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Complaint Investigation

Rose Villa Health Care Center

Inspection Date: November 26, 2025
Total Violations 1
Facility ID 056104
Location BELLFLOWER, CA
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Inspection Findings

F-Tag F0760

Pharmacy Service Deficiencies
Harm Level: Potential for More Than Minimal Harm

F 0760 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some

FORM CMS-2567 (02/99) Previous Versions Obsolete

Hydroxychloroquine at 11:56 a.m. (almost three hours after the scheduled dose). 7. Valproic Acid was scheduled to be administered at 9 a.m., however, the report indicated LVN 3 documented that she administered Valproic Acid at 11:55 a.m. (almost three hours after the scheduled dose). 8. Metoprolol was scheduled to be administered at 9 a.m., however, the report indicated LVN 3 documented she administered Metoprolol at 11:55 a.m. (almost three hours after the scheduled dose). 9. Potassium Chloride was scheduled to be administered at 9 a.m., however, the report indicated LVN 3 documented that she administered Potassium at 11:55 a.m. (almost three hours after the scheduled dose).10. Prednisone was scheduled to be administered at 9 a.m., however, the report indicated LVN 3 documented she administered Prednisone at 11:55 a.m. (almost three hours after the scheduled dose).11. Docusate was scheduled to be administered at 9 a.m., however, the report indicated LVN 3 documented she administered Docusate at 12:03 p.m. (three hours after the scheduled dose). During an interview on 11/26/2025, at 3:50 p.m. LVN 2 stated on 11/15/2025 she administered Resident 4's 9 am scheduled medications late due to the facility being short staffed that day. LVN 2 stated the facility policy states medications can be given up to one hour

before or one hour after the scheduled time. LVN 2 stated administered medications after the scheduled time leads to potential risk of overdosage or underdosage of medication.During an interview on 11/26/2025, at 4:05 p.m. LVN 3 stated on 11/19/2025 she administered Resident 4's 9 a.m. scheduled medications about three hours late due to being busy with other residents. LVN 3 stated she did not ask for help from her coworkers because everyone seemed busy.During an interview on 11/26/2025, at 4 p.m., the DON stated when residents do not receive their medications on time as prescribed and scheduled, the resident is at risk for underdosage or overdosage if the medications are given too close together. The DON stated that administering certain medications late that directly affect the heart rate and blood pressure can cause harm to the resident. The DON stated, the although the licensed nurses are instructed to ask for help when

they anticipate they are falling behind on administering medications, they often choose not to ask for assistance. The DON stated that the facility will call in additional nurses to work to cover shifts that are short staffed. The DON stated she was not aware of any short staffing on 11/15/2025 or 11/19/2025.During a

review of the facility's Policy and Procedure (P&P) titled, Medications Administration, revised 2012, the P&P indicated medications are administered within 60 minutes of scheduled time, except before or after meals orders, which are administered based on mealtimes.

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📋 Inspection Summary

ROSE VILLA HEALTH CARE CENTER in BELLFLOWER, CA inspection on recent inspection.

Found 0 violation(s). Severity: Standard violations. Status: 0 corrected, 0 pending.

What this means: Health inspections identify deficiencies that facilities must correct. Violations range from minor documentation issues to serious safety concerns. All deficiencies must be corrected within required timeframes and are subject to follow-up verification.

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 BELLFLOWER, 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 ROSE VILLA HEALTH CARE CENTER or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.
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