The Cove at la Jolla

In the surveyor’s words

From the most serious findings on record at The Cove at la Jolla, in the surveyor’s own words.

• No harm, potential for more than minimal, widespreadF908Dec 9, 2021

  Based on observations, interviews, and record reviews the facility failed to ensure essential kitchen equipment was maintained for the dish machine and a reach-in freezer according to food safety and sanitation standards of practice and facility policy. This failure had the potential to expose residents to contaminants that could cause foodborne illness. Cross reference F802 and F812 Findings: 1. On 12/6/21 at 8:04 A.M., an observation of the dish machine and interview with a Cook (CK 1) was conducted. CK 1 stated the dishmachine was a low-temperature machine and the wash temperature needed to reach a temperature of 110 degrees to clean the dishes properly. An observation of the temperature gauge on dishwasher while running read 115 degrees. […]

• No harm, potential for more than minimal, patternF689May 16, 2025

  Based on observation, interview, and record review, the facility failed to ensure fall mats were placed appropriately for one of 14 sampled residents (40), and ensure loose flooring was identified for three of three hallways. These failures placed residents at increased risk of injury. Findings: 1. Per the facility's Admission Record, Resident 40 was admitted to the facility on [DATE] with diagnosis of difficulty walking. Per the facility's undated Care Plan Report, Resident 40 was at risk for falls related to impaired mobility, weakness, and a history of falls. […]

• No harm, potential for more than minimal, patternF804May 16, 2025

  Based on observation, interview, and record review the facility failed to ensure that palatable food was served to fifteen of fifty-one sampled residents. This failure had the potential to prevent residents from eating their meals and not receiving their daily nutrition. Cross reference F550 Findings: On 5/13/25 from 7:30 A.M. to 4:30 P.M., resident interviews were conducted during the initial tour of the facility. The following represents residents' statements about food during the initial tour: Resident 8 stated I received cereal with no milk .the combinations are ridiculous like yesterday I got cold sausage with brussels sprouts .food is usually lukewarm, not enough food .I had two meals that I couldn't figure out what it was, it looked like fried mush, and I didn't' t eat it . […]

• No harm, potential for more than minimal, patternF812May 16, 2025

  Based on observation, interview and record review the facility failed to ensure that one kitchen staff wore a beard restraint during breakfast tray line. This failure had the potential to contaminate all residents' food with staff's facial hair and promote foodborne illness. Findings: On 5/13/25 at 7:45 A.M., an observation of the breakfast tray line and an interview with the Dietary Supervisor (DS) was conducted. The DS was observed with an uncovered beard and mustache plating breakfast food. The DS stated that the policy was that he could serve food without a beard restraint if the beard and mustache were trimmed and groomed. The Registered Dietician(RD) was asked to review policy for facial hair for kitchen staff. […]

• No harm, potential for more than minimal, patternF641Jun 6, 2024

  Based on observation, interview, and record review, the facility failed to accurately assess and code the Minimum Data Set (MDS-a clinical assessment tool) for three of four residents (1, 5, 103) reviewed for wander guards (a wrist band worn by residents that alarms and alerts staff when the resident get near or exit a specific area). As a result, the Centers for Medicare and Medicaid Services (CMS) was unaware of Resident 1, 5, and 103's current health status and wandering behavior. Findings: a. Resident 1 was admitted to the facility on [DATE], with diagnoses which included encephalopathy (a disease of the brain which affects daily function), per the facility's Admission Record. […]