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Deficiency Records for Fountain Valley Post Acute
A list of the most recent deficiencies for Fountain Valley Post Acute. 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 Fountain Valley Post Acute. 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? |
|---|---|---|---|---|
| Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | Health | 2024-04-25 | 2024-05-24 | Y |
| Provide for the safe, appropriate administration of IV fluids for a resident when needed. | Health | 2023-12-07 | 2023-12-15 | Y |
| Respond appropriately to all alleged violations. | Health | 2023-10-24 | 2023-11-06 | Y |
| Arrange for the provision of hospice services or assist the resident in transferring to a facility that will arrange for the provision of hospice services. | Health | 2023-10-24 | 2023-11-06 | Y |
| Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | Health | 2023-04-17 | 2023-05-07 | Y |
| Provide appropriate pressure ulcer care and prevent new ulcers from developing. | Health | 2023-03-27 | 2023-04-13 | Y |
| Provide appropriate treatment and care according to orders, resident?s preferences and goals. | Health | 2022-12-05 | 2023-01-20 | Y |
| Develop and implement policies and procedures to prevent abuse, neglect, and theft. | Health | 2022-11-29 | 2022-12-28 | Y |
| Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | Health | 2022-11-29 | 2022-12-28 | Y |
| Respond appropriately to all alleged violations. | Health | 2022-11-29 | 2022-12-28 | Y |
| Provide appropriate treatment and care according to orders, resident?s preferences and goals. | Health | 2022-09-06 | 2022-10-05 | Y |
| Conduct risk assessment and an All-Hazards approach. | Fire Safety | 2022-06-21 | 2022-07-18 | N |
| Establish policies and procedures for medical documentation. | Fire Safety | 2022-06-21 | 2022-07-18 | N |
| Develop a communication plan. | Fire Safety | 2022-06-21 | 2022-07-18 | N |
| Use approved construction type or materials. | Fire Safety | 2022-06-21 | 2022-07-18 | 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 | 2022-06-21 | 2022-07-18 | N |
| Provide exit doors that are held open by devices that will automatically close on the activation of a fire alarm or smoke detector. | Fire Safety | 2022-06-21 | 2022-07-18 | N |
| Have properly located and lighted "Exit" signs. | Fire Safety | 2022-06-21 | 2022-07-18 | N |
| Provide properly protected cooking facilities. | Fire Safety | 2022-06-21 | 2022-07-18 | N |
| Install an approved automatic sprinkler system. | Fire Safety | 2022-06-21 | 2022-07-18 | N |
| Inspect, test, and maintain automatic sprinkler systems. | Fire Safety | 2022-06-21 | 2022-07-18 | N |
| Properly select, install, inspect, or maintain portable fire extinguishes. | Fire Safety | 2022-06-21 | 2022-07-18 | N |
| Install corridor and hallway doors that block smoke. | Fire Safety | 2022-06-21 | 2022-07-18 | N |
| Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions. | Fire Safety | 2022-06-21 | 2022-07-18 | N |
| Have generator or other power source capable of supplying service within 10 seconds. | Fire Safety | 2022-06-21 | 2022-07-18 | N |
| Ensure precautions for handling oxygen cylinders and equipment are correctly followed. | Fire Safety | 2022-06-21 | 2022-07-18 | N |
| Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | Health | 2022-06-13 | 2022-07-13 | 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 | 2022-06-13 | 2022-07-13 | N |
| Provide appropriate treatment and care according to orders, resident?s preferences and goals. | Health | 2022-06-13 | 2022-07-13 | N |
| Provide enough food/fluids to maintain a resident's health. | Health | 2022-06-13 | 2022-07-13 | N |
| Provide safe and appropriate respiratory care for a resident when needed. | Health | 2022-06-13 | 2022-07-13 | N |
| Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | Health | 2022-06-13 | 2022-07-13 | 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 | 2022-06-13 | 2022-07-13 | 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 | 2022-06-13 | 2022-07-13 | N |
| Employ sufficient staff with the appropriate competencies and skills sets to carry out the functions of the food and nutrition service, including a qualified dietician. | Health | 2022-06-13 | 2022-07-13 | N |
| Provide sufficient support personnel to safely and effectively carry out the functions of the food and nutrition service. | Health | 2022-06-13 | 2022-07-13 | N |
| Ensure menus must meet the nutritional needs of residents, be prepared in advance, be followed, be updated, be reviewed by dietician, and meet the needs of the resident. | Health | 2022-06-13 | 2022-07-13 | N |
| Ensure each resident receives and the facility provides food that accommodates resident allergies, intolerances, and preferences, as well as appealing options. | Health | 2022-06-13 | 2022-07-13 | N |
| Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | Health | 2022-06-13 | 2022-07-13 | N |
| Have a policy regarding use and storage of foods brought to residents by family and other visitors. | Health | 2022-06-13 | 2022-07-13 | N |
| Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. | Health | 2022-06-13 | 2022-07-13 | N |
| Arrange for the provision of hospice services or assist the resident in transferring to a facility that will arrange for the provision of hospice services. | Health | 2022-06-13 | 2022-07-13 | N |
| Keep all essential equipment working safely. | Health | 2022-06-13 | 2022-07-13 | N |
| Assess the resident completely in a timely manner when first admitted, and then periodically, at least every 12 months. | Health | 2022-06-13 | 2022-07-13 | Y |
| Assure that each resident?s assessment is updated at least once every 3 months. | Health | 2022-06-13 | 2022-07-13 | Y |
| Develop and implement policies and procedures to prevent abuse, neglect, and theft. | Health | 2022-03-11 | 2022-04-11 | Y |
| Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | Health | 2022-03-11 | 2022-04-11 | Y |
| Provide appropriate treatment and care according to orders, resident?s preferences and goals. | Health | 2022-03-11 | 2022-04-11 | Y |
| Ensure each resident?s drug regimen must be free from unnecessary drugs. | Health | 2022-03-08 | 2022-04-08 | Y |
| Reasonably accommodate the needs and preferences of each resident. | Health | 2022-02-09 | 2022-03-08 | Y |
| Make sure that a working call system is available in each resident's bathroom and bathing area. | Health | 2022-02-09 | 2022-03-08 | Y |
| Provide appropriate treatment and care according to orders, resident?s preferences and goals. | Health | 2021-11-09 | 2021-12-09 | Y |
| Conduct risk assessment and an All-Hazards approach. | Fire Safety | 2019-09-05 | 2019-09-23 | N |
| Include a process for Emergency Preparedness collaboration. | Fire Safety | 2019-09-05 | 2019-09-23 | N |
| Establish policies and procedures for medical documentation. | Fire Safety | 2019-09-05 | 2019-09-23 | N |
| Create arrangements with other facilities to receive patients. | Fire Safety | 2019-09-05 | 2019-09-23 | N |
| Provide emergency officials' contact information. | Fire Safety | 2019-09-05 | 2019-09-23 | N |
| Establish methods for sharing information. | Fire Safety | 2019-09-05 | 2019-09-23 | N |
| Conduct testing and exercise requirements. | Fire Safety | 2019-09-05 | 2019-09-23 | N |
| Use approved construction type or materials. | Fire Safety | 2019-09-05 | 2019-09-23 | N |
| Have approved installation, maintenance and testing program for fire alarm systems. | Fire Safety | 2019-09-05 | 2019-09-23 | N |
| Have properly installed electrical wiring and gas equipment. | Fire Safety | 2019-09-05 | 2019-09-23 | N |
| Have posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed. | Fire Safety | 2019-09-05 | 2019-09-23 | N |
| Have generator or other power source capable of supplying service within 10 seconds. | Fire Safety | 2019-09-05 | 2019-09-23 | N |
| Ensure precautions for handling oxygen cylinders and equipment are correctly followed. | Fire Safety | 2019-09-05 | 2019-09-23 | N |
| Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | Health | 2019-08-14 | 2019-09-14 | N |
| Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | Health | 2019-08-14 | 2019-09-14 | 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 | 2019-08-14 | 2019-09-14 | N |
