Advanced Rehab Center Of Tustin
Inspection Findings
F-Tag F0609
F 0609 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few
FORM CMS-2567 (02/99) Previous Versions Obsolete
stated during the shower, Resident 1 became upset when CNA 1 was going to use the washcloth to clean Resident 1's body. CNA 1 stated Resident 1 said no and told CNA 1 not to use towels on her body. CNA 1 stated from that time, Resident 1 acted like CNA 1 was her enemy. CNA 1 stated after that shower incident, Resident 1 was telling other facility staff that CNA 1 was trying to kill her with the washcloth and soap. CNA 1 stated the next time she was assigned to give Resident 1 a shower, Resident 1 had refused the shower.
On 11/13/25 at 0835 hours, a follow-up telephone interview was conducted with CNA 1. CNA 1 stated on another date following the shower incident, CNA 1 was in Resident 1's room, providing care to Resident 2 (Resident 1's roommate) when CNA 1 heard Resident 1 had refused her shower with her assigned CNA that day. CNA 1 stated she heard the CNA ask Resident 1 why she did not want her shower. CNA 1 stated
she heard Resident 1 tell the CNA she did not want to have a shower because CNA 1 tried to kill her with
the washcloth in the shower. CNA 1 was asked about the facility's abuse protocol and CNA 1 stated any allegation of abuse should be reported to the abuse coordinator, the Administrator. CNA 1 was asked if she reported Resident 1's allegation of abuse and CNA 1 stated the allegation was not true and CNA 1 did not attempt to kill Resident 1 with the washcloth. CNA 1 stated she did not report Resident 1's allegation of abuse and she should have reported it. On 11/13/25 at 1300 hours, an interview was conducted with the DON. The DON stated all the facility staff were mandated reporters and should report any allegation of abuse to the abuse coordinator immediately. On 11/13/25 at 1630 hours, an interview was conducted with
the Administrator and the DON. The Administrator and DON were informed and acknowledged the above findings.
Event ID:
Facility ID:
If continuation sheet
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
11/13/2025
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Advanced Rehab Center of Tustin
2210 E. First Street Santa Ana, CA 92705
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)
F-Tag F0684
F 0684 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few
FORM CMS-2567 (02/99) Previous Versions Obsolete
skin problems were observed, the CNA would document on the CNA shower sheet and inform the charge nurse or treatment nurse. CNA 5 stated at the end of the shift, the licensed nurse checked and signed the CNA shower sheets. On 11/13/25 at 1145 hours, an interview and concurrent closed medical record review for Resident 1 was conducted with LVN 2. LVN 2 stated when new skin impairments were noted during care, the CNAs would inform the treatment nurse or the charge nurse. LVN 2 stated upon notification by the CNA of any new skin impairments, the licensed nurse would assess the resident's skin and document the findings, as well as notify the physician and initiate a change of condition. LVN 2 reviewed Resident 1's medical record and stated Resident 1 was readmitted to the facility with healed bilateral lower extremity wounds. LVN 2 further stated there were no physician's orders to administer treatment or monitor any skin impairments to Resident 1's bilateral lower legs. On 11/13/25 at 1300 hours, an interview and concurrent closed medical record review for Resident 1 was initiated with the DON. The DON stated the CNAs provided showers twice a week for each resident. The DON stated, if during the shower or any care, if the CNA observed any skin problems, the CNA would document the skin problem on the shower sheet. The DON stated the CNAs were also expected to complete the shower sheet and submit to the licensed nurses to sign. The DON stated the licensed nurses were expected to review the shower sheets and if there were any new skin issues, the licensed nurses were expected to do an assessment, document the findings, and initiate the monitoring of the skin impairment, as well as the notifications to the physician. The DON reviewed Resident 1's medical record and verified the above findings. The DON stated there should have been a care plan and monitoring for Resident 1's blister. On 11/13/25 at 1630 hours, an interview was conducted with the Administrator and DON. The Administrator and DON were informed and acknowledged
the above findings.
Event ID:
Facility ID:
If continuation sheet
ADVANCED REHAB CENTER OF TUSTIN in SANTA ANA, CA inspection on recent inspection.
Found 0 violation(s). Severity: Standard violations. Status: 0 corrected, 0 pending.
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 SANTA ANA, 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 ADVANCED REHAB CENTER OF TUSTIN or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.