Villa Del Rio
VILLA DEL RIO in BELL GARDENS, CA — inspection on November 18, 2025.
Found 2 citations. Severity: Standard violations.
Health inspections identify deficiencies that facilities must correct within required timeframes. Violations range from minor documentation issues to serious safety concerns and are subject to follow-up verification.
Inspection Findings
During an interview on 10/29/2025 at 1:00 p.m., with HK 2, HK 2 stated Resident 7's toilet seat was observed broken on 10/28/2025 but was not written in the maintenance book and the MS was not informed.
During an interview on 10/29/2025 at 1:54 p.m. with MS, the MS stated if there was anything in residents' rooms broken and needing repair, the staff should write the information in the maintenance repair binder at the nurses' station.
The MS stated the Maintenance Assistant (MA) would check the binder every morning.
During an interview on 10/29/2025 at 2:20 p.m., with the Director of Nursing (DON), the DON stated the facility must ensure the residents' bathrooms, doors, toilet seats and walls are kept clean and in good working condition, and residents are provided with a safe and home-like environment.
During a review of the facility's policy and procedures (P&P) titled, Safe and Homelike Environment, dated 1/2025, the P&P indicated the facility should provide residents with a safe, clean, comfortable and homelike environment.
During a review of the facility's P&P titled, Maintenance Services, dated 1/2025, the P&P indicated the maintenance department is responsible for maintaining the building is in good repair and free from hazards.
Facility ID:
IDENTIFICATION NUMBER:
A.
Building
COMPLETED
11/18/2025
STREET ADDRESS, CITY, STATE, ZIP CODE
Villa Del Rio
7002 Gage Avenue Bell Gardens, CA 90201
SUMMARY STATEMENT OF DEFICIENCIES
During a concurrent observation and interview on 10/28/2025 at 10:10 a.m., in Resident 3's room, LVN 1 had all of Resident 3's medications crushed in a plastic bag. LVN 1 administered Resident 3's medications via gastrostomy tube (a tube surgically inserted into the stomach for medications and nutrition administration). LVN 1 stated he usually put all medications in one bag and crush them. LVN 1 stated all the medications are going to the same place (unspecified). LVN 1 stated that after the medications were administered, the staff can monitor the residents. LVN 1 stated he does not know what the facility policy was on crushing the medications separate.During a review of Resident 3's admission Record, the admission Record indicated Resident 3 was admitted to the facility on [DATE] and re-admitted on [DATE]. Resident 3's diagnoses included HTN, DM, and Parkinson disease (a progressive neurological disorder that affects movement, balance, and coordination).During a review of Residents 3's MDS dated [DATE], the MDS indicated Resident 3 had cognitive impairment.
The MDS indicated Resident 3 was dependent on staff with ADLs such as dressing, toilet use, personal hygiene, transfer and mobility.During a review of Resident 3's Physicians Orders for 10/2025, the physician orders indicated Resident 2's order for Amlodipine 10 mg daily at 9 a.m., Carvedilol (treat high blood pressure) tablet 6.25mg daily, Metformin (treat type 2 diabetes) 500 mg daily and Amantadine (anti-Parkinson's agent) 50 mg daily.During an interview on 10/28/2025 at 1:58 p.m., with LVN 1, LVN 1 stated the nurses should let the residents know what kind of medications they were given to take regardless if they understand or not. LVN 1 stated each medication should have been administered separately, in case residents display any adverse reaction to the medication and vomit. LVN 1 stated it would be easier to point out which medication had caused the discomfort.
During an interview on 10/29/2025 at 2:20 p.m. with the Director of Nursing (DON), the DON stated nurses must follow the 5 rights of medications pass (unspecified).
The DON stated nurses should explain to the residents the name of medications they were administrating.
The DON stated staff should crush the medication separately to identify what medications were administrated.During a review of the facility's policy and procedures (P&P) titled, Medication Administration, dated 1/2025, the P&P indicated, medications should be administrated by licensed nurses, in accordance with professional standards of practice.
The P&P indicated to explain the purpose of medication administration.
Facility ID:
Frequently Asked Questions
- What is an F-tag violation?
- F-tags are federal deficiency codes used by CMS to categorize nursing home violations. Each F-tag corresponds to a specific federal regulation (42 CFR Part 483). For example, F607 relates to abuse prevention policies, F880 relates to infection control.
- Were these violations corrected?
- Facilities must submit plans of correction and implement changes within required timeframes. CMS conducts follow-up inspections to verify corrections. Check the inspection report for specific correction dates and follow-up verification status.
- How often do nursing home inspections happen?
- CMS conducts unannounced inspections of all Medicare/Medicaid-certified nursing homes at least once per year. Additional inspections may occur based on complaints, facility-reported incidents, or follow-up to verify previous violations were corrected.
- What should families do about these violations?
- Families should: (1) Review the full inspection report for details, (2) Ask facility administration about specific corrective actions taken, (3) Check if this represents a pattern by reviewing prior inspections, (4) Compare with other facilities in BELL GARDENS, CA, (5) Report new concerns to state authorities.
- Where can I see the full inspection report?
- Complete inspection reports are available on Medicare.gov's Care Compare website (www.medicare.gov/care-compare). You can also request copies directly from VILLA DEL RIO or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.