| Ensure necessary information is communicated to the resident, and receiving health care provider at the time of a planned discharge. | Health | 2019-08-14 | 2019-09-14 | N |
| Assist a resident in gaining access to vision and hearing services. | Health | 2019-08-14 | 2019-09-14 | N |
| Provide appropriate pressure ulcer care and prevent new ulcers from developing. | Health | 2019-08-14 | 2019-09-14 | N |
| Provide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM and/or mobility, unless a decline is for a medical reason. | Health | 2019-08-14 | 2019-09-14 | N |
| Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | Health | 2019-08-14 | 2019-09-14 | N |
| Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections. | Health | 2019-08-14 | 2019-09-14 | N |
| Provide enough food/fluids to maintain a resident's health. | Health | 2019-08-14 | 2019-09-14 | N |
| Provide safe and appropriate respiratory care for a resident when needed. | Health | 2019-08-14 | 2019-09-14 | N |
| Ensure medication error rates are not 5 percent or greater. | Health | 2019-08-14 | 2019-09-14 | 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 | 2019-08-14 | 2019-09-14 | N |
| Ensure menus must meet the nutritional needs of residents, be prepared in advance, be followed, be updated, be reviewed by dietician, and meet the needs of the resident. | Health | 2019-08-14 | 2019-09-14 | N |
| Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | Health | 2019-08-14 | 2019-09-14 | N |
| Provide and implement an infection prevention and control program. | Health | 2019-08-14 | 2019-09-14 | N |
| Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public. | Health | 2019-08-14 | 2019-09-14 | N |
| Develop a communication plan. | Fire Safety | 2018-11-27 | 2018-12-19 | N |
| Properly select, install, inspect, or maintain portable fire extinguishes. | Fire Safety | 2018-11-27 | 2018-12-19 | N |
| Have restrictions on the use of highly flammable decorations. | Fire Safety | 2018-11-27 | 2018-12-19 | N |
| Reasonably accommodate the needs and preferences of each resident. | Health | 2018-09-25 | 2018-10-25 | N |
| Allow residents to easily view the nursing home's survey results and communicate with advocate agencies. | Health | 2018-09-25 | 2018-10-25 | 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 | 2018-09-25 | 2018-10-25 | N |
| Ensure each resident receives an accurate assessment. | Health | 2018-09-25 | 2018-10-25 | 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 | 2018-09-25 | 2018-10-25 | N |
| Provide activities to meet all resident's needs. | Health | 2018-09-25 | 2018-10-25 | N |
| Assist a resident in gaining access to vision and hearing services. | Health | 2018-09-25 | 2018-10-25 | N |
| Provide enough food/fluids to maintain a resident's health. | Health | 2018-09-25 | 2018-10-25 | N |
| Provide for the safe, appropriate administration of IV fluids for a resident when needed. | Health | 2018-09-25 | 2018-10-25 | N |
| Provide safe, appropriate dialysis care/services for a resident who requires such services. | Health | 2018-09-25 | 2018-10-25 | N |
| Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | Health | 2018-09-25 | 2018-10-25 | 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 | 2018-09-25 | 2018-10-25 | N |
| Ensure medication error rates are not 5 percent or greater. | Health | 2018-09-25 | 2018-10-25 | N |
| Provide timely, quality laboratory services/tests to meet the needs of residents. | Health | 2018-09-25 | 2018-10-25 | N |
| Ensure menus must meet the nutritional needs of residents, be prepared in advance, be followed, be updated, be reviewed by dietician, and meet the needs of the resident. | Health | 2018-09-25 | 2018-10-25 | N |
| Ensure meals and snacks are served at times in accordance with resident?s needs, preferences, and requests. Suitable and nourishing alternative meals and snacks must be provided for residents who want to eat at non-traditional times or outside of scheduled meal times. | Health | 2018-09-25 | 2018-10-25 | N |
| Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | Health | 2018-09-25 | 2018-10-25 | N |
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