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Complaint Investigation

Southern California Hosp At Culver City D/p Snf

April 30, 2026 · Culver City, CA · 3828 Delmas Terrace
Citations 1
CMS Rating 2/5
Beds 21
Provider ID 555874
Healthcare Facility
Southern California Hosp At Culver City D/p Snf
Culver City, CA  ·  View full profile →
Source Document
Official CMS Inspection Report (Medicare.gov)
Downloaded from CMS/Medicare.gov. Reflects what state inspectors documented and does not include the facility's plan of correction, which is submitted separately. Facilities may have taken corrective actions since this report was released.
Inspection Summary

SOUTHERN CALIFORNIA HOSP AT CULVER CITY D/P SNF in CULVER CITY, CA — inspection on April 30, 2026.

Found 1 citation. 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

FF0609
Freedom from Abuse, Neglect, and Exploitation Deficiencies

During a review of Resident 1's Reporting of Suspected Dependent Adult/Elder Abuse Form SOC341, dated 3/24/2026, the SOC341 form indicated that it (the SOC341 form) was completed and faxed on 3/24/2026, which was two days (more than 24 hours) after the incident occurred.

During a review of the facility's incident report form, dated 3/26/2026, the incident report form indicated the incident occurred on 3/22/2026 at 1:10 pm, and the date of notification to CDPH was 3/26/2026, which was four days (more than 24 hours) after the incident occurred.

During an interview on 4/30/2026 at 11:45 a.m. with the Director of Risk and Quality (DRQ), the DRQ stated that according to Resident 1's Nursing Narrative Note, Resident 1's forehead bruise was discovered on 3/22/2026 at 5:49 pm, and according to the Social Services Note, the SW sent the SOC341 form to APS and called the Ombudsman on 3/24/26, which was two days (more than 24 hours) after the incident occurred.

The DRQ also verified the facility incident report was sent to CDPH on 3/26/2026 which was four days (more than 24 hours) after the incident occurred. DRQ stated that was a delay of reporting per state law and facility policy and that they were not aware of the reporting timeline regulation.

During an interview on 4/30/2026 at 12:33 p.m. with the Social Worker (SW), the SW stated that according to Resident 1's Social Services Note on 3/24/2026 at 10:49 a.m., the SW was aware the incident happened on 3/22/2026, which was a Sunday, and she (SW) followed up on this incident on 3/24/2026.

The SW confirmed she completed and faxed the SOC341 form to APS on 3/24/2026.

The SW also confirmed she (SW) called the ombudsman on the same day (3/24/2026), which was two days (more than 24 hours) after the incident occurred.

During a review of the facility's policy and procedure (P&P) titled, Abuse, Elder and Dependent Adult, Number SAU.002, dated 5/2025, the P&P indicated, Notify the state licensing agency within 24 hours by phone and within 72 hours by written report . and long term care ombudsman office by phone immediately. the following indicator do not always mean abuse or neglect has occurred, but they can be clues to the need for an abuse investigation. physical indicators, bruises, welts, discoloration, swelling cut lacerations, puncture wounds, cuts, lacerations, puncture wounds, pain or tenderness on touching.

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 CULVER CITY, 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 SOUTHERN CALIFORNIA HOSP AT CULVER CITY D/P SNF or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.


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About This Inspection Report

Source: This inspection report was downloaded directly from the Centers for Medicare & Medicaid Services (CMS) via Medicare.gov. CMS releases nursing home inspection reports in bulk. The findings reflect what state surveyors documented in the official Form CMS-2567 Statement of Deficiencies on the date of the inspection.

Plan of correction not included: The CMS report we receive does not include the facility's plan of correction. Facilities submit plans of correction separately to their state survey agency and those responses may not appear in CMS public data at the time of release. The absence of a plan of correction in this report does not mean one was not filed. Readers who want information about corrective steps taken by the facility are encouraged to contact the facility or their state survey agency directly.

Corrections may have been made: This report reflects conditions observed on the date of the survey. The facility may have implemented staffing changes, additional training, policy revisions, or other corrective actions since this report was issued. We publish what CMS provides and encourage readers to seek current information from the facility.