Inspection citations
3’23
39’24
23’25
24’26
89 shown
| Date | Severity | What inspectors found | Visit |
|---|---|---|---|
| Apr 16, 2026 | D · potential | Honor the resident's right to and the facility must promote and facilitate resident self-determination through support of resident choice. | Routine |
| Apr 16, 2026 | D · potential | Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. | Routine |
| Apr 16, 2026 | D · potential | Keep residents' personal and medical records private and confidential. | Routine |
| Apr 16, 2026 | D · potential | 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. | Routine |
| Apr 16, 2026 | E · potential | Prevent the use of unnecessary psychotropic medications or use medications that may restrain a resident's ability to function. | Routine |
| Apr 16, 2026 | D · potential | Ensure each resident receives an accurate assessment. | Routine |
| Apr 16, 2026 | E · potential | Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | Routine |
| Apr 16, 2026 | D · potential | Provide appropriate treatment and care according to orders, resident’s preferences and goals. | Routine |
| Apr 16, 2026 | D · potential | Assist a resident in gaining access to vision and hearing services. | Routine |
| Apr 16, 2026 | D · potential | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | Routine |
| Apr 16, 2026 | D · potential | Provide enough food/fluids to maintain a resident's health. | Routine |
| Apr 16, 2026 | D · potential | Ensure that feeding tubes are not used unless there is a medical reason and the resident agrees; and provide appropriate care for a resident with a feeding tube. | Routine |
| Apr 16, 2026 | D · potential | Try different approaches before using a bed rail. If a bed rail is needed, the facility must (1) assess a resident for safety risk; (2) review these risks and benefits with the resident/representative; (3) get informed consent; and (4) Correctly install and maintain the bed rail. | Routine |
| Apr 16, 2026 | D · potential | Ensure each resident must receive and the facility must provide necessary behavioral health care and services. | Routine |
| Apr 16, 2026 | D · potential | Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | Routine |
| Apr 16, 2026 | D · potential | Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures. | Routine |
| Apr 16, 2026 | D · potential | 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. | Routine |
| Apr 16, 2026 | D · potential | Provide sufficient support personnel to safely and effectively carry out the functions of the food and nutrition service. | Routine |
| Apr 16, 2026 | E · potential | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | Routine |
| Apr 16, 2026 | D · potential | Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. | Routine |
| Apr 16, 2026 | E · potential | Provide and implement an infection prevention and control program. | Routine |
| Apr 16, 2026 | D · potential | Develop and implement policies and procedures for flu and pneumonia vaccinations. | Routine |
| Apr 16, 2026 | E · potential | Educate residents and staff on COVID-19 vaccination, offer the COVID-19 vaccine to eligible residents and staff after education, and properly document each resident and staff member's vaccination status. | Routine |
| Apr 16, 2026 | D · potential | Make sure that a working call system is available in each resident's bathroom and bathing area. | Routine |
| Aug 14, 2025 | E · potential | Reasonably accommodate the needs and preferences of each resident. | Complaint |
| Aug 14, 2025 | D · potential | Ensure services provided by the nursing facility meet professional standards of quality. | Complaint |
| Jul 29, 2025 | D · potential | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | Complaint |
| Mar 2, 2025 | D · potential | Ensure that residents are fully informed and understand their health status, care and treatments. | Routine |
| Mar 2, 2025 | D · potential | Reasonably accommodate the needs and preferences of each resident. | Routine |
| Mar 2, 2025 | D · potential | Assess the resident completely in a timely manner when first admitted, and then periodically, at least every 12 months. | Routine |
| Mar 2, 2025 | D · potential | Ensure each resident receives an accurate assessment. | Routine |
| Mar 2, 2025 | D · potential | Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals. | Routine |
| Mar 2, 2025 | D · potential | Provide care and assistance to perform activities of daily living for any resident who is unable. | Routine |
| Mar 2, 2025 | D · potential | Assist a resident in gaining access to vision and hearing services. | Routine |
| Mar 2, 2025 | D · potential | Provide appropriate pressure ulcer care and prevent new ulcers from developing. | Routine |
| Mar 2, 2025 | D · potential | Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections. | Routine |
| Mar 2, 2025 | D · potential | Ensure that feeding tubes are not used unless there is a medical reason and the resident agrees; and provide appropriate care for a resident with a feeding tube. | Routine |
| Mar 2, 2025 | D · potential | Ensure each resident’s drug regimen must be free from unnecessary drugs. | Routine |
| Mar 2, 2025 | D · potential | Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited. | Routine |
| Mar 2, 2025 | D · potential | Ensure medication error rates are not 5 percent or greater. | Routine |
| Mar 2, 2025 | D · potential | Ensure that residents are free from significant medication errors. | Routine |
| Mar 2, 2025 | E · potential | Ensure menus must meet the nutritional needs of residents, be prepared in advance, be followed, be updated, be reviewed by dietician, and meet the needs of the resident. | Routine |
| Mar 2, 2025 | E · potential | Ensure each resident receives and the facility provides food prepared in a form designed to meet individual needs. | Routine |
| Mar 2, 2025 | E · potential | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | Routine |
| Mar 2, 2025 | D · potential | Provide and implement an infection prevention and control program. | Routine |
