Inland Valley Care And Rehabilitation Center
INLAND VALLEY CARE AND REHABILITATION CENTER in POMONA, CA — inspection on May 9, 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
During a review of Resident 1's Minimum Data Set (MDS - a resident assessment tool), dated 4/7/2025, the MDS indicated Resident 1 had intact cognition (ability to think, remember, and reason).
The MDS indicated Resident 1 required substantial/maximal assistance (helper does more than half the effort) with toileting hygiene.
During a review of Resident 1's Medication Administration Record (MAR, a log initialed and/or signed by the licensed nurse with the date and time a medication was administered to a resident) dated 5/5/2025 to 5/7/2025, the MAR did not indicate Resident 1 had pain.
During a review of Resident 1's Progress Notes (PN), dated 5/6/2025, timed at 7:51 am, the PN indicated at 6:05 am, Resident 1 complained of not having a BM for two days.
The PN indicated Resident 1 complained of abdominal pain (unrated), bloating, and feeling uncomfortable during the night shift (11 pm to 7 am).
The PN indicated Resident 1 was on two LPM of O2 via NC.
During a review of Resident 1's eINTERACT SBAR form dated 5/6/2025, timed at 8 am, the SBAR indicated RN 3 documented Resident 1 had a COC due to constipation.
The SBAR form did not indicate Resident 1 had abdominal distention, firmness, bloating, or pain.
During a review of Resident 1's PN dated 5/6/2025 between 3 pm and 11 pm, the PN did not indicate an abdominal/GI evaluation (assessment) was completed.
056431
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 056431 B.
Wing 05/09/2025
NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE
Inland Valley Care and Rehabilitation Center 250 W.
Artesia Street Pomona, CA 91768
During a review of Resident 1's care plan (CP) titled, COPD, initiated on [DATE] and reevaluated on , d+[DATE], the CP indicated Resident 1 was at risk for discomfort, shortness of breath, and exacerbation (worsening) secondary (due to) COPD.
The CP interventions indicated Resident 1 to receive O2 at two liters (unit of volume) per minute (LPM) via nasal canula (NC- tube which on one end splits into two prongs which are placed in the nostrils to deliver oxygen).
056431
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 056431 B.
Wing 05/09/2025
NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE
Inland Valley Care and Rehabilitation Center 250 W.
Artesia Street Pomona, CA 91768