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California CDPH state citations and administrative penalties, 1997 to early 2024 (archived dataset). Separate from federal CMS deficiencies.
| Severity | Isolated | Pattern | Widespread |
|---|---|---|---|
| Immediate jeopardy | J· | K· | L· |
| Actual harm | G· | H· | I· |
| Potential harm | D56 | E26 | F1 |
| Minimal | A· | B· |
CMS publishes about the three most recent standard surveys plus complaint and infection-control inspections from the prior three years. Older findings leave the dataset; their absence is not evidence they never happened.
Federal certification and the state license are different records. A nursing home is licensed by the state and, separately, certified by CMS to bill Medicare and/or Medicaid. We link them by the CCN when the state publishes it; otherwise by exact address, house number and street, or exact name within the same ZIP, and label that link as inferred. Never by name alone.
| Date | Domain | Survey types | Citations | Most severe | Open | |
|---|---|---|---|---|---|---|
| Jul 8, 2026 | Health | Health Complaint | 1 | Potential harm | — | Open → |
| Jun 25, 2026 | Fire safety | Fire Safety Standard | 8 | Potential harm | — | Open → |
| Jun 25, 2026 | Health | Health Standard | 11 | Potential harm | — | Open → |
| Jun 10, 2026 | Health | Health Complaint | 1 | Potential harm | — | Open → |
| May 21, 2026 | Health | Health Complaint | 1 | Potential harm | — | Open → |
| Apr 8, 2026 | Health | Health Complaint | 1 | Potential harm | — | Open → |
| Feb 4, 2026 | Health | Health Complaint | 1 | Potential harm | — | Open → |
| Sep 12, 2025 | Health | Health Complaint | 7 | Potential harm | — | Open → |
| Jul 17, 2025 | Health | Health Complaint | 4 | Potential harm | — | Open → |
| Apr 17, 2025 | Health | Health Complaint | 4 | Potential harm | — | Open → |
| Oct 24, 2024 | Fire safety | Fire Safety Standard | 7 | Potential harm | — | Open → |
| Oct 24, 2024 | Health | Health Standard | 10 | Potential harm | — | Open → |
| Jul 31, 2024 | Health | Health Complaint | 1 | Potential harm | — | Open → |
| May 21, 2024 | Health | Health Complaint | 8 | Potential harm | — | Open → |
| Apr 4, 2024 | Health | Health Complaint | 3 | Potential harm | — | Open → |
| Dec 13, 2023 | Health | Health Complaint | 1 | Potential harm | — | Open → |
| Aug 4, 2023 | Fire safety | Fire Safety Standard | 9 | Potential harm | — | Open → |
| Aug 4, 2023 | Health | Health Standard | 8 | Potential harm | — | Open → |
| Issued | Class | Type | Category | Final amount | Flags | Record |
|---|---|---|---|---|---|---|
| Nov 22, 2023 violation Nov 29, 2020 | AP NHPPD | Administrative Penalty AP - 3.2 Nursing-Hours-per-Patient-Day AP (HSC 1276.5) | DHPPD: 12 - 24 Days | $50,000 | Closed | 810019373 |
| Sep 21, 2021 violation Oct 1, 2019 | AP NHPPD | Administrative Penalty AP - 3.2 Nursing-Hours-per-Patient-Day AP (HSC 1276.5) | DHPPD: 1 Day (No Penalty) | $0 | Closed | 810017836 |
| Jun 12, 2019 violation Jan 1, 2018 | AP NHPPD | Administrative Penalty AP - 3.2 Nursing-Hours-per-Patient-Day AP (HSC 1276.5) | DHPPD: 2 - 11 Days | $15,000 | Closed | 230015127 |
| Severity | Isolated | Pattern | Widespread |
|---|---|---|---|
| Immediate jeopardy | J· | K· | L· |
| Actual harm | G· | H· | I· |
| Potential harm | D56 | E26 | F1 |
| Minimal | A· | B· | C3 |
| Date | Tag | Deficiency | Scope / severity | Correction | Flags |
|---|---|---|---|---|---|
| Jul 8, 2026 | F-0600 | Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. Freedom from Abuse, Neglect, and Exploitation Deficiencies · Resident rights & abuse/neglect | E · Potential harm Pattern | Corrected Jul 17, 2026 | Complaint |
| Jun 25, 2026 | K-0321 | Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system. Smoke Deficiencies · Environment & life safety | D · Potential harm Isolated | Corrected Jul 8, 2026 |
“Corrected” does not erase a citation: the historical finding stays listed with its disposition. Narrative statements of deficiencies are not part of the CMS dataset; see Care Compare for the official inspection report.
