Inspection visit
Health inspection
1 citation recorded
Inspector’s narrative
What the inspector wrote
This survey cited 1 deficiency. The full statement and the facility’s plan of correction follow, verbatim from the federal record.
F 0584
Level of Harm - Minimal harm
or potential for actual harm
Residents Affected - Some
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.
**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on
observation, interview, and record review, the facility failed to ensure indoor temperatures were maintained
between 71 to 81 degrees Fahrenheit (a temperature scale) for five of five sampled residents (Residents 1,
2, 3, 4, and 5). On 12/31/2025, temperatures were recorded between 66 to 68 degrees Fahrenheit in the
activity room (state and federally mandated common area specifically designed, equipped, and furnished
for residents to participate in a planned program of social, recreational, and educational activities) in the
hallway serving resident rooms 1-10 and in resident rooms. This deficient practice resulted in Residents 1,
2, 3, 4, and 5 to feel cold and had the potential to cause all other residents' discomfort, aggravate
respiratory conditions, and increase the risk of hypothermia (low body temperature) for residents with
impaired thermoregulation (body's natural process of maintaining a stable internal temperature).Findings:a.
During a review of Resident 1's admission Record (Face Sheet), the Face sheet indicated Resident 1 was
admitted to the facility on [DATE] and readmitted on [DATE] with diagnoses including Chronic obstructive
pulmonary disease ([COPD] a chronic lung disease causing difficulty in breathing).During a review of
Resident 1's Minimum Data Set ([MDS] a resident assessment tool), dated 11/26/2025, the MDS indicated
Resident 1 had no cognitive impairment (ability to think and reason) and was always understood and could
understand others. The MDS indicated Resident 1 required assistance from staff in dressing and personal
hygiene (combing hair, applying makeup, washing hands).During an interview on 12/31/2025 at 12:10 p.m.,
Resident 1 stated she felt cold during the day and at night. Resident 1 stated she notified staff (staff
unknown) that it was too cold, but no one did anything about it. b. During a review of Resident 2's Face
Sheet, the Face Sheet indicated Resident 2 was admitted to the facility on [DATE] with diagnoses including
rheumatoid arthritis (chronic progressive disease-causing inflammation in the joints and resulting in painful
deformity and immobility).During a review of Resident 2's History and Physical (H&P), dated 12/23/2025,
the H&P indicated Resident 2 had the capacity to make decisions.During an observation on 12/31/2025 at
1:56 p.m., in Resident 2's room, the thermostat read 69 degrees Fahrenheit. The thermostat was observed
to have a set point limit (ability to define minimum and maximum temperature for heating and cooling) set to
cool at 75 degrees (for maximum temperature) however no minimum temperature limit was set.During an
interview on 1/31/2025 at 1:57 p.m., Resident 2 stated her room was often too cold. Resident 2 stated staff
(staff unknown) were aware, but no corrective action had been taken. c. During a review of Resident 3's
Face Sheet, the Face Sheet indicated Resident 3 was initially admitted to the facility on [DATE] and
readmitted on [DATE] with diagnoses including heart failure (a heart disorder which causes the heart not to
pump the blood efficiently, sometime resulting in leg swelling).During a review of Resident 3's MDS, dated
[DATE], the MDS indicated Resident 3 had no cognitive impairment and was always understood and could
understand others. The MDS indicated Resident 3 required assistance from staff in
(continued on next page)
Any deficiency statement ending with an asterisk (*) denotes a deficiency which the institution may be excused from correcting providing it is determined that other
safeguards provide sufficient protection to the patients. (See instructions.) Except for nursing homes, the findings stated above are disclosable 90 days following the
date of survey whether or not a plan of correction is provided. For nursing homes, the above findings and plans of correction are disclosable 14 days following the date
these documents are made available to the facility. If deficiencies are cited, an approved plan of correction is requisite to continued program participation.
