Not rated by CMS — ratings are suppressed for new or low-volume facilities.
The next survey window likely opens around November 2026
Estimate from public CMS data, current as of June 2026. Survey timing is at the state agency's discretion.
Citation history
Health deficiencies cited at Del Mar Convalescent Hospital during CMS and state inspections, most recent first.
The facility failed to follow its policy for preventing food contamination, as observed when multiple food items in the kitchen's refrigerator were unlabeled. The Assistant Kitchen Manager was unsure of when the items were opened or prepared, and the Dietary Supervisor confirmed that not labeling could lead to expired food being served. The facility's policy requires date marking of food items at the time of opening or preparation.
The facility was found non-compliant with regulations limiting resident room capacity, as seven rooms housed more than four residents each. Despite claims of adequate space, this practice contradicted the facility's policy, potentially limiting care and services.
The facility failed to ensure call lights were within reach for two residents, both with cognitive impairments and at risk for falls. One resident's call light was out of reach while in bed, and another's was inaccessible while in a wheelchair. Staff acknowledged the importance of call light accessibility for safety, as per facility policy.
The facility failed to ensure that the POLST and Advance Directive Acknowledgment Forms accurately reflected the advance directives of two residents. One resident's POLST and acknowledgment form were inconsistent, while another resident's POLST lacked any indication of an advance directive. These discrepancies were confirmed by the Social Services Assistant and the Director of Nursing, highlighting the importance of accurate documentation to honor residents' wishes.
The facility failed to notify the ombudsman and family representatives of two residents about their transfers to a General Acute Care Hospital. For one resident with chronic respiratory failure and Alzheimer's, there was no documented evidence of notification to the ombudsman or a signed notice by the representative. Another resident with intrahepatic bile duct carcinoma was transferred without confirmation of notice to the ombudsman, despite family notification. The facility's policy requires timely notice in urgent cases, but evidence of such notice was lacking.
The facility failed to ensure proper use of motion alarms for two residents at high risk for falls. One resident's alarm was not transferred from the wheelchair to the bed, and another's alarm was found disconnected. These oversights were contrary to the care plans, which required alarms to alert staff and remind residents to wait for assistance.
A resident in an LTC facility experienced a significant medication error when the route of administration for Droxidopa did not match the physician's order. The resident, with conditions including Parkinson's disease and dysphagia, was prescribed Droxidopa via G-tube, but an LVN administered it by dissolving the capsule powder in water. The error was identified during a medication pass observation, revealing a mismatch between the medication label and the MAR.
Failure to Label Food Items in Kitchen
Penalty
Summary
The facility failed to adhere to its policy and procedures for preventing food contamination and the spread of foodborne illness in its kitchen. During an observation, multiple food items in the kitchen's refrigerator were found unlabeled, specifically four cups and one bowl of fruit mix. The Assistant Kitchen Manager (AK) confirmed that prepared and opened food items should be labeled with the date they were opened and their expiration date, but was unsure when these items were opened or prepared. In a follow-up interview, the Dietary Supervisor (DS) reiterated that opened items must have a label indicating the product name, opened date, and expiration date. The DS acknowledged that not following the facility's policy could harm residents, as unlabeled foods might be expired. The facility's policy, titled 'Date Marking for Food Safety,' requires the individual opening or preparing food to date mark it at the time of opening or preparation, including the date of opening and the date by which the item must be consumed or discarded.
Non-Compliance with Resident Room Capacity Regulations
Penalty
Summary
The facility failed to comply with regulations limiting the number of residents per room, as observed during a recertification survey. Specifically, seven rooms (Rooms 16, 19, 20, 21, 22, 25, and 26) were found to accommodate more than four residents, with each room containing five beds. This arrangement was confirmed through observations and interviews conducted between November 8 and November 10, 2024. The facility's Administrator acknowledged the situation, stating that the facility had rooms with variances and intended to apply for a Room Waiver. Despite the facility's claim that the rooms had adequate space for nursing care and that the multiple beds would not adversely affect residents' health and safety, the surveyors noted that this practice could potentially limit care and services. Observations included a family member's statement that there was enough space for staff to care for a resident in one of the rooms with five beds, and a resident being moved in a wheelchair without issues. However, the facility's policy and procedure, dated December 19, 2022, clearly indicated that resident bedrooms should not accommodate more than four residents, highlighting a discrepancy between practice and policy.
Failure to Ensure Call Light Accessibility for Residents
Penalty
Summary
The facility failed to accommodate the needs of two residents by not ensuring their call lights were within reach, as required by the facility's policy and procedure. Resident 21, who has severe cognitive impairment and is dependent on assistance for activities such as toileting and bed mobility, was observed with a call light hanging on the left side of the bed, out of reach. This was confirmed by a Certified Nursing Assistant (CNA) who acknowledged the call light should be within reach. The Director of Nursing (DON) also emphasized the importance of call lights being accessible to prevent falls and ensure residents can request help. Resident 23, who has moderately impaired cognitive skills and is at risk for falls, was observed sitting in a wheelchair with the call light placed on the bed, more than three feet away, making it inaccessible. A CNA confirmed the placement of the resident by the window and acknowledged the call light was out of reach, stressing the importance of accessibility for resident safety. The DON reiterated the necessity of call lights being within reach to allow residents to call for assistance when needed. The facility's policy, titled "Call Lights: Accessibility and Timely Response," mandates that call lights be within reach and accessible to residents while in bed. The failure to adhere to this policy for Residents 21 and 23 highlights a deficiency in ensuring the safety and accommodation of residents' needs, potentially leading to accidents and falls.
Failure to Accurately Document Advance Directives
Penalty
Summary
The facility failed to ensure that the Physician Orders for Life Sustaining Treatment (POLST) and Advance Directive Acknowledgment Form accurately reflected the advance directives of two residents. For one resident, the POLST indicated the presence of an advance directive, while the acknowledgment form stated otherwise, leading to a discrepancy. This resident, who was unable to make decisions due to medical conditions such as spinal stenosis and Parkinson's Disease, had an advance directive on file that was not acknowledged in the facility's records. The Social Services Assistant and the Director of Nursing confirmed the inconsistency, highlighting the importance of having accurate documentation to honor the resident's wishes in emergencies. Another resident, who had the capacity to make medical decisions despite a moderately impaired cognition, did not have an advance directive indicated in their POLST, nor was there evidence that an acknowledgment form was offered. This oversight occurred despite the facility's policy requiring the determination and documentation of advance directives upon admission. The Social Services Assistant noted the absence of this critical information, which is essential for understanding the resident's or responsible party's wishes in case of an emergency.
Failure to Notify Ombudsman and Family of Resident Transfers
Penalty
Summary
The facility failed to provide timely notification to the resident's family representative and the ombudsman regarding the transfer of two residents, Resident 24 and Resident 54, to a General Acute Care Hospital (GACH). For Resident 24, the facility did not have documented evidence that the Notice of Proposed Transfer/Discharge was sent to the ombudsman or signed by the resident's representative. The resident, who had chronic respiratory failure and Alzheimer's disease, was transferred due to respiratory distress. The Director of Nursing (DON) confirmed the lack of documentation and emphasized the importance of notifying the resident's representative in writing. For Resident 54, the facility also failed to provide documented evidence that the notice of transfer was sent to the ombudsman. The resident, who had intrahepatic bile duct carcinoma and other medical conditions, was transferred out of the facility. Although the resident's family member was notified, there was no fax confirmation for the receipt of the notice by the ombudsman. The DON acknowledged the oversight and mentioned that there was still time to send the notice to the ombudsman. The facility's policy and procedure on transfer and discharge require that notice be provided to the resident, the resident's representative, and the LTC ombudsman as soon as practicable in cases of urgent medical needs. However, the facility did not maintain evidence that the notice was sent to the ombudsman in these cases, violating the residents' rights to be informed of their transfer/discharge and their rights to appeal.
Failure to Ensure Proper Use of Motion Alarms for Fall Prevention
Penalty
Summary
The facility failed to ensure that residents assessed at high risk for falls received appropriate care and services to minimize the likelihood of falls, as per the facility's fall prevention program. Specifically, the facility did not adhere to the care plan for two residents, Resident 6 and Resident 30, who were both identified as high fall risks. The care plans required the use of motion alarms to alert staff and remind residents to wait for assistance before attempting to move unassisted. For Resident 6, the deficiency occurred when the facility staff did not transfer the motion alarm from the resident's wheelchair to the bed after assisting the resident back to bed. The motion alarm was left attached to the wheelchair, contrary to the care plan's instructions. This oversight was observed during a visit, and the staff member involved acknowledged the error, stating that the motion alarm should have been moved to the bed to prevent the resident from attempting to get up unassisted. In the case of Resident 30, the motion alarm was found disconnected while the resident was in bed. The alarm was supposed to be connected and functioning at all times due to the resident's high fall risk and history of falling from bed. The disconnection was noticed during an observation, and the staff member reconnected the alarm, indicating that it should have been operational to alert staff of any unassisted movements by the resident. The Director of Nursing emphasized the importance of having the alarms in place and functioning to prevent falls and injuries.
Medication Administration Error Due to Route Discrepancy
Penalty
Summary
The facility failed to ensure that a resident was free from significant medication errors when the route of administration for Droxidopa Oral Capsule did not match the physician's order on the Medication Administration Record (MAR). The resident, who was admitted with diagnoses including Parkinson's disease and dysphagia, was prescribed Droxidopa to be administered via a gastrostomy tube (G-tube). However, during a medication pass observation, a Licensed Vocational Nurse (LVN) was seen administering the medication by opening the capsules and dissolving the powder in water, which did not align with the prescribed G-tube administration. The discrepancy was identified when the LVN verified the medication bottle and MAR, confirming that the instructions on the medication label did not match the physician's order. The Director of Nursing (DON) acknowledged that the primary physician was unaware of the discrepancy and emphasized the importance of ensuring that medication orders match the physician's instructions to prevent errors. The facility's policy requires that medication sources be compared with the MAR to verify details such as resident name, medication name, form, dose, route, and time, which was not adhered to in this instance.
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Resident with a documented fall history left unattended on the patio; found on the ground with a hip fracture.
Walk-in cooler logs missing for 12 days; expired supplements in the medication room fridge.
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Nursing homes near Rosemead
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Monterey Park Conv Hosp | 1.1 mi | — | 0 | 0 |
| Heritage Manor | 1.2 mi | — | 3 | 0 |
| San Gabriel Conv Center | 1.5 mi | — | 0 | 0 |
| Green Acres Healthcare Center | 1.5 mi | — | 12 | 0 |
| Monterey Healthcare & Wellness Centre, Lp | 1.6 mi | — | 22 | 0 |
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Trusted data, never guesswork. Every citation, penalty, rating and Plan of Correction on this page is sourced from public CMS records (latest release August 2026) and official state health department websites.