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Complaint Investigation

Crystal Cove Care Center

Inspection Date: December 23, 2025
Total Violations 1
Facility ID 055929
Location NEWPORT BEACH, CA
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Inspection Findings

F-Tag F0880

Infection Control Deficiencies
Harm Level: Potential for More Than Minimal Harm

F 0880 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few

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

in placed (gloves, gown, alcohol-based hand rub, face-shield, signage, trash receptacle, etc.), hand hygiene utilizing alcohol-based hand rub, place EBP notification/signage near resident room doorway to alert staff/visitors of precautions, and to utilize PPE (gown and gloves; face-shield as indicated) during high-contact resident care activities (e.g., dressing, bathing/showering, transferring, hygiene, linen changes, brief changes, toileting assistance, device care, wound care). On 12/19/25 at 0935 hours, a wound care treatment observation for Resident 3 and concurrent interview was conducted with RN 1 and LVN 2. No EBP signage was observed in the resident's room door or at the bedside of Resident 3. RN 1 stated LVN 2 would be assisting in turning Resident 3 during the wound care treatment. RN 1 stated Resident 3 had a Stage 3 pressure injury in the sacrococcyx area, which was reclassified by the wound consultant after the debridement on 12/17/25. RN 1 was observed removing Resident 3's old dressing from the sacrococcyx area while LVN 2 was holding Resident 3. RN 1 and LVN 2 were observed only wearing gloves but no isolation gown. RN 1 was stopped when she was about to clean Resident 3's wound. RN 1 and LVN 2 were asked if they needed to observe any precautions during the wound care treatment. RN 1 and LVN 2 verified

the EBP was to be observed for Resident 3, since they were providing high contact resident care. RN 1 and LVN 2 verified they needed to wear the isolation gown and an EBP signage needed to be posted by the resident's room door to alert the facility staff or visitors of the precautions needed to observe or followed to prevent the spread of infection. On 12/19/25 at 1450 hours, an interview was conducted with the IP. The IP stated the EBP was needed to be observed during high-contact resident care activities like wound care treatment. The IP stated the facility staff needed to wear gloves and gowns during the wound care treatment when the resident was on an EBP. The IP further stated there could be possible transmission of infection when the proper PPE was not utilized by the facility staff. The IP was informed and acknowledged

the above findings. On 12/23/25 at 1640 hours, an interview was conducted with the DON and Quality Assurance Nurse. The DON and Quality Assurance Nurse were informed and acknowledged the above findings for Resident 3.

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📋 Inspection Summary

CRYSTAL COVE CARE CENTER in NEWPORT BEACH, 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 NEWPORT BEACH, 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 CRYSTAL COVE CARE CENTER or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.
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