Health inspection·May 12, 2025

F 0761 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few 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. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interview and record review, the facility failed to ensure medications were not left unattended for one resident (Res 1). This failure had the potential to affect Resident 1 ' s safety and staff drug diversion. Findings. A record review of the facility ' s undated admission record indicated Resident 1 was admitted to the facility on [DATE] with diagnoses that included Atrial Fibrillation (irregular rapid heart rate) and Urinary Tract Infection (bladder infection). An observation during a facility reported investigation on 5/12/24 at 10:00 A.M., in Resident 1 ' s room was conducted. Resident 1 had multiple number of medications, inside a small clear cup sitting on Resident 1's bedside table. Resident 1 stated, I think the nurse left the medications there for me to take, but I was still asleep. Resident 1 stated she did not know what the medications were and what they were for. A review of Resident 1 ' s minimum data set( MDS- federally mandated assessment tool) dated 2/3/25 indicated Resident 1 ' s brief interview for mental status (BIMS) score was 12 which meant Resident 1 ' s cognition (thought process) was intact. A joint interview and record review on 5/12/25 at 11 A.M., with Licensed Nurse (LN) 1 was conducted. LN 1 discussed the following medications listed on Resident 1 ' s Medication Administration Record( MAR). LN1 stated she had left the medications in a cup and placed on Resident 1 ' s bedside table. An observation of Medications at Resident 1's bedside were reconciled with Resident 1's MAR during an interview with LN 1. Amiodarone 200 mg ,give 1 tablet twice a day -Arrythmias. Check apical pulse .Hold if below 60. Cholecalciferol 50 mg by mouth one time a day for Supplement Co-enzyme Q10, 100 mg by mouth two times a day for Supplement (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 2 Event ID: 056040 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 056040 B. Wing A. Building (X3) DATE SURVEY COMPLETED 05/12/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Escondido Post Acute 421 E Mission Ave Escondido, CA 92025 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)