Sharon Care Center
SHARON CARE CENTER in LOS ANGELES, CA — inspection on November 19, 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
During a review of Resident 2's admission Record, the admission Record indicated Resident 2 was initially admitted to the facility on [DATE] with diagnosis of COPD, then readmitted on [DATE] with diagnosis of acute respiratory failure with hypoxia (low levels of oxygen in your body tissues).
During a review of Resident 2's MDS, dated [DATE], the MDS indicated Resident 2 had intact cognitive (ability to think, remember and reason) the mental action or process of acquiring knowledge and understanding through thought, experience, and the senses) skills for daily decision making.
The MDS indicated Resident 2 was independent (Resident completes the activity by themself with no assistance from a helper) for eating, oral hygiene, upper body dressing, personal hygiene, rolling left and right, sit to lying, and lying to sitting on side of bed.
The MDS indicated Resident 2 required supervision (Helper provides verbal cues and/or touching/steadying and/or contact guard assistance as resident completes activity.
Assistance may be provided throughout the activity or intermittently) for toileting, lower body dressing, putting on taking off footwear, sit to stand, toilet and shower transfer.
During a review of Resident 2's Care Plan, dated 5/30/2025, the Care Plan indicated administer oxygen as prescribed for COPD. No revisions to the Care Plan for diagnosis of COPD were found after Resident 2 had returned from the hospital on [DATE].
During an interview with RNS 2, on 11/19/2025 at 12:34 PM the RNS 2 stated the Care Plan had not been updated after Resident 2's return from the hospital.
The RNS stated failure to revise the Care Plan placed Resident 2 at risk for unmet needs and inadequate management of respiratory status.
During an interview with the DON, on 11/19/2025 at 2:14 PM the DON stated it was important to update and revise Care Plans as needed, following a change in condition, and quarterly in order to guide nurses to provide the care residents need and failure to do so places residents at risk for unmet needs and miscommunication among licensed nurses.
During a review of the facility's P&P titled Care Plan Comprehensive, dated 12/16/2024, the P&P indicated the facility is responsible for evaluation and updating of care plans when there has been a significant change in the resident's condition, when the resident has been readmitted to the facility from a hospital stay, and at least quarterly.
Facility ID:
IDENTIFICATION NUMBER:
A.
Building
COMPLETED
11/19/2025
STREET ADDRESS, CITY, STATE, ZIP CODE
Sharon Care Center
8167 West Third St.
Los Angeles, CA 90048
SUMMARY STATEMENT OF DEFICIENCIES
During a concurrent observation and interview on 11/19/2025 at 1:18 PM with the Director of Nursing (DON) in Resident 3's room, the DON verified that Resident 3's tube feeding was connected to an empty formula bottle and a bag with water. No labels were present on the tubing, formula bottle, nor the bag of water to indicate when these were first used.
The DON stated the tubing should be dated and initiated by the staff who hung the formula and tubing with a date of when these were administered and should be disposed of once they are turned off.
The DON stated failure to discard the tubing and formula and failing to label the feeding supplies placed Resident 3 at risk for inaccurate monitoring of nutritional intake, aspiration, and increased risk of infection.
During an interview with Licensed Vocational Nurse (LVN) 1, on 11/19/2025 at 1:43 PM the LVN1 stated she turned off Resident 3's feeding in the morning but failed to dispose of the feeding tubing, empty bottle of formula, and acknowledged she should have discarded the tubing and formula according to facility policy.
During a review of the facility's policy and procedures (P&P) titled Enteral Feedings Safety Precautions, dated 12/16/2024, the P&P indicated, to ensure the safe administration of enteral nutrition, prevent errors in administration by labeling enteral nutrition with date and time formula was prepared, and on the formula label document initials, date and time the formula was hung, and initial that the label was checked against the order.
Facility ID: