← All agencies in Northridge, CA · California

Montebello Home Health Care, Inc

No longer in CMS list This agency is not in CMS's current list of Medicare-certified home health agencies (file dated 2026-09-21), but it has federal inspection records. It may have closed, changed ownership, or changed its certification number. Address shown is from its inspection records.
19350 Business Center Dr Suite 200, Northridge, CA 91324
CMS Certification Number 059108
28deficiencies since 2018
5serious
1inspections
n/aCMS quality stars
Data from CMS inspection reports (Form 2567), 2018-01-02 to 2026-10-15, downloaded 2026-10-21; CMS agency list file dated 2026-09-21. What the labels mean

Inspection 2023-08-11

· Complaint · 28 deficiencies · CMS source report (PDF)
Serious Patient Rights

The Home Health Agency (HHA) failed to ensure the Condition of Participation regarding Patient Rights was met as follows: 1.The HHA failed to provide and/or obtain information of the Advance Directive (a written statement of a person's wishes regarding medical treatment, often including a living…

Source: CMS Form 2567, inspection 2023-08-11, tag G0406 · view on CMS
Show inspector's text

Loading…

Serious Comprehensive Assessment Of Patients

This CONDITION is NOT MET as evidenced by: Based on observation, interview, and record review, the Home Health Agency (HHA) failed to meet the Condition of Participation for Comprehensive Assessment (a tool used by nurses to evaluate a patient's complete health status) of Patients as follows: 1.…

Source: CMS Form 2567, inspection 2023-08-11, tag G0510 · view on CMS
Show inspector's text

Loading…

Serious Care Planning, Coordination, Quality Of Care

The Home Health Agency (HHA) failed to ensure the Condition of Participation for Care Planning, Coordination, Quality of Care was met as follows: 1.The HHA failed to ensure an individualized Plan of Care (POC – an individualized care plan developed by a support team using a person-centered approach…

Source: CMS Form 2567, inspection 2023-08-11, tag G0570 · view on CMS
Show inspector's text

Loading…

Serious Skilled Professional Services

The Home Health Agency (HHA) failed to ensure the Condition of Participation regarding Skilled Professional Services was met as follows: 1. The Home Health Agency (HHA) failed to ensure, a Registered Nurse (RN) conducted a Certified Home Health Aide (CHHA) supervisory visit (a personal visual…

Source: CMS Form 2567, inspection 2023-08-11, tag G0700 · view on CMS
Show inspector's text

Loading…

Serious Clinical Records

The Home Health Agency (HHA) failed to ensure the Condition of Participation for Clinical Records were met as follows: 1.The HHA failed to ensure the plan of care (documents the process of identifying a patient's needs and facilitating holistic care and ensures collaboration among nurses, patients…

Source: CMS Form 2567, inspection 2023-08-11, tag G1008 · view on CMS
Show inspector's text

Loading…

Moderate Content Of The Comprehensive Assessment

The Home Health Agency (HHA) failed to ensure the comprehensive assessment (a tool used by nurses to evaluate a patient's complete health status) accurately reflected the patient's health status for one of eight sampled patients (Patient 5).

Source: CMS Form 2567, inspection 2023-08-11, tag G0526 · view on CMS
Show inspector's text

Loading…

Moderate Update Of The Comprehensive Assessment

The Home Health Agency (HHA) failed to ensure a Registered Nurse (RN, in general) updated the comprehensive assessment for the recertification period for five of eight sampled patients (Patients 1, 4, 5, 6, and 8).

Source: CMS Form 2567, inspection 2023-08-11, tag G0544 · view on CMS
Show inspector's text

Loading…

Moderate Plan Of Care

The Home Health Agency (HHA) failed to ensure an individualized Plan of Care (POC – an individualized care plan developed by a support team using a person-centered approach that describes the services needed by the patient, and it also facilitates communication among members of the patients care…

Source: CMS Form 2567, inspection 2023-08-11, tag G0572 · view on CMS
Show inspector's text

Loading…

Moderate Written Instructions To Patient Include:

The Home Health Agency (HHA) failed to provide written information regarding the Plan of Care (POC – an individualized care plan developed by a support team using a person-centered approach that describes the services needed by the patient, and it also facilitates communication among members of the…

Source: CMS Form 2567, inspection 2023-08-11, tag G0612 · view on CMS
Show inspector's text

Loading…

Moderate Services By Skilled Professionals

The Home Health failed to ensure, a Registered Nurse (RN) conducted a Certified Home Health Aide (CHHA) Supervisory Visit (a personal visual observation of each facility staff by a Registered Nurse responsible for the care and services provided to the patients at home) to monitor and evaluate the…

Source: CMS Form 2567, inspection 2023-08-11, tag G0702 · view on CMS
Show inspector's text

Loading…

Moderate Responsibilities Of Skilled Professionals

The home health agency failed to ensure the established Plan of Care (POC, the process of identifying a patient's needs and facilitating holistic care and ensures collaboration among nurses, patients, and other healthcare providers) was provided to one of eight sampled patients, (Patient 6).

Source: CMS Form 2567, inspection 2023-08-11, tag G0704 · view on CMS
Show inspector's text

Loading…

Moderate Authentication

The home health agency failed to ensure the clinical records for one of eight sampled patients, (Patient 2), were appropriately authenticated, dated, and timed.