CMS ratings apply to CMS-certified nursing homes only and are relative within each state. They are not a guarantee of any individual resident’s experience.
CMS legal business name of the certified provider. Operates this facility only.
32 facilities in 1 states. CMS chain ID 98.
Chain average overall rating (CMS): 2.6
| Name | Type | Role (Carefield group) | CMS role text | Share | Since |
|---|---|---|---|---|---|
| Crescent Facilities Operations LLC | Organization | Direct owner | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 100% | Dec 19, 2006 |
| Win Win Enterprises, LLC | Organization | Indirect owner | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | 35% | Feb 1, 2007 |
| Jenmax Enterprises LLC | Organization | Indirect owner | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | 23% | Feb 1, 2007 |
| Jk-Csh Jv LLC | Organization | Indirect owner | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | 12% | Nov 1, 2006 |
| Manhattan Five Partners LLC | Organization | Indirect owner | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | 7% | Nov 1, 2006 |
| Bering Properties LLC | Organization | Indirect owner | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | 6% | Feb 1, 2007 |
| Bh Alliance | Organization | Indirect owner | INDIRECT OWNERSHIP INTEREST | not provided | Nov 1, 2006 |
| The Jacob Wintner Trust | Organization | Indirect owner | INDIRECT OWNERSHIP INTEREST | not provided | Nov 1, 2006 |
| The Wintner Living Trust Dated 7/08/1992 | Organization | Indirect owner | INDIRECT OWNERSHIP INTEREST | not provided | Feb 1, 2007 |
| Jacob Wintner | Individual | Indirect owner | INDIRECT OWNERSHIP INTEREST | not provided | Feb 1, 2007 |
| Name | Type | Role (Carefield group) | CMS role text | Share | Since |
|---|---|---|---|---|---|
| Crescent Facilities Operations LLC | Organization | Direct owner | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 100% | Dec 19, 2006 |
| Win Win Enterprises, LLC | Organization | Indirect owner | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | 35% | Feb 1, 2007 |
| Jenmax Enterprises LLC | Organization | Indirect owner | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | 23% | Feb 1, 2007 |
| Jk-Csh Jv LLC | Organization | Indirect owner | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | 12% | Nov 1, 2006 |
| Facility | Beds | CMS overall | Last inspection | Citations (window) | Fines |
|---|---|---|---|---|---|
| Madera Rehabilitation & Nursing Center 517 South a Street, Madera, CA 93638 CCN 0551471 state class AA/A | 176 | Feb 24, 2026 | 1001 IJ6 harm | $374k | |
| Watsonville Nursing Center |
Coordinates as published by CMS.
