Deficiency Index

Every finding on record at Dedication Hospice Care, Inc.

Thousand Oaks, California · CCN B51644

2 findings across 2 surveys, in the inspector's own words.

The inspector’s own words from form CMS-2567, unedited, including CMS’s own spacing. Names and some dates are redacted by CMS.

Survey of November 12, 2025

1 finding
L0555

Upon client record review, 2 of 5 (Patient #2,3) did not have evidence that the IDG ensures that the care and services are provided in accordance with the plan of care. Patient #2, MSW frequency 1x/month. No evidence of MSW visit completed in November 2022. Patient #3, MSW frequency 1x/month. No evidence of MSW visit completed in November. SC frequency 1x/month. No evidence of SC visit completed in November 2022.

Survey of November 18, 2022

1 finding
L0615

Upon personnel record review, 1 of 1 applicable (Personnel #6) did not have evidence in the personnel file that the following competency assessment was performed by the aide with a patient: (This standard applies to all Hospice Aides providing care/service who are directly employed by the hospice or through a contractual agreement.) ·(C) Shampoo, sink, tub, and bed Personnel #6: The competency form utilized by the agency does not specify different types of shampoo demonstrated. Therefore, cannot verify that HA competency was verified in sink, tub, and bed type shampoos.

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Federal survey findings only. State licensure findings for hospices are not shown.

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