Source: CMS Form 2567, inspection 2023-08-11, tag G1024 · view on CMS
Show inspector's text

Loading…

Minor Information To Patient

The Home Health Agency (HHA) failed to provide and/or obtain information of the Advance Directive (a written statement of a person's wishes regarding medical treatment, often including a living will, made to ensure those wishes are carried out should the person be unable to communicate them to a…

Source: CMS Form 2567, inspection 2023-08-11, tag G0410 · view on CMS
Show inspector's text

Loading…

Minor Written Notice Of Patient'S Rights

The Home Health Agency (HHA) failed to provide a written notice of the patient’s bill of rights in a language easily understood (Spanish) to one of eight sampled patients (Patient 2).

Source: CMS Form 2567, inspection 2023-08-11, tag G0412 · view on CMS
Show inspector's text

Loading…

Minor Receive All Services In Plan Of Care

The Home Health Agency (HHA) failed to provide all the services as indicated in the Plan of Care (POC – an individualized care plan developed by a support team using a person-centered approach that describes the services needed by the patient, and it also facilitates communication among members of…

Source: CMS Form 2567, inspection 2023-08-11, tag G0436 · view on CMS
Show inspector's text

Loading…

Minor State Toll Free Hh Telephone Hotline

The Home Health Agency (HHA) failed to provide and ensure three of eight sampled patients (Patient 1, Patient 2, and Patient 5) were advised of the State Toll Free home health hotline number, hours of operation, and its purpose.

Source: CMS Form 2567, inspection 2023-08-11, tag G0444 · view on CMS
Show inspector's text

Loading…

Minor text mentions immediate jeopardy 5 Calendar Days After Start Of Care

The Home Health Agency (HHA) failed to perform a comprehensive assessment (a tool used by nurses to evaluate a patient's complete health status) for one of eight samples patients (Patient 2) by failing to: 1. Complete Patient 2's comprehensive assessment within five calendar days of Patient 2's…

Source: CMS Form 2567, inspection 2023-08-11, tag G0520 · view on CMS
Show inspector's text

Loading…

Minor A Review Of All Current Medications

The Home Health Agency (HHA) failed to review and document all the current medications for four of eight sampled patients (Patients 1, 2, 5, and 6).

Source: CMS Form 2567, inspection 2023-08-11, tag G0536 · view on CMS
Show inspector's text

Loading…

Minor Plan Of Care Must Include The Following

The Home Health Agency (HHA) failed to include information required in the Plan of Care (POC – an individualized care plan developed by a support team using a person-centered approach that describes the services needed by the patient, and it also facilitates communication among members of the…

Source: CMS Form 2567, inspection 2023-08-11, tag G0574 · view on CMS
Show inspector's text

Loading…

Minor Only As Ordered By A Physician

The Home Health Agency (HHA) failed to provide blood sugar monitoring as ordered by the physician for three of eight sampled patients (Patient 4, Patient 5, and Patient 6).

Source: CMS Form 2567, inspection 2023-08-11, tag G0580 · view on CMS
Show inspector's text

Loading…

Minor Promptly Alert Relevant Physician Of Changes

The Home Health Agency (HHA) failed to inform the primary physician promptly of the patient's blood sugar levels not being monitored as indicated in the POC for one of eight sampled patients (Patient 6).

Source: CMS Form 2567, inspection 2023-08-11, tag G0590 · view on CMS
Show inspector's text

Loading…

Minor Communication With All Physicians

The HHA failed to ensure the physician was notified for one of eight sampled patients (Patient 4) when the respiratory rate was outside the ordered parameters.

Source: CMS Form 2567, inspection 2023-08-11, tag G0602 · view on CMS
Show inspector's text

Loading…

Minor Patients Receive Education And Training

The Home Health Agency (HHA) failed to ensure three of eight sampled patients (Patient 4 , Patient 5, and Patient 6) and or patient caregivers (PCG) receive ongoing education as specified in their Plan of Care (POC – an individualized care plan developed by a support team using a person-centered…

Source: CMS Form 2567, inspection 2023-08-11, tag G0610 · view on CMS
Show inspector's text

Loading…

Minor Patient Medication Schedule/Instructions

The Home Health Agency (HHA) failed to ensure two of eight sampled patients (Patient 5 and Patient 6) or their caregivers had the current medication list.

Source: CMS Form 2567, inspection 2023-08-11, tag G0616 · view on CMS
Show inspector's text

Loading…

Minor Nursing Services Supervised By Rn

The Home Health Agency (HHA) failed to ensure a Registered Nurse (RN) conducted the License Vocational Nurse (LVN) supervisory visit at least every 30 days, to monitor and evaluate the LVNs performance in the care and services provided to the four of eight sampled patients, (Patient 1, Patient 4…

Source: CMS Form 2567, inspection 2023-08-11, tag G0726 · view on CMS
Show inspector's text

Loading…

Minor Required Items In Clinical Record

The Home Health Agency (HHA) failed to ensure the plan of care (documents the process of identifying a patient's needs and facilitating holistic care and ensures collaboration among nurses, patients, and other healthcare providers), comprehensive assessment (an assessment conducted by a Registered…

Source: CMS Form 2567, inspection 2023-08-11, tag G1012 · view on CMS
Show inspector's text

Loading…

Minor Interventions And Patient Response

The home health agency failed to ensure the clinical records contained an accurate medication list that reflected the current medications for two of eight sampled patients, (Patient 5 and Patient 6).

Source: CMS Form 2567, inspection 2023-08-11, tag G1014 · view on CMS
Show inspector's text

Loading…

Minor Discharge And Transfer Summaries

The home health agency failed to ensure the discharge summary for one of eight sampled patients, (Patient 7), was sent to the patient’s primary physician within 5 days of discharge.

Source: CMS Form 2567, inspection 2023-08-11, tag G1022 · view on CMS
Show inspector's text

Loading…