California Post-acute Care

F 0550 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some

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

11/24/2024, the H&P indicated Resident 2 had the capacity to understand and make decisions.During a

review of Resident 2's MDS dated [DATE REDACTED], the MDS indicated Resident 2 was cognitively intact. The MDS indicated Resident 2 required substantial/maximum assistance to perform ADLs such as showering/bathing self and required supervision or touching assistance when transferring from bed to chair. The MDS daily preferences while in the facility indicated it was very important for the Resident that his personal belongings or things are taken care of.During an interview on 8/26/2025 at 12:44 p.m., with Resident 2 in Resident 2's room, Resident 2 stated, he left his room while housekeeping was deep cleaning (date unknown) and when

he returned (to his room), Resident 2 noticed his bag of belongings were missing. Resident 2 stated, later laundry staff (unnamed) informed him the bag of his belongings were in the laundry department and would return them after the clothes were cleaned. Resident 2 stated he was upset because he did not ask staff to take his belongings and did not like sending his clothes to the laundry. Resident 2 stated a glass jar and paper item with sentimental value was in a coat pocket that was laundered and was damaged. During an

interview on 8/27/2025 at 12:34 p.m., with Laundry Staff (LS) 1, LS 1 stated to have observed broken glass

in the dryer after washing Resident 2's clothes when Resident 2's room was deep cleaned. During interviews on 8/27/2025 at 1:32 p.m. and 8/28/2025 at 2:29 p.m., with the Maintenance Supervisor (MS),

the MS stated he took Resident 2's bag of belongings from the resident's room (while Resident 2 was not in

the room) to the laundry department while the resident's room was being deep cleaned. The MS stated he observed the bag of clothing on the floor and believed that Resident 2 wanted to have his clothes washed because Resident 2 was agreeable to have his room cleaned. The MS stated he did not speak and confirm with Resident 2 if the resident wanted his clothes to be washed. The MS also stated he did not speak with Resident 2 about his clothes because he believed Resident 2 was aware of the deep cleaning process.During an interview on 9/2/2025 at 1:01 p.m., with the Director of Nursing (DON), the DON stated it was important to ensure staff answered residents' call lights and assist residents timely. The DON stated, failing to assist (Resident 1), who was continent and needed staff's help (up to the bathroom or commode) could lead to falls and could leave the resident irritable, angry, and upset. The DON stated staff should always ask the residents permission prior to moving his/her belongings. The DON also stated, it was important to ask for permission before touching residents' belongings because it was part of residents' rights. During an interview on 9/2/2025 at 3:35 p.m. with the Administrator (Admin), the Admin stated staff should confirm with residents if it would be acceptable to clean their clothes during deep cleaning. Admin stated the purpose of the deep cleaning is to clean the room, not the residents' clothes and clothes should not be taken to get washed unless the resident asks.During a review of facility's Policy and Procedure (P&P) titled, Resident Dignity & Personal Privacy, dated 12/2016, the P&P indicated, The facility provides care for residents in a manner that respects and enhance each resident's dignity, individually, and right to personal privacy. The P&P also indicated, All activities and interactions with residents by any staff, temporary agency staff, or volunteers must focus on assisting the resident in maintaining and enhancing his or her self-esteem and self-worth and incorporating the resident's goals, preferences, and choices.During a

review of facility's P&P titled, Resident's Homelike Environment, dated 12/2017, the P&P indicated, Staff shall provide person-centered care that emphasizes the residents' comfort, independence, personal needs and preferences.

Event ID:

Facility ID:

If continuation sheet

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

California Post-Acute Care

3615 E. Imperial Hiwy Lynwood, CA 90262

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)

Federal health inspectors cited CALIFORNIA POST-ACUTE CARE in LYNWOOD, CA for a deficiency under regulatory tag F-F0725 during a complaint investigation conducted on 2025-08-27.

Category: Nursing and Physician Services Deficiencies

The facility was found deficient in the following area: Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.

Scope/Severity Level E: pattern, no actual harm with potential for more than minimal harm.

While no actual harm was documented, there was potential for more than minimal harm to residents.

This was one of 2 deficiencies cited during this inspection of CALIFORNIA POST-ACUTE CARE.

Correction Status: Deficient, Provider has date of correction.

The facility reported correction as of 2025-09-17.