Terrace View Care Center
TERRACE VIEW CARE CENTER in FULLERTON, CA — inspection on October 29, 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
Review of Resident 1's Fall Risk assessment dated [DATE] at 0441 hours, showed multiple inaccurate entries for Resident 1 including no falls for the resident when the resident had two falls in the past three weeks. Resident 1 had a fall in the facility on 6/2/25 at 2310 hours; and one on 5/11/25, in the community, which resulted in severe injury and subsequent hospitalization and transfer to the facility.
Additionally, the high risk medication screening section of the Fall Risk Assessment showed no medications taken by Resident 1, however, Resident 1 had a physician's orders for a diuretic (medications to help the body get rid of excess salt and water by increasing urine production) medication, an antihypertensive (medication to lower blood pressure) , a narcotic (controlled medications which require prescription from the physician) medication and a sedative (medications to provide calming or sleep-inducing effect). On 10/29/25 at 0640 hours, an interview and concurrent closed medical record review for Resident 1 was conducted with LVN 3. LVN 3 verified Resident 1's Fall Risk Assessment had multiple inaccuracies, which included the number of falls and the medications Resident 1 was taking. LVN 3 stated the resident's fall risk score would have been higher if it had been scored accurately. On 10/29/25 at 1445 hours, an interview and concurrent closed medical record review for Resident 1 was conducted with the DON.
The DON verified Resident 1's Fall Risk Assessment contained multiple inaccuracies, which included the number of falls and the medications Resident 1 was taking.
The DON stated the resident's fall risk score would be higher if it had been assessed and scored accurately.
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 REPRESENTATIVE'S SIGNATURE
TITLE
Facility ID:
IDENTIFICATION NUMBER:
A.
Building
COMPLETED
10/29/2025
STREET ADDRESS, CITY, STATE, ZIP CODE
Terrace View Care Center
201 East Bastanchury Fullerton, CA 92835
SUMMARY STATEMENT OF DEFICIENCIES
Review of Resident 1's 72 Hour Neuro Check - List dated 6/2/25, at 2310 hours showed Resident 1 had an unwitnessed fall.
Review of Resident 1's 72 Hour Neuro Check - List dated 6/3/25, showed the time entries for the required time intervals for neuro checks for Resident 1.
The interval between the three one-hour required neuro checks showed time entries of 0140, 0240, and 0340 hours.
The neuro check time intervals then changed to every two hours and the next time interval for the neuro check would have been at 0540 hours.
The time interval on the neuro check sheet showed an entry at 0640 hours, which was an incorrect time interval by one hour. On 10/29/25 at 0640 hours, an interview and concurrent closed medical record review for Resident 1 was conducted with LVN 3. LVN 3 verified Resident 1's 72 Hour Neuro Check - List entry was inaccurate. On 10/29/25 at 1445 hours, an interview and concurrent closed medical record review for Resident 1 was conducted with the DON.
The DON verified the time entry on the 72 Hour Neuro Check List had incorrect time entry.
Facility ID: