Complaint Investigation

Capistrano Beach Care Center

May 28, 2026 · Dana Point, CA · 35410 Del Rey

Citations 2

CMS Rating 1/5

Beds 93

Provider ID 055585

Healthcare Facility

Capistrano Beach Care Center

Dana Point, 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

CAPISTRANO BEACH CARE CENTER in DANA POINT, CA — inspection on May 28, 2026.

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

FF0842

Resident Assessment and Care Planning Deficiencies

Review of Resident 1's H&P examination dated 5/11/26, showed Resident 1 had the capacity to understand and make medical decisions.

Review of Resident 1's MDS assessment dated [DATE], showed the resident had moderate cognitive impairment.

Review of Resident 1's Order Summary Report showed a physician's order dated 5/15/26, for Resident 1 to have his Right Upper Arm PICC dressing and Stat-lock changed every Friday. On 5/27/26 at 1545 hours, an observation was conducted with Resident 1.

Resident was observed to have a PICC line inserted into his right upper arm with a dressing over it dated 5/15/25. On 5/27/26 at 1608 hours, an observation, interview, and concurrent medical record review for Resident 1 was conducted with RN 2. RN 2 confirmed he changed the dressing and Stat-lock on 5/15/25. RN 2 stated the dressing and Stat-lock should have been changed a week later on 5/22/26.

Review of Resident 1's Intravenous MAR showed the PICC line dressing and Stat-lock had been documented as changed on 5/22/26 by RN 1. RN 2 stated the documentation should be done after a task was completed and not before. On 5/27/26 at 1630 hours an observation, interview, and concurrent medical record review for Resident 1 was conducted with the DON.

The DON verified the above findings.

The DON stated the PICC line dressing and Stat-lock should have been changed every Friday and as needed to prevent infections.

The DON stated the documentation should have been done after the nurse completed the dressing change.

The DON stated if the documentation was done prior to a task being performed, there was a potential for it to be missed. On 5/28/26 at 0730 hours, an interview and concurrent record review was conducted with RN

RN 1 stated she had documented that the task was completed but must have forgotten to update

the record accordingly. RN 1 stated she should have documented it after she finished the dressing change.

Cross Reference to F-F880 Any deficiency statement ending with an asterisk (*) denotes a deficiency which the institution may be excused from correcting providing it is determined that other safeguards provide sufficient protection to the patients. (See instructions.) Except for nursing homes, the findings stated above are disclosable 90 days following the date of survey whether or not a plan of correction is provided.

For nursing homes, the above findings and plans of correction are disclosable 14 days following the date these documents are made available to the facility. If deficiencies are cited, an approved plan of correction is requisite to continued program participation.

LABORATORY DIRECTOR'S OR PROVIDER/SUPPLIER TITLE (X6) DATE REPRESENTATIVE'S SIGNATURE

055585 05/28/2026

Capistrano Beach Care Center 35410 Del Rey Dana Point, CA 92624

FF0880

Infection Control Deficiencies

Review of Resident 1's H&P examination dated 5/11/26, showed Resident 1 had the capacity to understand and make medical decisions.

Review of Resident 1's MDS assessment dated [DATE], showed the resident had moderate cognitive impairment.

Review of Resident 1's Order Summary Report showed a physician's order dated 5/15/26, for Resident 1 to have his right upper arm PICC dressing and Stat-lock to change every Friday. On 5/27/26 at 1545 hours, an observation was conducted with Resident 1. Resident 1 was observed to have a PICC line inserted in his right upper arm with a dressing dated 5/15/25. On 5/27/26 at 1608 hours, an observation, interview, and concurrent medical record review for Resident 1 was conducted with RN 2. RN 2 confirmed he changed the dressing and Stat-Lock on 5/15/25. RN 2 stated the dressing and Stat-Lock should have been changed one week later, on 5/22/26. On 5/27/26 at 1630 hours an observation, interview, and concurrent medical record review for Resident 1 was conducted with the DON.

The DON confirmed the above findings.

The DON stated the PICC line dressing and Stat-lock should have been changed every Friday, and as needed to prevent infections.

Cross Reference to F-F842

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 DANA POINT, 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 CAPISTRANO BEACH CARE CENTER or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.

More Reports

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.