| Source | Record | Facts | Evidence | Source release | Retrieved |
|---|---|---|---|---|---|
| CMS Provider Information US-CMS | 056231 | name, address, phone, certification, certified_beds, ownership_type, legal_business_name, chain | Verified | Oct 1, 2026 | Nov 7, 2026 |
| CMS Provider Information US-CMS | 056231 | ratings, staffing, health_survey_score Five-Star ratings and PBJ staffing apply to the CMS-certified universe only. | Verified | Oct 1, 2026 | Nov 7, 2026 |
| California CDPH Licensed Facility Listing CA | 230000039 | state_license, licensed_beds, licensee Linked to the CMS record by exact CCN. | Verified | Oct 16, 2026 | Nov 7, 2026 |
First seen by Carefield Nov 7, 2026 · last changed Nov 7, 2026. This record as JSON · Report a correction
| Mar 19, 2015 violation Nov 14, 2012 |
| Class A |
| Citation Citation A (HSC 1424) |
| Patient Care |
| $10,000 |
Closed |
| 230011339 |
| Mar 19, 2015 violation Feb 2, 2013 | Class A | Citation Citation A (HSC 1424) | Patient Care | $10,000 | Closed | 230010145 |
| Feb 24, 2015 violation Mar 17, 2014 | AP NHPPD | Administrative Penalty AP - 3.2 Nursing-Hours-per-Patient-Day AP (HSC 1276.5) | DHPPD: 2 - 11 Days | $15,000 | Closed | 230011278 |
| Mar 14, 2014 violation Jul 19, 2013 | Class B | Citation Citation B (HSC 1424) | Patient Care | $2,000 | Closed | 230010540 |
| Mar 14, 2014 violation Apr 12, 2013 | Class B | Citation Citation B (HSC 1424) | Patient Care | $2,000 | Closed | 230010538 |
| Mar 14, 2014 violation Dec 1, 2013 | Class B | Citation Citation B (HSC 1424) | Other · H&SC 1418.91(a) | $2,000 | Closed | 230010343 |
| Mar 14, 2014 violation Nov 9, 2012 | Class B | Citation Citation B (HSC 1424) | Patient Care | $2,000 | Closed | 230010144 |
| Feb 13, 2014 violation Oct 9, 2012 | Class A | Citation Citation A (HSC 1424) | Patient Care | $10,000 | Appealed Closed | 230010390 |
| Feb 13, 2014 violation Feb 27, 2012 | Class B | Citation Citation B (HSC 1424) | Patient Care | $2,000 | Closed | 230010059 |
| Feb 13, 2014 violation Nov 6, 2012 | Class B | Citation Citation B (HSC 1424) | Patient Care | $2,000 | Closed | 230010058 |
| Feb 13, 2014 violation Oct 30, 2012 | Class A | Citation Citation A (HSC 1424) | Patient Care | $10,000 | Appealed Closed | 230009581 |
| Feb 13, 2014 violation Mar 10, 2012 | Class B | Citation Citation B (HSC 1424) | Patient Care | $2,000 | Closed | 230009299 |
| Dec 13, 2013 violation Mar 30, 2012 | Class B | Citation Citation B (HSC 1424) | Problem Transfer | $1,000 | Closed | 230009387 |
| Aug 11, 2011 violation Dec 15, 2010 | Class B | Citation Citation B (HSC 1424) | Other · Health & Safety | $800 | Closed | 230008441 |
| Apr 7, 2011 violation Jan 6, 2011 | Class B | Citation Citation B (HSC 1424) | Patient Rights | $1,150 initial $800 | Closed | 230008122 |
| Apr 7, 2011 violation Jan 6, 2011 | Class B | Citation Citation B (HSC 1424) | Other · FTR Timely | $850 initial $500 | Closed | 230008121 |
| Apr 7, 2011 violation Feb 25, 2011 | Class B | Citation Citation B (HSC 1424) | Other · FTR | $800 | Closed | 230008120 |
| Aug 19, 2009 violation Apr 6, 2009 | Class B | Citation Citation B (HSC 1424) | Patient Care | $1,000 | Appealed Closed | 230006457 |
| Aug 19, 2009 violation Apr 1, 2009 | Class B | Citation Citation B (HSC 1424) | Other · FTR within 24 hours | $750 | Appealed Closed | 230006456 |
| May 15, 2009 violation Feb 16, 2009 | Class B | Citation Citation B (HSC 1424) | Staffing | $700 | Closed | 230006190 |
| May 15, 2009 violation Feb 26, 2009 | Class B | Citation Citation B (HSC 1424) | Patient Care | $3,000 initial $1,000 | Closed | 230006188 |
| Apr 15, 2009 violation Mar 8, 2009 | Class B | Citation Citation B (HSC 1424) | Administration | $750 | Closed | 230006087 |
| Dec 11, 2008 violation Oct 25, 2008 | Class B | Citation Citation B (HSC 1424) | Patient Care | $1,000 | Closed | 230005676 |
| Apr 25, 2008 violation Apr 3, 2008 | Class B | Citation Citation B (HSC 1424) | Patient Care | $1,000 | Closed | 230004952 |
| Apr 17, 2008 violation Feb 10, 2008 | Class B | Citation Citation B (HSC 1424) | Other · failure to report | $750 | Closed | 230004925 |