LABORATORY DIRECTOR'S OR PROVIDER/SUPPLIER
REPRESENTATIVE'S SIGNATURE
TITLE
(X6) DATE
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Facility ID:
If continuation sheet
Page 1 of 3
Event ID:
055032
Printed: 05/15/2026
Form Approved OMB
No. 0938-0391
Department of Health & Human Services
Centers for Medicare & Medicaid Services
STATEMENT OF DEFICIENCIES
AND PLAN OF CORRECTION
(X1) PROVIDER/SUPPLIER/CLIA
IDENTIFICATION NUMBER:
(X2) MULTIPLE CONSTRUCTION
055032
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
12/31/2025
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
The Earlwood
20820 Earl Street
Torrance, CA 90503
For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency.
(X4) ID PREFIX TAG
SUMMARY STATEMENT OF DEFICIENCIES
(Each deficiency must be preceded by full regulatory or LSC identifying information)
F 0584
Level of Harm - Minimal harm
or potential for actual harm
Residents Affected - Some
dressing and personal hygiene (combing hair, shaving, washing hands).During an observation on
12/31/2025 at 1:20 p.m., in Resident 3's room, a blanket was observed covering the floor vent. When the
blanket was removed, cold air was felt blowing from the air vent. During an interview on 12/31/2025 at 1:22
p.m., Resident 3 stated he placed a blanket over the vent to cover it to block cold air entering the room.
Resident 3 stated he notified staff (staff unknown), but nothing has been done to make the situation
better.d. During a review of Resident 4's Face Sheet, the Face Sheet indicated Resident 4 was initially
admitted to the facility on [DATE] and readmitted on [DATE] with diagnoses including hemiplegia (one sided
weakness) and hemiparesis (total paralysis of one side of arm, leg and trunk on one side of body).During a
review of Resident 4's MDS, dated [DATE], the MDS indicated Resident 4 had moderate cognitive
impairment and was always understood and could understand others. The MDS indicated Resident 4
required substantial (helper does more than half of the effort) assistance from staff in dressing and
personal hygiene (combing hair, shaving, washing hands).During an observation on 12/31/2025 at 1:59
p.m., in Resident 4's room, the thermostat was observed to read 68 degrees Fahrenheit. The thermostat
was observed to have a set point limit set to cool at 75 degrees, for maximum temperature setting however
no minimum temperature limit was set.During a subsequent interview on 12/31/2025, at 2:05 p.m.,
Resident 4 stated his room is too cold and has notified the Director of Nursing (DON) with no resolution.
Resident 2 stated he feels frustrated and it can be hard to rest.e. During a review of Resident 5's Face
Sheet, the Face sheet indicated Resident 5 was initially admitted to the facility on [DATE] and readmitted on
[DATE] with diagnosis including atrial fibrillation (condition when heart beats irregularly). During an
interview on 12/31/2025 at 12:50 p.m., Resident 5 stated despite having a blanket on her while in bed, she
still feels cold in her room.During a review of Resident 5's H/P, dated 12/31/2025, the MDS indicated
Resident 5 had the capacity to make decisions.During a concurrent observation and interview on
12/31/2025 at 12 p.m., with the Maintenance Supervisor (MS), in facility hallway near resident rooms 1-10,
the thermostat read 69 degrees Fahrenheit. The MS stated regulatory guidelines require a minimum
temperature of 71 degrees Fahrenheit.During an observation on 12/31/2025, at 2:42 p.m., in the activities
room, the thermostat read at 66 degrees Fahrenheit. The thermostat was observed to have a set point limit
set to cool at 75 degrees; however no minimum temperature limit was set.During an interview on
12/31/2025 at 3:30 p.m., the MS stated he or his assistant perform daily temperature checks using their
phones because the thermostats are controlled remotely online. He explained the thermostats are
programmed to cool at 75 degrees Fahrenheit but do not automatically switch to heat when temperatures
fall below a certain point. As a result, the facility has no minimum temperature setting, and the heat is
turned on manually only when residents or staff report feeling cold. The MS stated he is available onsite
during the day to adjust the thermostats, and at night, staff must call him. MS stated delays occur if staff do
