Complaint Investigation

Costa Del Sol Healthcare

November 17, 2025 · Los Angeles, CA · 1016 S. Record St.

Citations 2

CMS Rating 2/5

Beds 99

Provider ID 055697

Healthcare Facility

Costa Del Sol Healthcare

Los Angeles, 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

COSTA DEL SOL HEALTHCARE in LOS ANGELES, CA — inspection on November 17, 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

FF0658

Resident Assessment and Care Planning Deficiencies

Potential for More Than Minimal Harm

During a review of the facility's P&P titled Blood Glucose Monitoring and Quality Control, dated 10/2025, the P&P indicated quality control testing for both high and low ranges should be completed daily and documented on the quality control log.

During a review of the facility's Job Description: LVN, dated 2/2024, the Job description indicated LVNs were responsible for ensuring all equipment is maintained at all times to meet the needs of the residents and ensure to chart routinely in accordance with documentation policies.

Facility ID:

IDENTIFICATION NUMBER:

Building

COMPLETED

11/17/2025

STREET ADDRESS, CITY, STATE, ZIP CODE

Costa Del Sol Healthcare

1016 S.

Record St.

Los Angeles, CA 90023

SUMMARY STATEMENT OF DEFICIENCIES

FF0761

Pharmacy Service Deficiencies

Potential for More Than Minimal Harm

Summary Report, dated [DATE], the Order Summary Report indicated an order of Insulin Glargine (long-acting insulin for DM) dated [DATE].During a concurrent observation and interview on [DATE] at 8:05 a.m. with Licensed Vocational Nurse (LVN 1), Resident 1 had an opened Insulin Glargine pen that was not labelled with date opened or expiration date. LVN 1 stated the LVN who opened the insulin pen should have labelled the insulin pen with date opened and expiration date.During a concurrent interview and record review with Pharmacist 1 (Pharm 1), the Insulin Glargine Full Prescribing Information, dated 6/2022, was reviewed.

Pharm 1 stated the Instructions for use indicated Insulin Glargine pens should not be administered 28 days after storing at room temperature, opening, or first use of the pen.

Pharm 1 stated Insulin Glargine pens must be labeled with the open date and expiration date.

During an interview on [DATE] at 12:01 p.m. with LVN 3, LVN 3 stated all insulin pens must be labeled with the open and expiration dates so licensed nurses know when it was opened and when the expiration date would be and will not have the risk of administering an expired insulin to Resident 1.

During an interview on [DATE] at 2:45 p.m. with LVN 1, LVN 1 stated she would not know when Resident 1's Insulin Glargine pen was opened because the insulin was not labelled with date. LVN 1 stated it placed Resident 1 at risk of receiving expired insulin medication because the insulin pen was not labelled.During a concurrent interview and record review on [DATE] at 3:00 p.m. with the Director of Nursing (DON), the facility's P&P titled Medication Labeling and Storage, dated 2/2023, was reviewed.

The DON stated the P&P indicated multi-dose vials that have been opened or accessed must be dated and discarded within 28 days.

The DON stated the P&P was not followed when the licensed nurse did not label Resident 1's Insulin Glargine pen with the date when opened and the expiration date.During a review of the facility's P&P titled Medication Labeling and Storage, dated 2/2023, the P&P indicated the medication label should include the expiration date.

The P&P indicated multi-dose vials that have been opened or accessed must be dated and discarded within 28 days unless the manufacturer specifies a shorter or longer date for the open vial.During a review of the Insulin Glargine Full Prescribing Information, dated 6/2022, the Insulin Glargine Full Prescribing Information indicated room temperature or in-use single-resident-used prefilled pens can only be stored for 28 days.

Facility ID:

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 LOS ANGELES, 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 COSTA DEL SOL HEALTHCARE 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.