The resident, identified in inspection records only as R5, was assessed at 11:45 that night by a licensed practical nurse, E34.
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She was entirely dependent on staff for bathing, dressing, hygiene, and movement.
A physician had ordered Hydrocodone-Acetaminophen, 10-325 milligrams, one tablet by mouth every four hours as needed for moderate to severe pain.
Resident 1 had been living at Summerfield Health Care Center when he was hospitalized.
The violation was rated minimal harm, affecting a small number of residents.
Federal health inspectors visited Santa Anita Convalescent Hospital on May 29 as part of a complaint investigation.
The resident, identified in inspection records as R2, required two staff members and a mechanical lift for safe transfers.
The facility's Director of Customer Engagement, the staff member responsible for completing admission packets, left on April 30, 2026.
That detail made what inspectors found more striking, not less.
The inspection, completed May 29, 2026, documented that residents beyond the one named in the original complaint were missing clothing.
The inspection, completed May 30, 2026, cited violations affecting many residents.
Resident 1 is a woman with difficulty walking, unsteadiness on her feet, muscle weakness, and abnormal gait.