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Complaint Investigation

Park Avenue Healthcare & Wellness Center

April 16, 2025 · Pomona, CA · 1550 North Park Avenue
Citations 1
CMS Rating 1/5
Beds 231
Provider ID 555852
Healthcare Facility
Park Avenue Healthcare & Wellness Center
Pomona, CA  ·  View full profile →
Inspection Summary

PARK AVENUE HEALTHCARE & WELLNESS CENTER in POMONA, CA — inspection on April 16, 2025.

Found 1 citation. 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.

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Inspection Findings

FF689
Minimal harm or body dressing and toileting hygiene. The MDS indicated Resident 4 required partial/moderate (helper does Some During a review of Resident 5's AR, the AR indicated the facility admitted Resident 5 on 1/27/2025 with affected

During a review of Resident 7's Admission Record (AR), the AR indicated Resident 7 was admitted to the facility on [DATE] with diagnoses that included dementia (a group of symptoms affecting memory, thinking, and social abilities), Schizophrenia (a serious mental health condition that affects how people think, feel, and behave) and psychosis (abnormal condition of the mind that involves a loss of contact with reality).

During a review of Resident 7's Minimum Data Set (MDS, a resident assessment tool), dated 3/11/2025, the MDS indicated Resident 7's cognition (ability to think and process information) was severely impaired.

The MDS indicated Resident 7 used a wheelchair for mobility.

During a review of Resident 7's Change in Condition Evaluation (COC, a sudden clinically important deviation from a resident's baseline in physical, cognitive, behavioral, or functional domains), dated 3/31/2025, timed at 8:40 AM, the COC indicated (on 3/31/2025) at 6:30 AM, Resident 7 was sitting in the hallway on Resident 7's wheelchair saying, P--a (offensive language in Spanish) repeatedly and was swinging Resident 7's doll.

The COC indicated the doll touched another resident (Resident 9).

The COC indicated Resident 9 reacted and made physical contact with Resident 7's face by using a closed fist.

The COC indicated Resident 7 had swelling and discoloration on Resident 7's left cheek, left and right eyelids, and Resident 7 was bleeding inside Resident 7's mouth.

The COC indicated Resident 7 complained of sudden pain rated six out of 10.

During a review of Resident 7's Physician's Order (PO), dated 3/31/2025, the PO indicated to apply an ice pack to Resident 7's face prn (as needed).

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 04/16/2025

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

Park Avenue Healthcare & Wellness Center 1550 North Park Avenue Pomona, CA 91768

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 PARK AVENUE HEALTHCARE & WELLNESS CENTER or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.


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