Skip to main content
Advertisement
Complaint Investigation

The Ellison John Transitional Care Center

Inspection Date: December 30, 2025
Total Violations 1
Facility ID 555904
Location LANCASTER, CA
Advertisement

Inspection Findings

F-Tag F0755

Pharmacy Service Deficiencies
Harm Level: Potential for More Than Minimal Harm

F 0755 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few

FORM CMS-2567 (02/99) Previous Versions Obsolete

prophylactic treatment, one day, apply from the neck down to the toes, leave on for 12 hours, then wash off

in the morning. The MAR for 12/2/2025 indicated 9 (other/see nurses notes). During a review of Resident 1's MAR note dated 12/2/2025 at 8:34 p.m., the MAR note indicated medication not found. Reordered.

During an interview on 12/30/2025 at 4:23p.m. with Licensed Vocational Nurse (LVN) 2, LVN 2 stated LVN 2 recalls Resident 1 was suspected to have scabies and was placed on isolation. LVN 2 stated LVN 2 thinks there was an order for scabies cream for Resident 1 but there was no cream. LVN 2 stated she reordered

the cream. During a record review and interview on 12/30/2025 at 4:40 p.m. of Resident 1's Order Summary Report with the Director of Nursing (DON), the DON reviewed Resident 1's Order Summary Report and stated permethrin was ordered twice and was given on 11/25/2025. The DON stated at the time of the second dose, the Infection Preventionist (IP) had not gotten the second tube, then LVN 2 reordered

the medication. The DON stated the medication was delivered but Resident 1 had been discharged home.

The DON stated the doctor agreed to let Resident 1 go home because Resident 1 was negative for scabies and had already gotten the first treatment and could get the other treatment at home. The DON stated if the residents order is disrupted and does not receive the treatment as ordered by the doctor, the resident did not complete the treatment. The DON stated the facility should have the treatment if it was ordered. The DON stated if Resident 1 did not get the second dose and did have scabies the treatment would not be completed and there is a potential for the scabies not to be eradicated. During a review of the Facility Policy and Procedure (P&P) titled, Medication Administration-General Guidelines, last reviewed on 12/10/2025,

the P&P indicated medications are administered as prescribed in accordance with good nursing principles and practices.B. Administration 2. Medications are administered in accordance with written orders of the attending physician.10. Medications are administered within 60 minutes of scheduled time (1 hour before and 1 hour after), except before or after meal orders, which are administered based on mealtimes. Unless otherwise specified by the prescriber, routine medication are administered according to the established medication administration schedule for the facility.

Event ID:

Facility ID:

If continuation sheet

📋 Inspection Summary

THE ELLISON JOHN TRANSITIONAL CARE CENTER in LANCASTER, CA inspection on recent inspection.

Found 0 violation(s). Severity: Standard violations. Status: 0 corrected, 0 pending.

What this means: Health inspections identify deficiencies that facilities must correct. Violations range from minor documentation issues to serious safety concerns. All deficiencies must be corrected within required timeframes and are subject to follow-up verification.

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 LANCASTER, 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 ELLISON JOHN TRANSITIONAL CARE CENTER or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.
« Back to Facility Page
Advertisement
Advertisement