| Jan 2, 2008 violation Dec 8, 2007 | Class B | Citation Citation B (HSC 1424) | Staffing | $750 | Closed | 230004542 |
| Dec 4, 2007 violation Aug 23, 2007 | Class B | Citation Citation B (HSC 1424) | Patient Care | $1,000 | Closed | 230004471 |
| Jul 17, 2007 violation Jun 6, 2006 | Class B | Citation Citation B (HSC 1424) | Administration | $450 initial $750 | Appealed Closed | 230004076 |
| May 10, 2006 violation Dec 24, 2004 | Class B | Citation Citation B (HSC 1424) | Patient Care | $500 initial $1,000 | Appealed Closed | 230003049 |
| Sep 24, 2003 violation Aug 4, 2003 | Class B | Citation Citation B (HSC 1424) | Patient Rights | $500 initial $1,000 | Appealed Closed | 230001057 |
| May 5, 2003 violation Jul 28, 2002 | Class B | Citation Citation B (HSC 1424) | Patient Rights | $1,000 | Closed | 230001026 |
| Oct 31, 2002 violation Oct 18, 2001 | Class B | Citation Citation B (HSC 1424) | Patient Rights | $1,000 | Closed | 230001001 |
| May 14, 2002 violation Jan 5, 2002 | Class AA | Citation Citation AA (HSC 1424) | Medication | $25,000 initial $80,000 | Death relatedAppealed Closed | 230000982 |
| Apr 24, 2001 violation Feb 20, 2001 | Class B | Citation Citation B (HSC 1424) | Patient Rights | $750 | Appealed Closed | 230000936 |
| Jun 25, 2026 | K-0324 | Provide properly protected cooking facilities. Smoke Deficiencies · Environment & life safety | D · Potential harm Isolated | Corrected Jul 8, 2026 |
| Jun 25, 2026 | K-0355 | Properly select, install, inspect, or maintain portable fire extinguishes. Smoke Deficiencies · Environment & life safety | D · Potential harm Isolated | Corrected Jul 8, 2026 |
| Jun 25, 2026 | K-0919 | Meet requirements for the use of electrical equipment. Gas, Vacuum, and Electrical Systems Deficiencies · Environment & life safety | D · Potential harm Isolated | Corrected Jul 8, 2026 |
| Jun 25, 2026 | K-0920 | Ensure proper usage of power strips and extension cords. Gas, Vacuum, and Electrical Systems Deficiencies · Environment & life safety | E · Potential harm Pattern | Corrected Jul 8, 2026 |
| Jun 25, 2026 | K-0923 | Have proper medical gas storage and administration areas. Gas, Vacuum, and Electrical Systems Deficiencies · Environment & life safety | D · Potential harm Isolated | Corrected Jul 8, 2026 |
| Jun 25, 2026 | F-0558 | Reasonably accommodate the needs and preferences of each resident. Resident Rights Deficiencies · Resident rights & abuse/neglect | D · Potential harm Isolated | Corrected Jul 15, 2026 |
| Jun 25, 2026 | F-0658 | Ensure services provided by the nursing facility meet professional standards of quality. Resident Assessment and Care Planning Deficiencies · Clinical care | D · Potential harm Isolated | Corrected Jul 15, 2026 |
| Jun 25, 2026 | F-0677 | Provide care and assistance to perform activities of daily living for any resident who is unable. Quality of Life and Care Deficiencies · Clinical care | D · Potential harm Isolated | Corrected Jul 15, 2026 |
| Jun 25, 2026 | F-0690 | Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections. Quality of Life and Care Deficiencies · Clinical care | D · Potential harm Isolated | Corrected Jul 15, 2026 |
| Jun 25, 2026 | F-0725 | Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift. Nursing and Physician Services Deficiencies · Staffing & supervision | E · Potential harm Pattern | Corrected Jul 15, 2026 |
| Jun 25, 2026 | F-0801 | Employ sufficient staff with the appropriate competencies and skills sets to carry out the functions of the food and nutrition service, including a qualified dietician. Nutrition and Dietary Deficiencies · Food, nutrition & hydration | D · Potential harm Isolated | Corrected Jul 15, 2026 |
| Jun 25, 2026 | F-0802 | Provide sufficient support personnel to safely and effectively carry out the functions of the food and nutrition service. Nutrition and Dietary Deficiencies · Food, nutrition & hydration | E · Potential harm Pattern | Corrected Jul 15, 2026 |