| Feb 12, 2025 | D · potential | Let each resident or the resident's legal representative access or purchase copies of all the resident's records. | Complaint |
| Jan 24, 2025 | D · potential | Ensure that residents are free from significant medication errors. | Complaint |
| Nov 5, 2024 | D · potential | Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive. | Complaint |
| Oct 30, 2024 | D · potential | Permit a resident to return to the nursing home after hospitalization or therapeutic leave that exceeds bed-hold policy. | Complaint |
| Aug 15, 2024 | D · potential | Provide safe and appropriate respiratory care for a resident when needed. | Complaint |
| Aug 1, 2024 | D · potential | Provide and implement an infection prevention and control program. | Complaint |
| Jul 18, 2024 | D · potential | Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | Complaint |
| Jul 18, 2024 | D · potential | Provide appropriate treatment and care according to orders, resident’s preferences and goals. | Complaint |
| Jul 18, 2024 | D · potential | Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections. | Complaint |
| Jul 18, 2024 | F · potential | Have a registered nurse on duty 8 hours a day; and select a registered nurse to be the director of nurses on a full time basis. | Complaint |
| Jul 18, 2024 | D · potential | Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | Complaint |
| Jul 2, 2024 | D · potential | Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | Complaint |
| Jul 2, 2024 | D · potential | Provide the appropriate treatment and services to a resident who displays or is diagnosed with dementia. | Complaint |
| Jun 7, 2024 | D · potential | Ensure services provided by the nursing facility meet professional standards of quality. | Complaint |
| Jun 7, 2024 | D · potential | Administer the facility in a manner that enables it to use its resources effectively and efficiently. | Complaint |
| Apr 22, 2024 | E · potential | Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. | Complaint |
| Apr 22, 2024 | D · potential | Honor the resident's right to voice grievances without discrimination or reprisal and the facility must establish a grievance policy and make prompt efforts to resolve grievances. | Complaint |
| Apr 22, 2024 | D · potential | Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | Complaint |
| Apr 22, 2024 | D · potential | Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | Complaint |
| Mar 8, 2024 | D · potential | Reasonably accommodate the needs and preferences of each resident. | Complaint |
| Mar 8, 2024 | E · potential | Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | Complaint |
| Mar 8, 2024 | E · potential | Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited. | Complaint |
| Mar 6, 2024 | G · harm | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | Complaint |
| Mar 6, 2024 | D · potential | Ensure that residents are free from significant medication errors. | Complaint |
| Feb 23, 2024 | D · potential | Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | Complaint |
| Feb 8, 2024 | D · potential | Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | Complaint |
| Feb 8, 2024 | D · potential | Ensure that residents are fully informed and understand their health status, care and treatments. | Complaint |
| Feb 8, 2024 | E · potential | Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive. | Complaint |
| Feb 8, 2024 | D · potential | Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed. | Complaint |
| Feb 8, 2024 | E · potential | Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | Complaint |
| Feb 8, 2024 | D · potential | Ensure residents do not lose the ability to perform activities of daily living unless there is a medical reason. | Complaint |
| Feb 8, 2024 | D · potential | Provide appropriate pressure ulcer care and prevent new ulcers from developing. | Complaint |
| Feb 8, 2024 | D · potential | Provide safe and appropriate respiratory care for a resident when needed. | Routine |
| Feb 8, 2024 | E · potential | Post nurse staffing information every day. | Complaint |
| Feb 8, 2024 | D · potential | 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. | Routine |
| Jan 23, 2024 | D · potential | Ensure services provided by the nursing facility meet professional standards of quality. | Complaint |
| Jan 23, 2024 | D · potential | Provide appropriate treatment and care according to orders, resident’s preferences and goals. | Complaint |
| Jan 23, 2024 | D · potential | Ensure each resident receives and the facility provides food that accommodates resident allergies, intolerances, and preferences, as well as appealing options. | Complaint |
| Jan 23, 2024 | D · potential | Make sure that a working call system is available in each resident's bathroom and bathing area. | Complaint |
| Jan 5, 2024 | D · potential | Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | Complaint |
| Jan 5, 2024 | D · potential | 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. | Complaint |
| Dec 4, 2023 | D · potential | Respond appropriately to all alleged violations. | Complaint |
| Nov 4, 2023 | G · harm | Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. | Complaint |
| Nov 4, 2023 | G · harm | Provide appropriate treatment and care according to orders, resident’s preferences and goals. | Complaint |
Medicare's severity letters: A–C minimal harm, D–F potential for more than minimal harm, G–L actual harm or immediate danger. Source: CMS health deficiencies file, processed October 1, 2026.
Questions to ask on a visit
Los Angeles Post Acute
915 S. Crenshaw Blvd., Los Angeles, CA 90019 · (323) 937-5466
Visit date: ____________ Spoke with: ______________________
Record on file
- Certification
- Medicare and Medi-Cal certified skilled nursing facility
- Medicare number (CCN)
- 056194
- Certified beds
- 98
- Legal owner
- Windsor Gardens Convalescent Hospital INC
- Part of
- Windsor
Full profile on Medicare's Care Compare. Source: CMS, processed October 1, 2026.
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