California Healthcare And Rehabilitation Center
Inspection Findings
F-Tag F0686
F 0686 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few
FORM CMS-2567 (02/99) Previous Versions Obsolete
area, with measurements of 7.2 cm in length and 6.2 cm in width with 60 percent (%) of granulation (the process of forming healthy, red, bumpy tissue as the wound heals) and 40% slough (a type of non-viable, dead tissue that is typically yellowish, soft, and stringy, or creamy in texture) with light serous exudate observed. During a review of Resident 3's Wound Care Notes documented by the Wound Care Specialist dated 9/17/2025, the Wound Care Notes indicated that on 9/17/2025, Resident 3 was seen, evaluated and treated Resident 3's wound. The Wound Care Notes indicated that Resident 3 had an unstageable pressure-induced tissue injury to the sacral (located near the sacrum) coccyx (tailbone) area measuring 7 cm in length, 6.2 cm in width and unable to determine (UTD) depth. A sharp excisional debridement (removes unhealthy tissue by cutting it off) of necrotic subcutaneous tissue (contains dead tissue, which is caused by a lack of blood flow, severe injury, or infection, and can appear black, brown, or yellow) was performed. During a concurrent interview and record review on 10/31/2025 at 3:30 p.m., with LVN 1, the Skin and Wound Evaluation forms dated 9/6/2025 timed at 4:58 p.m.; 9/15/2025 timed at 10:41 a.m.; and 9/22/2025 timed at 11:36 a.m. were reviewed. LVN 1 stated that on 9/15/2025, he (LVN 1) performed and completed the skin and wound evaluation for Resident 3 and documented his (LVN 1) findings on the Skin and Wound Evaluation form. LVN 1 stated that based on the wound's appearance and characteristics including the presence of exudate, Resident 3's wound on the sacrum area should have been identified as
an unstageable PU rather than a DTI. LVN 1 stated that he (LVN 1) was unable to assess Resident 3's wound accurately. LVN 1 stated that appropriate interventions for an unstageable PU were not implemented; instead, interventions for a DTI were provided. LVN 1 further stated that he (LVN 1) should have assessed the resident (Resident 3) for pain as well, developed a care plan, and provided appropriate wound care management and treatment for Resident 3's unstageable PU. LVN 1 stated he (LVN 1) failed to recognize and document Resident 3's wound accurately, documenting it as a DTI instead. During an
interview on 11/4/2025 at 3:20 p.m., with the Director of Nursing (DON), the DON stated that LVN 1 should have accurately identified and assessed Resident 3's wound. The DON stated that as a result of the inaccurate assessment, Resident 3 did not receive appropriate interventions, management and care for an unstageable PU, placing Resident 3 at risk for PU deterioration. During a review of the facility's policy and procedure (P&P) titled Staging Pressure Sores last reviewed on 10/20/2025, the policy indicated that it is
the facility's policy to provide appropriate staging of pressure sores (pressure ulcers). During a review of the facility's P&P titled Pressure Sore Management, last reviewed on 10/20/2025, the policy indicated that all available measures shall be taken to reduce skin breakdown and pressure sores. Individual care plans for management of skin condition will be developed as indicated.
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CALIFORNIA HEALTHCARE AND REHABILITATION CENTER in VAN NUYS, 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 VAN NUYS, 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 CALIFORNIA HEALTHCARE AND REHABILITATION CENTER or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.