Health inspection·July 25, 2024

F 0558 Reasonably accommodate the needs and preferences of each resident. Level of Harm - Potential for minimal harm Based on observation and interview, the facility failed to provide reasonable accommodation to meet the needs for one of five sampled residents (Resident 5) and two nonsampled residents (Residents B and E). Residents Affected - Some * The facility failed to ensure the TV remote controls were available for Residents 5, B, and E. This failure had the potential to negatively impact the residents' physical and psychosocial well-being. Findings: On 7/23/23 from 0920 to 1045 hours, a tour of the facility and concurrent interview was conducted with the Maintenance Director. The following was identified: - Resident 5 was observed lying in bed, awake, and looking at the ceiling. When asked how her day was, Resident 5 stated it was boring and the TV was not working because there was no remote control. - Resident B was observed sitting up in her wheelchair. When asked about her TV, Resident B stated there was no remote control. Resident B further stated she wanted to watch TV at night to keep up with the news. Resident B stated she told the nurse there was no remote control for her TV. - Resident E was observed sitting up in his wheelchair. When asked about the TV, Resident E stated the TV was not working. Resident E stated he told the nurse about it, but nothing had been done so he gave up. The Maintenance Director verified the above findings and stated each bed should have a remote control for the TV. 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: 056010 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 056010 B. Wing A. Building (X3) DATE SURVEY COMPLETED 07/25/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Seal Beach Health and Rehabilitation Center 3000 N Gate Road Seal Beach, CA 90740 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)