Inspection·January 21, 2026

F 0656 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few 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, medical record review, and facility P&P review, the facility failed to develop the comprehensive plan of care to reflect the individual care needs for two of five sampled residents (Residents 1 and 3). * The facility failed to develop a care plan to address when Resident 1 had an actual fall on 11/26/25. * The facility failed to develop a care plan to address Resident 3's upper back abrasion. These failures had the potential risk of not providing the appropriate, consistent, and individualized care to these residents.Findings: Review of the facility's P&P titled Care Plans, Comprehensive Person-Centered revised December 2016 showed a comprehensive, person-centered care plan that includes measurable objectives and timetables to meet the resident's physical, psychosocial and functional needs is developed and implemented for each resident. The Policy Interpretation and Implementation section showed the IDT must review and update the care plan when there has been a significant change in the resident's condition. 1. Medical record review for Resident 1 was initiated on 12/24/25. Resident 1 was admitted to the facility on [DATE]. Review of Resident 1's MDS assessment dated [DATE], showed the resident had severe cognitive impairment. Review of Resident 1's eINTERACT Change in Condition Evaluation V5 dated 11/26/25, showed the resident had an unwitnessed fall. Review of Resident 1's plan of care failed to show a care plan was developed to address the resident's actual fall on 11/26/25. On 1/21/26 at 1353 hours, an interview and concurrent medical record review was conducted with RN 2. RN 2 verified there was no care plan to address Resident 1's actual fall on 11/26/25. RN 2 stated the licensed nurse should have created the care plan for the actual fall and placed interventions and goals. On 1/21/26 at 1518 hours, an interview and concurrent medical record review was conducted with the DON. The DON verified there was no care plan for Resident 1's actual fall on 11/26/25. The DON stated the licensed nurse should have developed a care plan. 2. Medical record review for Resident 3 was initiated on 1/20/26. Resident 3 was admitted to the facility on [DATE]. Review of Resident 3's MDS assessment dated [DATE], showed the resident had severe cognitive impairment. Review of Resident 3's Post Fall IDT dated 1/12/26, showed Resident 3 had an upper back abrasion. Review of Resident 3's plan of care failed to show a care plan was developed to address Resident 3's upper back abrasion. On 1/21/26 at 1405 hours, an interview and concurrent medical record review was conducted with RN 2. RN 2 verified there was no care plan to address Resident 3's upper back abrasion. RN 2 stated the licensed nurse should have created a care plan for the upper back abrasion so the interventions would be implemented and to create the goals. On 1/21/26 at 1530 hours, an interview and concurrent medical record review was conducted with the DON. The DON verified there was no care plan to address Resident 3's upper back abrasion. The DON stated the care plan should have been done to address Resident 3's upper back abrasion. 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: 555462 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 555462 B. Wing A. Building (X3) DATE SURVEY COMPLETED 01/21/2026 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Villa Valencia Healthcare Center 25000 Calle DE Los Caballeros Laguna Hills, CA 92653 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)