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Complaint Investigation

Golden Haven Care Center

August 10, 2024 · Glendale, CA · 409 W. Glenoaks Blvd.
Citations 3
CMS Rating 1/5
Beds 99
Provider ID 056317
Healthcare Facility
Golden Haven Care Center
Glendale, CA  ·  View full profile →
Inspection Summary

GOLDEN HAVEN CARE CENTER in GLENDALE, CA — inspection on August 10, 2024.

Found 3 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

FF635
Minimal harm or M. The Nursing Admission Assessment indicated Resident 1 had a diagnosis of DM Type 2. Few prevent complications related to diabetes, Resident 1 will be monitored and will document, and report signs affected

During a review of Resident 1 ' s GACH 1 record titled Discharge Documentation dated [DATE], timed at 11:07 AM, indicated Issues to Address on Outpatient Follow Up/Discharge Action Plan which included Resident 1 to have continued diabetes management upon admission in the facility.

The Discharge Documentation record indicated Resident 1 received insulin in GACH 1 and will need physician [follow up] for DM care.

Further review of the Discharge Documentation indicated Resident 1 ' s last blood

sugar result in GACH 1 on [DATE] was 157.

During a review of Resident 1 ' s Facility Admission Record indicated the resident was admitted to the facility on [DATE], with diagnoses that included DM, encephalopathy (damage or disease that affects the brain), dementia (a syndrome that causes a decline in cognitive [thought process] abilities, such as thinking, remembering, and making decisions, that can interfere with daily activities), and hypertension (high blood pressure).

056317

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 056317 B.

Wing 08/10/2024

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

Golden Haven Care Center 409 W.

Glenoaks Blvd.

Glendale, CA 91202

During a review of Resident 1 ' s GACH 1 record titled Discharge Documentation dated [DATE], timed at 11:07 AM, indicated Issues to Address on Outpatient Follow Up/Discharge Action Plan which included Resident 1 to have continued diabetes management upon admission in the facility.

The Discharge Documentation record indicated Resident 1 received insulin in GACH 1 and will need physician [follow up] for DM care.

Further review of the Discharge Documentation indicated Resident 1 ' s last blood sugar result in GACH 1 on [DATE] was 157.

During a review of Resident 1 ' s Facility Admission Record indicated the resident was admitted to the facility on [DATE], with diagnoses that included DM, encephalopathy (damage or disease that affects the brain), dementia (a syndrome that causes a decline in cognitive [thought process] abilities, such as thinking, remembering, and making decisions, that can interfere with daily activities), and hypertension (high blood pressure).

During a review of Resident 1 ' s Facility Nursing Admission Assessment, dated [DATE], timed at 6:03 PM, signed by LVN 1 and LVN 3, indicated the resident was admitted to the facility on [DATE] at around 5:10 P. M.

The Nursing Admission Assessment indicated Resident 1 had a diagnosis of DM Type 2.

056317

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 056317 B.

Wing 08/10/2024

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

Golden Haven Care Center 409 W.

Glenoaks Blvd.

Glendale, CA 91202

During a review of Resident 1 ' s GACH 1 record titled Discharge Documentation dated [DATE], timed at 11:07 AM, indicated Issues to Address on Outpatient Follow Up/Discharge Action Plan which included Resident 1 to have continued diabetes management in the facility.

The Discharge Documentation record indicated Resident 1 received insulin in GACH 1 and will need physician [follow up] for DM care.

Further review of the Discharge Documentation indicated Resident 1 ' s last blood sugar result in GACH 1 on [DATE] was 157.

During a review of Resident 1 ' s Admission Record indicated the resident was admitted to the facility on [DATE], with diagnoses that included DM, encephalopathy (damage or disease that affects the brain), dementia (a syndrome that causes a decline in cognitive [thought process]) abilities, such as thinking, remembering, and making decisions, that can interfere with daily activities), and hypertension (high blood pressure).

During a review of Resident 1 ' s Nursing Admission Assessment, dated [DATE], timed at 6:03 PM, signed by LVN 1 and LVN 3, indicated the resident was admitted to the facility on [DATE] at around 5:10 P.M.

The Nursing Admission Assessment indicated Resident 1 had a diagnosis of DM Type 2.

During a review of Resident 1 ' s care plan titled, The resident [Resident 1] has DM, initiated on [DATE] and revised on [DATE], indicated a goal for the resident to not have complications related to diabetes.

The care plan interventions included to monitor, document, and report signs and symptoms of hyperglycemia and hypoglycemia.

056317

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 056317 B.

Wing 08/10/2024

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

Golden Haven Care Center 409 W.

Glenoaks Blvd.

Glendale, CA 91202

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


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