Park Regency Care Center
Inspection Findings
F-Tag F0656
F 0656 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few
FORM CMS-2567 (02/99) Previous Versions Obsolete
risk for elopement and there was no care plan to address the resident's elopement risk before 8/18/25. RN 2 acknowledged the care plan for Resident 2's elopement risk was created on 8/18/25. RN 2 stated Resident 2's care plan should have been initiated right away. On 8/27/25 at 1625 hours, an interview and concurrent medical record review was conducted with the DON. The DON acknowledged the above findings. The DON stated Resident 2's care plan should have been created as soon as the resident was identified as an elopement risk. On 8/27/25 at 1644 hours, the Administrator and DON were informed and acknowledged the above findings.
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Printed: 04/13/2026 Form Approved OMB No. 0938-0391
Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION
(X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER:
(X2) MULTIPLE CONSTRUCTION
B. Wing
A. Building
(X3) DATE SURVEY COMPLETED
08/27/2025
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Park Regency Care Center
1770 W. LA Habra Blvd.
LA Habra, CA 90631
For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG
SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)
F-Tag F0689
F 0689 Level of Harm - Potential for minimal harm Residents Affected - Some
FORM CMS-2567 (02/99) Previous Versions Obsolete
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on interview, closed medical record review, and facility P&P review, the facility failed to provide the necessary care and services to prevent accident hazards for one of three sampled residents (Resident 1). * The facility failed to ensure Resident 1 did not eloped from the facility. This failure had the potential to place Resident 1 at risk of serious injury.Findings: Review of the facility's P&P titled Elopements and Wandering Residents reviewed/revised 12/2022 showed this facility ensures that residents who exhibit wandering behavior and/or are at risk for elopement receive adequate supervision to prevent accidents and receive care in accordance with their person-centered plan of care addressing the unique factors contributing to wandering or elopement risk. The Policy Explanation and Compliance Guidelines section showed alarms are not a replacement for necessary supervision. Staff are to be vigilant in responding to alarms in a timely manner.
- 1. Closed medical record review for Resident 1 was initiated on 8/26/25. Resident 1 was admitted to the
facility on [DATE REDACTED], and discharged on 8/24/25. Review of Resident 1's MDS assessment dated [DATE REDACTED], showed the resident had severe cognitive impairment. Review of Resident 1's eINTERACT Change in Condition Evaluation - V 5.1 dated 8/13/25, showed the resident attempted to enter other female rooms.
Further review of Resident 1's medical record failed to show documented evidence the Elopement Risk - V 3 assessment was done on 8/13/25. The elopement risk assessment included the question does the resident wander? Review of Resident 1's eINTERACT Change in Condition Evaluation - V 5.1 dated 8/17/25, showed elopement and wanderer. In addition, the evaluation showed Resident 1's body assessment was done and noted with skin discoloration 3 cm (length) x 4 cm (width) at the left forearm. On 8/26/25 at 1315 hours, an interview was conducted with CNA 1. CNA 1 verified Resident 1 eloped from the facility on 8/17/25. CNA 1 stated the elopement occurred on 8/17/25 at around 0930 hours. CNA 1 stated Resident 1 was in his wheelchair at 0830 hours and could move himself. CNA 1 further stated she was busy and did not hear the door alarm. CNA 1 stated she told the supervisor she did not see Resident 1 leaving the facility. On 8/26/25 at 1340 hours, an interview and concurrent closed medical record review was conducted with RN 2. RN 2 verified Resident 1 eloped from the facility on 8/17/25. RN 2 stated the CNA reported to him Resident 1 eloped at 0930 hours. RN 2 stated when the CNA reported she could not find Resident 1, the facility staff started looking for Resident 1 in every room. RN 2 further stated Resident 1 had a history of attempting to enter female rooms. RN 2 stated he initiated the elopement protocol when the facility staff could not find Resident 1. RN 2 stated the police found Resident 1 by the [NAME] church at 1000 hours. On 8/27/25 at 1051 hours, an interview was conducted with the Laundry Staff. The Laundry Staff stated she was having her lunch break when she heard the door alarm. The Laundry staff stated she did not get up and checked the door because she was on her lunch break and assumed somebody else would check the door alarm. On 8/27/25 at 1555 hours, a follow-up interview and concurrent medical record
review was conducted with RN 2. RN 2 acknowledged Resident 1 had change in condition evaluation dated 8/13/25, for wandering by attempting to enter other female rooms. RN 2 verified the Elopement Risk - V 3 assessment was not done on 8/13/25. RN 2 stated the licensed nurse should have done the elopement risk assessment for Resident 1 to prevent episode of elopement. On 8/27/25 at 1632 hours, an interview and concurrent medical record review was conducted with the DON. The DON acknowledged the above findings. The DON stated the licensed nurse should have initiated an elopement assessment to identify Resident 1 was an elopement risk. The DON stated the facility staff should have attended to the door alarm immediately. On 8/27/25 at 1644 hours, the Administrator and DON were informed and acknowledged the above findings.
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PARK REGENCY CARE CENTER in LA HABRA, CA inspection on recent inspection.
Found 0 violation(s). Severity: Standard violations. Status: 0 corrected, 0 pending.
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 LA HABRA, 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 PARK REGENCY CARE CENTER or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.