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Complaint Investigation

Mainplace Post Acute

Inspection Date: December 1, 2025
Total Violations 2
Facility ID 555259
Location ORANGE, 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

bed bath for two weeks, the licensed nurses must complete a change of condition assessment, inform the resident's physician and responsible party, monitor documentation every shift for 72 hours, and develop a care plan. On 11/25/25 at 1115 hours, an interview and concurrent medical record review for Resident 1 was conducted with the IP. Review of Resident 1's Shower Sheets for October and November 2025 showed

the resident had refused showers on the following dates: - on 10//9/25- on 10/13/25- on 10/23/25; and - on 11/6/25. Additionally, there were missing shower sheets for the dates of 10/30, 11/3, 11/10, 11/13, 11/17, 11/20, and 11/24/25. The IP reviewed Resident shower schedule and stated Resident 1's shower was scheduled every Monday and Thursday during the pm shift. The IP verified the above findings. The IP stated the medical record staff and DSD should have followed up Resident 1's missing shower sheets. The IP stated the shower sheets served as a communication for any significant changes with resident's refusal of showers and skin condition and must be accurately completed to reflect the resident's plan of care. On 12/1/25 at 1153 hours, a telephone interview was conducted with LVN 1. LVN 1 stated Resident 1 had refused showers for the past three months. LVN 1 verified he did not document the refusals in Resident 1's progress notes, and verified there was no care plan for the refusal. LVN 1 stated care plan was important because it is a guide for the resident's care while in the facility. On 12/1/25 at 1257 hours, an interview was conducted with the DON. The DON stated if a resident refused showers, the CNAs could offer and provide full body bath or bed bath. The DON clarified the sponge bath was not an equivalent or replacement to a shower and full body or bed bath. The DON was informed and acknowledged the above findings.

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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

12/01/2025

NAME OF PROVIDER OR SUPPLIER

STREET ADDRESS, CITY, STATE, ZIP CODE

Mainplace Post Acute

1835 West LA Veta Avenue Orange, CA 92868

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 F0684

Quality of Life and Care Deficiencies
Harm Level: Potential for More Than Minimal Harm

F 0684 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few

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

Resident 1's order for miconazole nitrate from the physician on 11/18/25, however, he failed to complete a change of condition assessment and monitoring documentation. LVN 1 stated accurate and timely assessment and documentation are important to show resident's condition or problems are monitored by licensed staff, interventions were implemented, and medical records were updated. On 12/1/25 at 1257 hours, an interview was conducted with the DON. The DON was informed and acknowledged the above findings.

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📋 Inspection Summary

MAINPLACE POST ACUTE in ORANGE, 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 ORANGE, 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 MAINPLACE POST ACUTE or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.
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