The resident at the center of the incident, identified in inspection records only as Resident 1, was admitted to the Fortuna facility in October 2025.
Nursing Home News — Page 495
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The resident already had a history of gangrene on her left pointer finger.
That is what federal inspectors found when they visited Griffith Park Healthcare Center on January 28 and 29, 2026.
That gap, and others like it, is what federal inspectors found when they visited Woodland Care Center, a nursing home at 7120 Corbin Ave.
When these standards are not met, the risk of accidents, injuries, and health complications increases significantly for vulnerable nursing home residents.
The facility violated regulations requiring nursing homes to notify residents and their representatives in writing before any transfer or discharge.
Under that protocol, staff are required to wear gowns and gloves during hands-on care for residents who have indwelling medical devices or open wounds.
Federal inspectors documented the failure during a complaint inspection on January 29, 2026.
That finding sits at the center of a complaint inspection completed January 29, 2026, at the Palm Desert nursing home.
Employee E3 told state inspectors on January 29 that she never verified whether the resident's representative had been notified about the transfer.
Inspectors touring the floor with the nursing home administrator that morning measured nine rooms.
She had last been seen around 9:10 p.m.