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Health Inspection

Heritage Manor

March 28, 2025 · Monterey Park, CA · 610 North Garfield Avenue
Citations 3
CMS Rating 2/5
Beds 99
Provider ID 055989
Healthcare Facility
Heritage Manor
Monterey Park, CA  ·  View full profile →
Inspection Summary

HERITAGE MANOR in MONTEREY PARK, CA — inspection on March 28, 2025.

Found 3 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.

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Inspection Findings

FF695
Minimal harm or temperature and pulse oximetry per physician ' s order and report abnormal findings to the physician. Few related to Afib, hypertension (high blood pressure), and hyperlipidemia (high level of fats in the bloodstream). affected

During a kitchen observation on [DATE] at 10:46 AM, the dietary staff did not review and follow the recipe to ensure adequate measurement of thickener powder (powder like starch used to thicken the texture of food) were mixed when preparing the pureed food who were prescribed with pureed diet and were served pureed food that was pasty and thick in texture.

During a concurrent observation and interview on [DATE] at 1:10 PM with the Dietary Manager (DM), the DM stated the dietary staff did not measure how much the thickener power was put into the pureed food when they were preparing them.

The DM stated someone was supposed to check the final products to make sure texture of the food was correct, but she was not sure which dietary staff was the one in charge of checking the final product before the tray line and they did not have log of checking the textures of the food.

055989

Form Approved OMB

STATEMENT OF DEFICIENCIES (X1) PROVIDER/SUPPLIER/CLIA (X2) MULTIPLE CONSTRUCTION (X3) DATE SURVEY AND PLAN OF CORRECTION IDENTIFICATION NUMBER: COMPLETED A.

Building 055989 B.

Wing 03/28/2025

NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE

Heritage Manor 610 North Garfield Avenue Monterey Park, CA 91754

During a review of Resident 52 ' s History and Physical (H&P), dated 12/24/2024 indicated, Resident 52 does not have the mental capacity to make medical decisions.

During a review of Resident 52's Minimum Data Set (MDS-a federally mandated resident assessment tool), dated 1/16/2025, indicated the resident ' s cognitive (the ability to think and process information) skills for daily decisions making was severely impaired, and was dependent on staff for the activities of daily living.

During a review of Resident 52's Order Summary, dated 3/27/2025, the Order Summary Report indicated to administer the following medications to the resident:

a.

Amlodipine Besytate Oral tablet 10mg (milligram) give one table by mouth in the morning for HTN hold for systolic blood pressure (SBP - the amount of pressure in the arteries during contraction of the heart muscle) <110 or HR (hear rate) <60 with a Start date 1/13/2025

055989

Form Approved OMB

STATEMENT OF DEFICIENCIES (X1) PROVIDER/SUPPLIER/CLIA (X2) MULTIPLE CONSTRUCTION (X3) DATE SURVEY AND PLAN OF CORRECTION IDENTIFICATION NUMBER: COMPLETED A.

Building 055989 B.

Wing 03/28/2025

NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE

Heritage Manor 610 North Garfield Avenue Monterey Park, CA 91754

During a review of Resident 98's Order Summary Report (OSR), indicated on [DATE], Resident 98 had a physician order to monitor temperature and oxygen saturation every shift for suspected/confirmed Covid-19 (Coronavirus disease, an infectious disease caused by the SARS-CoV-2 virus), and to call the physician if oxygen saturation is newly below 91%, or if the resident's usual oxygen saturation is lower or is 3% or more lower than their baseline.

During a review of Resident 98's Care plan (CP), dated [DATE], indicated Resident 98 had COPD exacerbation.

The goal was that the Resident 98 would display optimal breathing patterns (a respiratory rate of 12 to 20 breaths per minute with regular, rhythmic inhalations and exhalations) daily with the interventions that included monitoring for signs and symptoms of acute respiratory insufficiency such as shortness of breath at rest, cyanosis (a bluish or purplish discoloration of the skin, typically caused by a lack of oxygen in the blood), and somnolence (lethargy, weakness, and difficulty thinking), and to administer oxygen via NC at , d+[DATE] LPM continuously, may titrate oxygen to ,d+[DATE] LPM via mask to maintain oxygen saturation greater or equal to 94%.

During a review of Resident 98's CP, dated [DATE], indicated Resident 98 was at risk for Covid-19 related to diagnosis of COPD exacerbation, DM, and afib.

The interventions included to follow Resident 98's POLST, monitor temperature and pulse oximetry (a test used to measure oxygen levels of the blood) per physician's order and report abnormal findings to the physician.

055989

Form Approved OMB

STATEMENT OF DEFICIENCIES (X1) PROVIDER/SUPPLIER/CLIA (X2) MULTIPLE CONSTRUCTION (X3) DATE SURVEY AND PLAN OF CORRECTION IDENTIFICATION NUMBER: COMPLETED A.

Building 055989 B.

Wing 03/28/2025

NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE

Heritage Manor 610 North Garfield Avenue Monterey Park, CA 91754

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 MONTEREY PARK, 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 HERITAGE MANOR or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.


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