| Jun 25, 2026 | F-0806 | Ensure each resident receives and the facility provides food that accommodates resident allergies, intolerances, and preferences, as well as appealing options. Nutrition and Dietary Deficiencies · Food, nutrition & hydration | E · Potential harm Pattern | Corrected Jul 15, 2026 |
| Jun 25, 2026 | F-0808 | Ensure therapeutic diets are prescribed by the attending physician and may be delegated to a registered or licensed dietitian, to the extent allowed by State law. Nutrition and Dietary Deficiencies · Food, nutrition & hydration | D · Potential harm Isolated | Corrected Jul 15, 2026 |
| Jun 25, 2026 | F-0812 | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. Nutrition and Dietary Deficiencies · Food, nutrition & hydration | F · Potential harm Widespread | Corrected Jul 15, 2026 |
| Jun 25, 2026 | F-0908 | Keep all essential equipment working safely. Environmental Deficiencies · Environment & life safety | D · Potential harm Isolated | Corrected Jul 15, 2026 |
| Jun 25, 2026 | K-0353 | Inspect, test, and maintain automatic sprinkler systems. Smoke Deficiencies · Environment & life safety | C · Minimal Widespread | Corrected Jul 8, 2026 |
| Jun 25, 2026 | K-0712 | Have simulated fire drills held at unexpected times. Miscellaneous Deficiencies · Environment & life safety | C · Minimal Widespread | Corrected Jul 8, 2026 |
| Jun 10, 2026 | F-0600 | Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. Freedom from Abuse, Neglect, and Exploitation Deficiencies · Resident rights & abuse/neglect | E · Potential harm Pattern | Corrected Jun 16, 2026 | Complaint |
| May 21, 2026 | F-0609 | Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. Freedom from Abuse, Neglect, and Exploitation Deficiencies · Resident rights & abuse/neglect | D · Potential harm Isolated | Corrected Jun 9, 2026 | Complaint |
| Apr 8, 2026 | F-0760 | Ensure that residents are free from significant medication errors. Pharmacy Service Deficiencies · Medication management | D · Potential harm Isolated | Corrected Apr 16, 2026 | Complaint |
| Feb 4, 2026 | F-0691 | Provide appropriate colostomy, urostomy, or ileostomy care/services for a resident who requires such services. Quality of Life and Care Deficiencies · Clinical care | D · Potential harm Isolated | Corrected Feb 9, 2026 | Complaint |
| Sep 12, 2025 | F-0550 | Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. Resident Rights Deficiencies · Resident rights & abuse/neglect | D · Potential harm Isolated | Corrected Sep 25, 2025 | Complaint |
| Sep 12, 2025 | F-0637 | Assess the resident when there is a significant change in condition Resident Assessment and Care Planning Deficiencies · Clinical care | D · Potential harm Isolated | Corrected Sep 25, 2025 | Complaint |
| Sep 12, 2025 | F-0656 | Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. Resident Assessment and Care Planning Deficiencies · Clinical care | D · Potential harm Isolated | Corrected Sep 25, 2025 | Complaint |
| Sep 12, 2025 | F-0755 | Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. Pharmacy Service Deficiencies · Medication management | E · Potential harm Pattern | Corrected Sep 25, 2025 | Complaint |
| Sep 12, 2025 | F-0800 | Provide each resident with a nourishing, palatable, well-balanced diet that meets his or her daily nutritional and special dietary needs. Nutrition and Dietary Deficiencies · Food, nutrition & hydration | E · Potential harm Pattern | Corrected Sep 25, 2025 | Complaint |
| Sep 12, 2025 | F-0801 | Employ sufficient staff with the appropriate competencies and skills sets to carry out the functions of the food and nutrition service, including a qualified dietician. Nutrition and Dietary Deficiencies · Food, nutrition & hydration | E · Potential harm Pattern | Corrected Sep 25, 2025 | Complaint |
| Sep 12, 2025 | F-0806 | Ensure each resident receives and the facility provides food that accommodates resident allergies, intolerances, and preferences, as well as appealing options. Nutrition and Dietary Deficiencies · Food, nutrition & hydration | D · Potential harm Isolated | Corrected Sep 25, 2025 | Complaint |
