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Deficiency Records for Glendora Health Care Center
A list of the most recent deficiencies for Glendora Health Care Center. The list is based on the information provided by CMS from both standard inspections and from complaints filed by residents.
A list of the most recent deficiencies for Glendora Health Care Center. The list is based on the information provided by CMS from both standard inspections and from complaints filed by residents.
| Deficiency | Type of Deficiency | Deficiency Date | Date Corrected | Resulted from a Complaint? |
|---|---|---|---|---|
| Have generator or other power source capable of supplying service within 10 seconds. | Fire Safety | 2024-09-17 | 2024-10-30 | N |
| Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive. | Health | 2024-09-24 | 2024-10-16 | N |
| Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely. | Health | 2024-09-24 | 2024-10-16 | N |
| Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted | Health | 2024-09-24 | 2024-10-16 | N |
| Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | Health | 2024-09-24 | 2024-10-16 | N |
| Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals. | Health | 2024-09-24 | 2024-10-16 | N |
| Provide activities to meet all resident's needs. | Health | 2024-09-24 | 2024-10-16 | N |
| Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures. | Health | 2024-09-24 | 2024-10-16 | N |
| Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited. | Health | 2024-09-24 | 2024-10-16 | N |
| Ensure medication error rates are not 5 percent or greater. | Health | 2024-09-24 | 2024-10-16 | N |
| Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs. | Health | 2024-09-24 | 2024-10-16 | N |
| Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | Health | 2024-09-24 | 2024-10-16 | N |
| Provide and implement an infection prevention and control program. | Health | 2024-09-24 | 2024-10-16 | N |
| Implement a program that monitors antibiotic use. | Health | 2024-09-24 | 2024-10-16 | N |
| Make sure that a working call system is available in each resident's bathroom and bathing area. | Health | 2024-09-24 | 2024-10-16 | N |
| Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | Health | 2024-09-24 | 2024-10-16 | Y |
| Have corridors or aisles that are unobstructed and are at least 8 feet in width. | Fire Safety | 2024-09-17 | 2024-10-16 | N |
| Have approved installation, maintenance and testing program for fire alarm systems. | Fire Safety | 2024-09-17 | 2024-10-16 | N |
| Ensure smoke barriers are constructed to a 1 hour fire resistance rating. | Fire Safety | 2024-09-17 | 2024-10-16 | N |
| Have simulated fire drills held at unexpected times. | Fire Safety | 2024-09-17 | 2024-10-16 | N |
| Have posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed. | Fire Safety | 2024-09-17 | 2024-10-16 | N |
| To conduct inspection, testing and maintenance of fire doors by qualified individuals. | Fire Safety | 2024-09-17 | 2024-10-16 | N |
| Ensure proper usage of power strips and extension cords. | Fire Safety | 2024-09-17 | 2024-10-16 | N |
| Have restrictions on the use of highly flammable decorations. | Fire Safety | 2024-09-17 | 2024-10-14 | N |
| Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | Health | 2024-07-03 | 2024-07-23 | Y |
| Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift. | Health | 2024-07-03 | 2024-07-23 | Y |
| Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. | Health | 2023-11-07 | 2023-11-24 | Y |
| Develop and implement policies and procedures to prevent abuse, neglect, and theft. | Health | 2023-11-07 | 2023-11-24 | Y |
| Respond appropriately to all alleged violations. | Health | 2023-11-07 | 2023-11-24 | Y |
| Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | Health | 2023-11-07 | 2023-11-24 | Y |
| Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely. | Health | 2023-07-06 | 2023-07-21 | Y |
| Follow proper procedures when the automatic sprinkler systems was out of service for more than 10 hours. | Fire Safety | 2023-07-10 | 2023-07-21 | Y |
| Provide a written emergency evacuation plan. | Fire Safety | 2023-07-10 | 2023-07-21 | Y |
| Have a complete alarm system manually initiated and initiated by fire sprinkler system connection. | Fire Safety | 2022-11-15 | 2023-06-21 | N |
| Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals. | Health | 2023-01-30 | 2023-02-15 | Y |
| Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being. | Health | 2023-01-30 | 2023-02-15 | Y |
| Provide and implement an infection prevention and control program. | Health | 2023-01-30 | 2023-02-15 | Y |
| Ensure each resident receives an accurate assessment. | Health | 2023-01-06 | 2023-02-15 | Y |
| Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | Health | 2023-01-06 | 2023-02-15 | Y |
| Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely. | Health | 2022-11-21 | 2022-12-30 | N |
| Ensure each resident receives an accurate assessment. | Health | 2022-11-21 | 2022-12-30 | N |
| Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | Health | 2022-11-21 | 2022-12-30 | N |
| Provide appropriate treatment and care according to orders, resident?s preferences and goals. | Health | 2022-11-21 | 2022-12-30 | N |
| Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | Health | 2022-11-21 | 2022-12-30 | N |
| Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being. | Health | 2022-11-21 | 2022-12-30 | N |
| Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures. | Health | 2022-11-21 | 2022-12-30 | N |
| Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited. | Health | 2022-11-21 | 2022-12-30 | N |
| Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. | Health | 2022-11-21 | 2022-12-30 | N |
| Provide and implement an infection prevention and control program. | Health | 2022-11-21 | 2022-12-30 | N |
| Keep aisles, corridors, and exits free of obstruction in case of emergency. | Fire Safety | 2022-11-15 | 2022-12-30 | N |
| Have properly located and lighted "Exit" signs. | Fire Safety | 2022-11-15 | 2022-12-30 | N |
| Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system. | Fire Safety | 2022-11-15 | 2022-12-30 | N |
| Provide properly protected cooking facilities. | Fire Safety | 2022-11-15 | 2022-12-30 | N |
| Inspect, test, and maintain automatic sprinkler systems. | Fire Safety | 2022-11-15 | 2022-12-30 | N |
| Install corridor and hallway doors that block smoke. | Fire Safety | 2022-11-15 | 2022-12-30 | N |
| Ensure smoke barriers are constructed to a 1 hour fire resistance rating. | Fire Safety | 2022-11-15 | 2022-12-30 | N |
| Have simulated fire drills held at unexpected times. | Fire Safety | 2022-11-15 | 2022-12-30 | N |
| Have posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed. | Fire Safety | 2022-11-15 | 2022-12-30 | N |
| Provide activities to meet all resident's needs. | Health | 2022-08-24 | 2022-08-25 | Y |
| Ensure medication error rates are not 5 percent or greater. | Health | 2022-08-24 | 2022-08-25 | Y |
| Protect each resident from the wrongful use of the resident's belongings or money. | Health | 2022-08-01 | 2022-08-25 | Y |
| Develop and implement policies and procedures to prevent abuse, neglect, and theft. | Health | 2022-08-01 | 2022-08-25 | Y |
| Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | Health | 2022-08-01 | 2022-08-25 | Y |
| Provide the appropriate treatment and services to a resident who displays or is diagnosed with dementia. | Health | 2022-08-01 | 2022-08-25 | Y |
| Ensure medication error rates are not 5 percent or greater. | Health | 2022-08-01 | 2022-08-25 | Y |
| Administer the facility in a manner that enables it to use its resources effectively and efficiently. | Health | 2022-08-01 | 2022-08-25 | Y |
| Have the Quality Assessment and Assurance group have the required members and meet at least quarterly | Health | 2022-08-01 | 2022-08-25 | Y |
| Ensure staff are vaccinated for COVID-19 | Health | 2022-08-01 | 2022-08-25 | Y |
| Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely. | Health | 2019-10-09 | 2019-11-08 | N |
| Add doors in an exit area that do not require the use of a key from the exit side unless in case of special locking arrangements. | Fire Safety | 2019-10-08 | 2019-11-08 | N |
| Inspect, test, and maintain automatic sprinkler systems. | Fire Safety | 2019-10-08 | 2019-11-08 | N |
| Have properly installed electrical wiring and gas equipment. | Fire Safety | 2019-10-08 | 2019-11-08 | N |
| Have posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed. | Fire Safety | 2019-10-08 | 2019-11-08 | N |
| Ensure proper usage of power strips and extension cords. | Fire Safety | 2019-10-08 | 2019-11-08 | N |
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