Crestwood Manor - 104
Inspection Findings
F-Tag F0656
F 0656 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few
FORM CMS-2567 (02/99) Previous Versions Obsolete
that when the physical therapist tried to get Resident 1 to walk, Resident 1 was too scared and would not cooperate. The DON confirmed that Resident 1 had a fear of falling and refusal to walk. The DON confirmed that there was no care plan to help Resident 1 who was afraid of falling and refused to walk with assistance. During an interview on 9/22/25 at 12:06 PM, the Director of Staff Development (DSD) stated that CNAs should inform the nurses if a resident refused help with an ADL care and if Resident 1 showed fear of falling when walking. The DSD further explained that the nurse needs to create a care plan, so the staff know how to properly take care of the residents. The DSD stated that a care plan was important because it informed the staff what to do to help the residents. The DSD stated, if staff did not assist a resident with exercise or walking when needed, it could lead to a loss of mobility. Review of facility's policy and procedure (P&P) titled, Care Planning, dated 10/28/17 indicated, Policy: A person-centered care plan to meet the individual needs of residents/clients is prepared by an Interdisciplinary Team. 9. Care planning shall include measurable objectives and timeframes to meet resident's medical, nursing, and mental and psychosocial needs.10. Develop care plans to be consistent with the resident rights, including review of clinical issues,.coordination of care,.to attain or maintain the resident's highest practicable physical, mental, and psychosocial well-being. 11. Include resident refusals of treatment, the right to refuse treatment, alternate treatments attempted, resident education.
Event ID:
Facility ID:
05A340
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
05A340
B. Wing
A. Building
(X3) DATE SURVEY COMPLETED
09/18/2025
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Crestwood Manor - 104
1130 Monaco Court Stockton, CA 95207
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 F0676
Federal health inspectors cited CRESTWOOD MANOR - 104 in STOCKTON, CA for a deficiency under regulatory tag F-F0676 during a complaint investigation conducted on 2025-09-18.
Category: Quality of Life and Care Deficiencies
The facility was found deficient in the following area: Ensure residents do not lose the ability to perform activities of daily living unless there is a medical reason.
Scope/Severity Level D: isolated, no actual harm with potential for more than minimal harm.
While no actual harm was documented, there was potential for more than minimal harm to residents.
This was one of 2 deficiencies cited during this inspection of CRESTWOOD MANOR - 104.
Correction Status: Deficient, Provider has date of correction.
The facility reported correction as of 2025-11-16.
CRESTWOOD MANOR - 104 in STOCKTON, 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 STOCKTON, 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 CRESTWOOD MANOR - 104 or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.