| Jul 17, 2025 | F-0602 | Protect each resident from the wrongful use of the resident's belongings or money. Freedom from Abuse, Neglect, and Exploitation Deficiencies · Resident rights & abuse/neglect | D · Potential harm Isolated | Corrected Jul 30, 2025 | Complaint |
| Jul 17, 2025 | F-0609 | Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. Freedom from Abuse, Neglect, and Exploitation Deficiencies · Resident rights & abuse/neglect | D · Potential harm Isolated | Corrected Jul 30, 2025 | Complaint |
| Jul 17, 2025 | F-0842 | Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. Resident Assessment and Care Planning Deficiencies · Clinical care | E · Potential harm Pattern | Corrected Jul 30, 2025 | Complaint |
| Jul 17, 2025 | F-0940 | Develop, implement, and/or maintain an effective training program for all new and existing staff members. Administration Deficiencies · Administration & records | D · Potential harm Isolated | Corrected Jul 30, 2025 | Complaint |
| Apr 17, 2025 | F-0690 | Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections. Quality of Life and Care Deficiencies · Clinical care | D · Potential harm Isolated | Corrected Apr 30, 2025 | Complaint |
| Apr 17, 2025 | F-0804 | Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature. Nutrition and Dietary Deficiencies · Food, nutrition & hydration | E · Potential harm Pattern | Corrected Apr 30, 2025 | Complaint |
| Apr 17, 2025 | F-0880 | Provide and implement an infection prevention and control program. Infection Control Deficiencies · Infection prevention | E · Potential harm Pattern | Corrected Apr 30, 2025 | Complaint |
| Apr 17, 2025 | F-0919 | Make sure that a working call system is available in each resident's bathroom and bathing area. Environmental Deficiencies · Environment & life safety | E · Potential harm Pattern | Corrected Apr 30, 2025 | Complaint |
| Oct 24, 2024 | K-0321 | Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system. Smoke Deficiencies · Environment & life safety | D · Potential harm Isolated | Corrected Nov 8, 2024 |
| Oct 24, 2024 | K-0353 | Inspect, test, and maintain automatic sprinkler systems. Smoke Deficiencies · Environment & life safety | D · Potential harm Isolated | Corrected Nov 8, 2024 |
| Oct 24, 2024 | K-0355 | Properly select, install, inspect, or maintain portable fire extinguishes. Smoke Deficiencies · Environment & life safety | D · Potential harm Isolated | Corrected Nov 8, 2024 |
| Oct 24, 2024 | K-0363 | Install corridor and hallway doors that block smoke. Smoke Deficiencies · Environment & life safety | D · Potential harm Isolated | Corrected Nov 8, 2024 |
| Oct 24, 2024 | K-0919 | Meet requirements for the use of electrical equipment. Gas, Vacuum, and Electrical Systems Deficiencies · Environment & life safety | D · Potential harm Isolated | Corrected Nov 8, 2024 |
| Oct 24, 2024 | K-0923 | Have proper medical gas storage and administration areas. Gas, Vacuum, and Electrical Systems Deficiencies · Environment & life safety | D · Potential harm Isolated | Corrected Nov 8, 2024 |
| Oct 24, 2024 | F-0550 | Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. Resident Rights Deficiencies · Resident rights & abuse/neglect | D · Potential harm Isolated | Corrected Nov 11, 2024 |
| Oct 24, 2024 | F-0584 | 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. Resident Rights Deficiencies · Resident rights & abuse/neglect | D · Potential harm Isolated | Corrected Nov 11, 2024 |
| Oct 24, 2024 | F-0609 | Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. Freedom from Abuse, Neglect, and Exploitation Deficiencies · Resident rights & abuse/neglect | D · Potential harm Isolated | Corrected Nov 11, 2024 |
| Oct 24, 2024 | F-0725 | Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift. Nursing and Physician Services Deficiencies · Staffing & supervision | E · Potential harm Pattern | Corrected Nov 11, 2024 |
| Oct 24, 2024 | F-0759 | Ensure medication error rates are not 5 percent or greater. Pharmacy Service Deficiencies · Medication management | D · Potential harm Isolated | Corrected Nov 11, 2024 |
| Oct 24, 2024 | F-0761 | 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. Pharmacy Service Deficiencies · Medication management | D · Potential harm Isolated | Corrected Nov 11, 2024 |
