Park Avenue Healthcare & Wellness Center
PARK AVENUE HEALTHCARE & WELLNESS CENTER in POMONA, CA — inspection on March 28, 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 2 ' s FRA dated 1/11/2025, timed at 5:10 pm, the FRA indicated Resident 2 was at high-risk for falls.
During a review of Resident 2 ' s Minimum Data Set (MDS- a resident assessment tool) dated 1/18/2025, the MDS indicated Resident 2 had severely impaired cognition (ability to think, remember, and function).
The MDS indicated Resident 2 was dependent (helper does ALL the effort.
Resident does none of the effort to completely the activity, or the assistance of 2 or more helpers is required for the resident to complete the activity) with toileting hygiene, showering/bathing self, lower body dressing, putting on/taking off footwear, rolling left and right (in bed), sitting to lying, lying to sitting on side of the bed, and chair/bed-to-chair transfers.
The MDS indicated Resident 2 required substantial/maximal assistance (helper does more than half the effort.
Helper lifts or holds trunk or limbs and provides more than half effort) with eating, oral and personal hygiene, and upper body dressing.
The MDS indicated walking 10 feet was not attempted due to medical condition or safety concerns.
555852
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 555852 B.
Wing 03/28/2025
NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE
Park Avenue Healthcare & Wellness Center 1550 North Park Avenue Pomona, CA 91768
During a review of Resident 2 ' s FRA dated 1/11/2025, timed at 5:10 pm, the FRA indicated Resident 2 was at high-risk for falls.
During a review of Resident 2 ' s Minimum Data Set (MDS- a resident assessment tool) dated 1/18/2025, the MDS indicated Resident 2 had severely impaired cognition (ability to think, remember, and function).
The MDS indicated Resident 2 was dependent (helper does ALL the effort.
Resident does none of the effort to completely the activity, or the assistance of 2 or more helpers is required for the resident to complete the activity) with toileting hygiene, showering/bathing self, lower body dressing, putting on/taking off footwear, rolling left and right (in bed), sitting to lying, lying to sitting on side of the bed, and chair/bed-to-chair transfers.
The MDS indicated Resident 2 required substantial/maximal assistance (helper does more than half the effort.
Helper lifts or holds trunk or limbs and provides more than half effort) with eating, oral and personal hygiene, and upper body dressing.
The MDS indicated walking 10 feet was not attempted due to medical condition or safety concerns.
Any deficiency statement ending with an asterisk (*) denotes a deficiency which the institution may be excused from correcting providing it is determined that other safeguards provide sufficient protection to the patients. (See instructions.) Except for nursing homes, the findings stated above are disclosable 90 days following the date of survey whether or not a plan of correction is provided.
For nursing homes, the above findings and plans of correction are disclosable 14 days following the date these documents are made available to the facility. If deficiencies are cited, an approved plan of correction is requisite to continued program participation.
LABORATORY DIRECTOR'S OR PROVIDER/SUPPLIER TITLE (X6) DATE REPRESENTATIVE'S SIGNATURE
555852
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 555852 B.
Wing 03/28/2025
NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE
Park Avenue Healthcare & Wellness Center 1550 North Park Avenue Pomona, CA 91768
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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.