not notify him as they cannot manually adjust thermostats. The MS stated registered nurses can adjust
settings with a key, but he has not trained them yet. He confirmed regulations require temperatures to
remain between 71- and 81-degrees Fahrenheit.During an interview on 12/31/2025 at 3:45 p.m., the DON
stated she was not aware that the thermostats did not have a minimum temperature setting. The DON
stated the residents' quality of life is affected negatively when the facility temperature is not kept between
71 degrees to 81 degrees Fahrenheit. The DON stated the cold temperature can cause residents to feel
cold leading to difficulty in sleeping, increased pain sensations due to aggravating arthritis in some
residents, in addition to risk for hypothermia for residents that cannot regulate their body temperatures
worsening and the respiratory symptoms of some residents prone to respiratory distress.During a review of
facility's undated Policy and Procedure (P&P) titled Maintenance of
(continued on next page)
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
055032
If continuation sheet
Page 2 of 3
Printed: 05/15/2026
Form Approved OMB
No. 0938-0391
Department of Health & Human Services
Centers for Medicare & Medicaid Services
STATEMENT OF DEFICIENCIES
AND PLAN OF CORRECTION
(X1) PROVIDER/SUPPLIER/CLIA
IDENTIFICATION NUMBER:
(X2) MULTIPLE CONSTRUCTION
055032
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
12/31/2025
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
The Earlwood
20820 Earl Street
Torrance, CA 90503
For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency.
(X4) ID PREFIX TAG
SUMMARY STATEMENT OF DEFICIENCIES
(Each deficiency must be preceded by full regulatory or LSC identifying information)
F 0584
Level of Harm - Minimal harm
or potential for actual harm
Residents Affected - Some
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Building Temperatures/Provisions for Extreme Hot or Cold, the P&P indicated, the building temperature in
all resident areas at the facility will be maintained between seventy-one degrees Fahrenheit and eighty-one
degrees Fahrenheit. The Maintenance department staff are responsible for adjusting temperature
thermostats and servicing heating and cooling units during the change of season, monitoring thermostats
in resident rooms.During a review of facility's P&P titled Homelike Environment, revised 2/2021, the P&P
indicated the facility staff and management utilizes, to the extent possible the characteristics of the facility
that reflect a personalized, homelike setting, these characteristics include comfortable and safe
temperatures (71 degrees Fahrenheit to 81 degrees Fahrenheit).
Event ID:
Facility ID:
055032
If continuation sheet
Page 3 of 3
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Back to topCitations
1 citation recorded*CMS
What do CMS severity letters mean?
Serious (G-L). Actual harm to a resident, or immediate jeopardy. Codes G through I indicate actual harm; J through L indicate immediate jeopardy to resident health or safety.
General (A-F). No actual harm found, or harm that is minimal. The facility must still submit a Plan of Correction. Most CMS citations land here.
Each letter combines severity with scope: how many residents the deficiency affected.
F584 - Safe Environment
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.
FAQ · About this visit
Common questions about this visit
What happened during the December 31, 2025 survey of THE EARLWOOD?
This was a inspection survey of THE EARLWOOD on December 31, 2025. The surveyor cited 1 deficiency, recorded on the federal Form 2567 statement of deficiencies.
Were any deficiencies cited at THE EARLWOOD on December 31, 2025?
Yes, 1 deficiency was cited, each with a CMS Scope and Severity grade. The first was: "Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receivin..."
What type of survey was this?
This was a inspection survey conducted by state surveyors under federal Centers for Medicare & Medicaid Services (CMS) oversight. Findings are published on CMS Care Compare.
SourceView on CMS Care Compare
Next steps
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Data from CMS Care Compare public records. Dataset last refreshed . If you believe any information is inaccurate, report it here.