facility's plan of correction. Facilities submit plans of correction separately to state survey agencies and those responses may not be reflected in CMS data at the time of publication. The absence of a plan of correction in our data does not mean one was not filed. Readers who want information about corrective steps taken are encouraged to contact the facility directly or their state survey agency.
Corrections may have occurred: Inspection reports reflect conditions observed on the date of the survey. Facilities may have implemented corrections, staffing changes, additional training, or other remediation since the report was issued. We report what CMS provides and encourage readers to seek current information from the facility.
Editorial process: Inspection findings are extracted from CMS source documents and synthesized using AI, reviewed for factual accuracy against the original report by our editorial team.
Professional review: All content reviewed by Christopher F. Nesbitt, Sr., NH EMT & BU-trained Paralegal.
Last verified: August 28, 2026 · Our methodology
ALHAMBRA HEALTHCARE & WELLNESS CENTRE, LP in ALHAMBRA, CA was cited for violations during a health inspection on November 25, 2025.
The lapse surfaced during a complaint inspection at Alhambra Healthcare & Wellness Centre on November 25, 2025.
Health inspections identify deficiencies that facilities must correct. Violations range from minor documentation issues to serious safety concerns. Review the full report below for specific details and facility response.