Inspection·November 22, 2024

F 0656 Level of Harm - Potential for minimal harm Residents Affected - Some Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on interview and medical record review, the facility failed to monitor the resident's psychosocial wellness as per the care plan interventions for one of two sampled residents (Resident 1) after the allegation of the financial abuse. This failure had the potential to negatively impact Resident 1's mental and emotional well-being. Findings: On 11/7/24, the CDPH Licensing and Certification program received a report from the facility regarding Resident 1 allegedly being financially abused by the friend. Medical record review of Resident 1 was initiated on 11/22/24. Resident 1 was admitted to the facility on [DATE]. Review of Resident 1's care plan for the alleged financial abuse dated 11/6/24, showed the following interventions: - for three days monitoring by the nursing staff - for three days psychosocial monitoring by the social services staff - to assist the resident in developing a program of activities that is meaningful and of interest to encourage and provide opportunities for exercise and physical activity - to notify the Ombudsman and/or local law enforcement - to notify the provider of the incident - to notify the resident's responsible party - to observe the resident for any signs and symptoms of depression, including: hopelessness, anxiety, sadness, insomnia, anorexia, verbalizing, negative statement, repetitive anxious or health-related complaints and tearfulness; and - for psychological or psychiatric evaluation as needed. (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: 555295 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 555295 B. Wing A. Building (X3) DATE SURVEY COMPLETED 11/22/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Regents Point - Windcrest 19191 Harvard Avenue Irvine, CA 92612 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)