Santa Anita Convalescent Hospital
Inspection Findings
F-Tag F0550
F 0550 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few
FORM CMS-2567 (02/99) Previous Versions Obsolete
respectful. ? During an interview on 8/26/2025 at 3:50 PM, CNA 3 stated she was assigned to Resident 3
on the night shift of 8/21/2205. CNA 3 stated she told Resident 3 she would be providing her incontinent care, but the resident refused. CNA 3 stated she could not leave Resident 3 wet, so she insisted she needed to be changed and Resident 3 resisted. CNA 3 stated she did not think of leaving Resident 3 alone or calling for another nurse or translator to further understand or explain clearly to Resident 3. CNA3 stated
she should not have provided care at that time if Resident 3 said she did not want it. ? During an interview
on 8/27/2025 with LVN 3 at 12:14 PM, LVN 3 stated Resident 3's primary language was Spanish, and she was able to make her needs and wants known. LVN 3 stated according to facility policy, Residents have a right to refuse care and if Resident 3 refused ADL care, the staff should have acknowledged the resident's wants and went back later to offer ADL assistance and should have informed the LVN charge nurse. LVN 3 also stated that not honoring the residents' rights can upset them and can make them distrust staff there to help them. ? During an interview on 8/27/2025 at 4:03 PM with CNA 4, CNA 4 stated Resident 3 spoke Spanish and able to let staff know if she wanted incontinence care provided at that time. CNA 4 stated
during the night shift on 8/22/2025, Resident 3 informed her CNA 3 was rough with care and not listening or trying to understand her while providing incontinent care. ? During a concurrent interview with the Director of Nursing (DON) and record review on 8/27/2025 at 5:00 PM, the facility's policy & procedure (P&P) titled Resident Rights- Quality of Life, implemented 5/1/2023, the P&P indicated the purpose to ensure all residents are treated with the level of dignity they are entitled to while residing at the facility. The P&P also indicated facility staff speak respectfully to residents at all times and staff treats cognitively impaired residents with dignity and sensitivity. The DON stated per policy, dignity and respect are to be given to every resident and speaking respectfully?means using a normal time of voice, respectful tone, explaining to
the resident what is to be done, and ensure culture and language differences are honored. The DON also stated, if a resident is refusing care, staff should never force a resident to do comply but educate them, inform the charge nurse and return later to ensure the care is provided. ? During a review of the facility's P&P titled Resident Rights, revised 10/1/2017, the P&P indicated the facility must treat each resident with respect and dignity and care for each resident in a manner and in an environment, that promotes maintenance or enhancement of his or her quality of life, recognizing each resident's individuality. ? During
a review of the facility's P&P titled Privacy and Dignity, revised 6/1/2017, the P&P indicated staff assists the resident in maintaining self-esteem and self-worth, residents are groomed as they wish to be groomed and staff treats residents with respect including respecting their social status, speaking respectfully, listening carefully.
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
08/27/2025
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Santa Anita Convalescent Hospital
5522 Gracewood Ave.
Temple City, CA 91780
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
Federal health inspectors cited SANTA ANITA CONVALESCENT HOSPITAL in TEMPLE CITY, CA for a deficiency under regulatory tag F-F0684 during a complaint investigation conducted on 2025-08-27.
Category: Quality of Life and Care Deficiencies
The facility was found deficient in the following area: Provide appropriate treatment and care according to orders, resident’s preferences and goals.
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 SANTA ANITA CONVALESCENT HOSPITAL.
Correction Status: Deficient, Provider has date of correction.
The facility reported correction as of 2025-09-16.
SANTA ANITA CONVALESCENT HOSPITAL in TEMPLE CITY, 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 TEMPLE CITY, 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 SANTA ANITA CONVALESCENT HOSPITAL or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.