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Complaint Investigation

Fountain View Subacute And Nursing Center

Inspection Date: November 24, 2025
Total Violations 2
Facility ID 055111
Location LOS ANGELES, CA
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Inspection Findings

F-Tag F0656

Resident Assessment and Care Planning Deficiencies
Harm Level: Potential for More Than Minimal Harm

F 0656 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few

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

Licensed Vocational Nurse 1 (LVN 1), the LVN1 stated she was the charge nurse and the medication administration nurse for the day shift and that although Resident 3's ordered eye medication was present in

the medication cart, it had not been administered to Resident 3 as scheduled. The LVN1 further reported that the missed dose at 6 AM on 11/24/2025 was not endorsed to her during shift report. The LVN1 also acknowledged that she did not assess Resident 3's pain level during her shift.During a concurrent interview and record review on 11/24/2025 at 3:41 PM with the Director of Nursing (DON), Resident 3's Care Plan, Order Summary, and Medication Administration Record was reviewed. The DON stated the omission of the medication should have been documented, explained, and endorsed by the licensed nurses. The DON stated a Comprehensive Care Plan should have been initiated for Resident 3's left eye blindness to ensure continuity of care between shifts, and failure to do so placed Resident 3 at risk for unmet needs and worsening health condition due to lack of interventions.During a review of the facility's policy and procedure titled Care Planning, dated 8/25/2021, indicated the facility's interdisciplinary team is responsible for the development of an individualized comprehensive care plan for each resident and is developed within seven days of the completion of the comprehensive assessment (MDS).During a review of the facility's policy and procedures (P&P) titled Nursing Documentation, dated 6/27/2022, the P&P indicated nursing documentation includes information about the patient's status, nursing assessment, interventions and expected outcomes, evaluation of patient's outcomes, and responses to nursing care.

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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

11/24/2025

NAME OF PROVIDER OR SUPPLIER

STREET ADDRESS, CITY, STATE, ZIP CODE

Fountain View Subacute and Nursing Center

5310 Fountain Ave Los Angeles, CA 90029

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)

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F-Tag F0760

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

F 0760 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few

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

medication should have been documented, explained, and endorsed by the licensed nurses. The DON stated a Comprehensive Care Plan should have been initiated for Resident 3's left eye blindness to ensure continuity of care between shifts, and failure to do so placed Resident 3 at risk for unmet needs and worsening health condition due to lack of interventions.During a review of the facility's policy and procedures (P&P) titled Medication Administration, undated, indicated medications are administered in accordance with prescriber orders, including any required time frame. Medication errors are documented, reported, and reviewed by the QAPI committee to inform changes or the need for additional staff training.

Medications are administered within one hour of their prescribed time. If a drug is withheld, refused, or given at a time other than the scheduled, document the reason.

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📋 Inspection Summary

FOUNTAIN VIEW SUBACUTE AND NURSING CENTER in LOS ANGELES, 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 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 FOUNTAIN VIEW SUBACUTE AND NURSING CENTER or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.
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