Complaint Investigation

The Pavilion At Sunny Hills

January 30, 2026 · Fullerton, CA · 2222 N. Harbor Blvd.

Citations 1

CMS Rating 2/5

Beds 300

Provider ID 555733

Healthcare Facility

The Pavilion At Sunny Hills

Fullerton, 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

THE PAVILION AT SUNNY HILLS in FULLERTON, CA — inspection on January 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

FF0695

Quality of Life and Care Deficiencies

assessment dated [DATE], showed a BIMS score of 12 (moderately impaired cognition).

Review of

observation was conducted in Resident 3's room.

The oxygen tubing curled around the portable

the back of Resident 3's wheelchair. In addition, Resident 3 was on oxygen therapy using an oxygen concentrator via nasal canula.

However, there was no oxygen in use signage outside of Resident 3's room. On 1/30/26 at 0949 hours, an observation and concurrent interview was conducted with CNA 3.

CNA 3 verified Resident 3's oxygen tubing curled around the oxygen tank at the back of Resident 3's wheelchair was not bagged and labeled. CNA 3 also verified Resident 3's entrance door did not have an oxygen in use sign. On 1/30/26 at 0952 hours, an observation and concurrent interview was conducted with LVN 5. LVN 5 verified Resident 3's oxygen tubing curled around the oxygen tank at the back of Resident 3's wheelchair was not bagged and labeled. LVN 5 stated it should have been bagged and labeled. LVN 5 also verified there was no oxygen in use signage in Resident 3's room entrance door. On 1/30/26 at 1100 hours, an interview was conducted with the IP.

The IP was informed and acknowledged the above findings.

The IP stated the oxygen and nebulizer tubing should be changed, bagged and dated by the night shift once a week and as needed.

The IP stated there should be an oxygen in use signage for all rooms with residents using oxygen.

The IP further stated the oxygen and nebulizer tubing should have been bagged and dated when not in use.

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 FULLERTON, 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 THE PAVILION AT SUNNY HILLS 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.