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Health Inspection

Claremont Manor Care Center

January 24, 2025 · Claremont, CA · 621 W Bonita Ave
Citations 4
CMS Rating 3/5
Beds 59
Provider ID 555085
Healthcare Facility
Claremont Manor Care Center
Claremont, CA  ·  View full profile →
Inspection Summary

CLAREMONT MANOR CARE CENTER in CLAREMONT, CA — inspection on January 24, 2025.

Found 4 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.

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Inspection Findings

FF580
Actual harm Few on 1/17/2025, the CP's interventions indicated to provide reorientation, and redirection as needed to affected

During a review of Resident 92's Progress Notes (PN), dated 1/16/2025, timed at 3:10 PM, the PN indicated Resident 92 was alert (a state of careful watching and readiness) and had some forgetfulness.

The PN indicated Resident 92's gait (manner of walking) was unsteady, and Resident 92 had poor balance.

During a review of Resident 92's PN, dated 1/16/2025, timed at 9:34 PM, the PN indicated Resident 92 was confused, needed full assistance with activities of daily living (ADL, term used in healthcare that refers to self-care activities), and was at risk for falls (fall risk was not indicated).

555085

Form Approved OMB

STATEMENT OF DEFICIENCIES (X1) PROVIDER/SUPPLIER/CLIA (X2) MULTIPLE CONSTRUCTION (X3) DATE SURVEY AND PLAN OF CORRECTION IDENTIFICATION NUMBER: COMPLETED A.

Building 555085 B.

Wing 01/24/2025

NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE

Claremont Manor Care Center 621 W Bonita Ave Claremont, CA 91711

During a review of Resident 32's Admission Record (AR), the AR indicated the facility admitted Resident 32 on 6/26/2024, and readmitted the resident on 10/30/2024, with diagnoses including hemiplegia/hemiparesis (paralysis [complete or partial loss of muscle function] on one side of the body), and hemiparesis, muscle weakness (generalized), and need for assistance with personal care.

555085

Form Approved OMB

STATEMENT OF DEFICIENCIES (X1) PROVIDER/SUPPLIER/CLIA (X2) MULTIPLE CONSTRUCTION (X3) DATE SURVEY AND PLAN OF CORRECTION IDENTIFICATION NUMBER: COMPLETED A.

Building 555085 B.

Wing 01/24/2025

NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE

Claremont Manor Care Center 621 W Bonita Ave Claremont, CA 91711

During a review of Resident 37's Admission Record (AR), the AR indicated Resident 37 was admitted to the facility on [DATE] with diagnoses that included anxiety, Raynaud's Syndrome (condition that causes blood vessels in the extremities to narrow), and dysphagia (difficulty swallowing).

During a review of Resident 37's History and Physical (H&P), formal document of a medical provider's examination of a patient) dated 12/27/2024, the H&P indicated Resident 37 did not have the capacity to understand and make decisions.

During a review of Resident 37's Minimum Data Set (MDS, a standardized comprehensive assessment of each resident's functional capabilities and identifies health problems) dated 1/2/2025, the MDS indicated Resident 37's cognitive abilities (ability to think, learn, and process information) were intact.

The MDS indicated Resident 37 required maximal assistance with rolling left and right.

During a review of Resident 37's Continuous Pressure Ulcer Prevention (CPUP) form dated 1/11/2025, the CPUP form indicated a skin change with a circle on the rear side of the anatomical diagram.

555085

Form Approved OMB

STATEMENT OF DEFICIENCIES (X1) PROVIDER/SUPPLIER/CLIA (X2) MULTIPLE CONSTRUCTION (X3) DATE SURVEY AND PLAN OF CORRECTION IDENTIFICATION NUMBER: COMPLETED A.

Building 555085 B.

Wing 01/24/2025

NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE

Claremont Manor Care Center 621 W Bonita Ave Claremont, CA 91711

During a review of Resident 92's Progress Notes (PN), dated 1/16/2025, timed at 3:10 PM, the PN indicated Resident 92 was alert (a state of careful watching and readiness) and had some forgetfulness.

During an interview with Registered Nurse (RN)1 on 1/22/2025, at 11:48 PM, RN 1 stated upon Resident 92's admission (1/16/2025), Resident 92 was non-verbal and did not attempt to get out of bed. RN 1 stated on 1/20/2025, during the AM shift, Resident 92 was placed at the nurse's station for constant (occurring continuously oer a period of time) monitoring because Resident 92 consistently attempted to stand up, mumbled, and spoke to herself. RN 1 stated, she (RN 1) did not notify MD 1 about the change in Resident 1's condition/mentation (the ability, activity, or result of using your mind to think).

During an interview and concurrent record review with the Director of Nursing (DON) on 1/24/2025, at 8:55 AM, the DON stated a change in resident's condition (COC, a sudden clinically important deviation from a resident's baseline in physical, cognitive, behavioral, or functional domains), was defined as someone not at their baseline (an initial condition taken at an early time and used for comparison over time to look for changes).

The DON stated on 1/20/2025, when Resident 92 had an increase in confusion and was attempting to get up [from the bed/ wheelchair], this behavior made Resident 92 at risk for falling.

The DON stated RN 1 needed to call and notify MD 1 to make MD 1 aware of what was going on when Resident 92 had an increase in confusion and started to get up unassisted while on the WC.

555085

Form Approved OMB

STATEMENT OF DEFICIENCIES (X1) PROVIDER/SUPPLIER/CLIA (X2) MULTIPLE CONSTRUCTION (X3) DATE SURVEY AND PLAN OF CORRECTION IDENTIFICATION NUMBER: COMPLETED A.

Building 555085 B.

Wing 01/24/2025

NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE

Claremont Manor Care Center 621 W Bonita Ave Claremont, CA 91711

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 CLAREMONT, 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 CLAREMONT MANOR CARE CENTER or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.


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