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Complaint Investigation

Claremont Care Center

May 7, 2025 · Pomona, CA · 219 E. Foothill Blvd
Citations 2
CMS Rating 4/5
Beds 99
Provider ID 055394
Healthcare Facility
Claremont Care Center
Pomona, CA  ·  View full profile →
Source Document
Official CMS Inspection Report (Medicare.gov)  ·  10 pages
Downloaded from CMS/Medicare.gov. Reflects what state inspectors documented and does not include the facility's plan of correction, which is submitted separately. Facilities may have taken corrective actions since this report was released.
Inspection Summary

CLAREMONT CARE CENTER in POMONA, CA — inspection on May 7, 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

FF697
a unit of mass) give one (1) tablet by mouth every six hours as needed (PRN) for moderate to Some During a review of Resident 1's PT TEN dated 4/7/2025, timed at 2:38 PM, completed by PT 1, the PT TEN affected

During a review of Resident 1's Minimum Data Set (MDS- resident assessment tool), dated 4/1/2025, the MDS indicated Resident 1 had moderately impaired cognition (ability to think, remember and make decisions) for daily decision making.

The MDS indicated Resident 1 required supervision (helper provides verbal cues and or touching as resident competes activity) for oral and personal hygiene, partial/moderate assistance (helper does less than half the effort to lift, hold, or support trunk or arms and legs) for upper body dressing, and substantial/maximal assistance (helper does more than half the effort to lift or hold trunk or limbs) for showering/bathing, rolling left and right, sitting to lying on the bed, lying to sitting on side of the bed, and toilet transfer.

The MDS indicated Resident 1 had not attempted to transfer to and from a bed to a wheelchair, sit to stand, or walk ten feet due to medical condition or safety concerns.

The MDS indicated Resident 1 had a fall in the last month prior to admission, surgical repair of the hip, required pain assessment interview, and had not had any pain in the last five days of the assessment.

055394

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 055394 B.

Wing 05/07/2025

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

Claremont Care Center 219 E.

Foothill Blvd Pomona, CA 91767

During a review of Resident 1's Minimum Data Set (MDS- resident assessment tool), dated 4/1/2025, the MDS indicated Resident 1 had moderately impaired cognition (ability to think, remember and make decisions) for daily decision making.

The MDS indicated Resident 1 required supervision (helper provides verbal cues and or touching as resident competes activity) for oral and personal hygiene, partial/moderate assistance (helper does less than half the effort to lift, hold, or support trunk or arms and legs) for upper body dressing, and substantial/maximal assistance (helper does more than half the effort to lift or hold trunk or limbs) for showering/bathing, rolling left and right, sitting to lying on the bed, lying to sitting on side of the bed, and toilet transfer.

The MDS indicated Resident 1 had not attempted to transfer to and from a bed to a wheelchair, sit to stand, or walk ten feet due to medical condition or safety concerns.

The MDS indicated Resident 1 had a fall in the last month prior to admission, surgical repair of the hip, required pain assessment interview, and had not had any pain in the last five days of the assessment.

During a review of Resident 1's Care Plan (CP) titled Care Plan Report, dated 3/28/2025, the CP indicated Resident 1 had pain of the right femur due to a recent right femur fracture and surgical intervention following a fall.

The CP interventions indicated for staff to administer analgesia (absence of pain) medication as per physician orders and give one-half (1/2) hour before treatments or care, anticipate need for pain relief, and respond immediately to any complaint of pain.

055394

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 055394 B.

Wing 05/07/2025

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

Claremont Care Center 219 E.

Foothill Blvd Pomona, CA 91767

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 POMONA, 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 CLAREMONT CARE CENTER or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.


More Reports

About This Inspection Report

Source: This inspection report was downloaded directly from the Centers for Medicare & Medicaid Services (CMS) via Medicare.gov. CMS releases nursing home inspection reports in bulk. The findings reflect what state surveyors documented in the official Form CMS-2567 Statement of Deficiencies on the date of the inspection.

Plan of correction not included: The CMS report we receive does not include the facility's plan of correction. Facilities submit plans of correction separately to their state survey agency and those responses may not appear in CMS public data at the time of release. The absence of a plan of correction in this report does not mean one was not filed. Readers who want information about corrective steps taken by the facility are encouraged to contact the facility or their state survey agency directly.

Corrections may have been made: This report reflects conditions observed on the date of the survey. The facility may have implemented staffing changes, additional training, policy revisions, or other corrective actions since this report was issued. We publish what CMS provides and encourage readers to seek current information from the facility.