Lomita Post-Acute Care Center

In the surveyor’s words

From the most serious findings on record at Lomita Post-Acute Care Center, in the surveyor’s own words.

• Actual harm, isolatedF689Jun 18, 2021

  Based on interview and record review, the facility's staff failed to ensure adequate supervision was provided for a resident who had a high risk for falls and was assessed as requiring an extensive assistance with toileting for one of three sampled residents (Resident 1). Resident 1, who had dementia (group of thinking and social disorders that interfere with daily functioning) with severe cognitive (thought process) impairment was left in the bathroom unsupervised, out of the line of sight with the door closed. […]

• No harm, potential for more than minimal, widespreadF925Mar 11, 2025

  Based on observation, interview, and record review, the facility failed to have an effective pest control program to prevent the infestation of gnats (fruit fly: flying, winged flies) by failing to: 1. Maintain a sanity environment for the residents' shared refrigerator in the dining room. 2. Prevent gnats from flying in Resident 1's room during lunch time. 3. Place UV fly traps throughout the facility and have working UV fly traps in Resident 5's room. 4. Maintain a sanitary environment in the storage room in the kitchen. These deficient practices have the potential to have flies in the food while having lunch and can affect residents that has open wounds prone to infection. Findings: During an observation on 3/11/2025 at 12:05p.m. […]

• No harm, potential for more than minimal, widespreadF812Oct 19, 2023

  Based on observation, interview, and record review, the facility failed to ensure food was stored, prepared, distributed, and served in a sanitary manner to prevent foodborne illness (also called food poisoning caused by eating contaminated food or eating food not kept at appropriate temperatures) by failing to: 1) Label canned foods, corn bread powder, butter, meat products, and vegetables with opened date and received date. 2) Ensure damp cloth used by Cook 1 did not repeatedly touched the food inside the plate. 3) Ensure Cook 2 who handed utensils back and forth to Cook 1 wore gloves. […]

• No harm, potential for more than minimal, patternF605Dec 11, 2025

  Based on interviews and record reviews, the facility failed to ensure two of four sampled residents (Resident 25 and Resident 35) were free from unnecessary psychotropic medications (any drug that affects brain activity related to mental processes and behavior) by failing to:1. Ensure an appropriate diagnosis and evaluation was conducted for Resident 35 before starting the treatment with Seroquel ([generic name - quetiapine] a medication used to treat schizophrenia [a mental illness that is characterized by disturbances in thought], bipolar disorder [sometimes called manic-depressive disorder; mood swings that range from the lows of depression to elevated periods of emotional highs] and as an adjunct treatment option for depression (a serious mood disorder causing persistent sadness and… […]

• No harm, potential for more than minimal, patternF688Dec 11, 2025

  Based on observation, interview, and record review, the facility failed to provide services to improve or maintain range of motion ([ROM] full movement potential of a joint) for two of eight sampled residents (Residents 52 and 65) with ROM concerns by failing to: 1. Objectively measure Resident 65's limited finger ROM of the left hand during the Occupational Therapy (OT, profession that provides services to increase and/or maintain a person's capability to participate in everyday life activities) Evaluation, dated 3/25/2025.2. Provide ROM exercises to Resident 65's right knee during a Restorative Nursing Aide (RNA, nursing aide program that helps residents maintain any progress made after therapy intervention to maintain their function) session in accordance with physician's orders.3. […]