| Oct 24, 2024 | F-0804 | Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature. Nutrition and Dietary Deficiencies · Food, nutrition & hydration | E · Potential harm Pattern | Corrected Nov 11, 2024 |
| Oct 24, 2024 | F-0809 | Ensure meals and snacks are served at times in accordance with resident’s needs, preferences, and requests. Suitable and nourishing alternative meals and snacks must be provided for residents who want to eat at non-traditional times or outside of scheduled meal times. Nutrition and Dietary Deficiencies · Food, nutrition & hydration | D · Potential harm Isolated | Corrected Nov 11, 2024 |
| Oct 24, 2024 | F-0812 | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. Nutrition and Dietary Deficiencies · Food, nutrition & hydration | E · Potential harm Pattern | Corrected Nov 11, 2024 |
| Oct 24, 2024 | F-0880 | Provide and implement an infection prevention and control program. Infection Control Deficiencies · Infection prevention | E · Potential harm Pattern | Corrected Nov 11, 2024 |
| Oct 24, 2024 | K-0918 | Have generator or other power source capable of supplying service within 10 seconds. Gas, Vacuum, and Electrical Systems Deficiencies · Environment & life safety | C · Minimal Widespread | Corrected Nov 8, 2024 |
| Jul 31, 2024 | F-0691 | Provide appropriate colostomy, urostomy, or ileostomy care/services for a resident who requires such services. Quality of Life and Care Deficiencies · Clinical care | D · Potential harm Isolated | Corrected Aug 8, 2024 | Complaint |
| May 21, 2024 | F-0565 | Honor the resident's right to organize and participate in resident/family groups in the facility. Resident Rights Deficiencies · Resident rights & abuse/neglect | E · Potential harm Pattern | Corrected May 29, 2024 | Complaint |
| May 21, 2024 | F-0697 | Provide safe, appropriate pain management for a resident who requires such services. Quality of Life and Care Deficiencies · Clinical care | D · Potential harm Isolated | Corrected May 29, 2024 | Complaint |
| May 21, 2024 | F-0725 | Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift. Nursing and Physician Services Deficiencies · Staffing & supervision | E · Potential harm Pattern | Corrected May 29, 2024 | Complaint |
| May 21, 2024 | F-0726 | Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being. Nursing and Physician Services Deficiencies · Staffing & supervision | D · Potential harm Isolated | Corrected May 29, 2024 | Complaint |
| May 21, 2024 | F-0745 | Provide medically-related social services to help each resident achieve the highest possible quality of life. Quality of Life and Care Deficiencies · Clinical care | D · Potential harm Isolated | Corrected May 29, 2024 | Complaint |
| May 21, 2024 | F-0756 | Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures. Pharmacy Service Deficiencies · Medication management | D · Potential harm Isolated | Corrected May 29, 2024 | Complaint |
| May 21, 2024 | F-0757 | Ensure each resident’s drug regimen must be free from unnecessary drugs. Pharmacy Service Deficiencies · Medication management | D · Potential harm Isolated | Corrected May 29, 2024 | Complaint |
| May 21, 2024 | F-0773 | Provide or obtain laboratory tests/services when ordered and promptly tell the ordering practitioner of the results. Administration Deficiencies · Administration & records | D · Potential harm Isolated | Corrected May 29, 2024 | Complaint |
| Apr 4, 2024 | F-0552 | Ensure that residents are fully informed and understand their health status, care and treatments. Resident Rights Deficiencies · Resident rights & abuse/neglect | E · Potential harm Pattern | Corrected May 2, 2024 | Complaint |
| Apr 4, 2024 | F-0641 | Ensure each resident receives an accurate assessment. Resident Assessment and Care Planning Deficiencies · Clinical care | E · Potential harm Pattern | Corrected Apr 29, 2024 | Complaint |
| Apr 4, 2024 | F-0791 | Provide or obtain dental services for each resident. Quality of Life and Care Deficiencies · Clinical care | E · Potential harm Pattern | Corrected May 3, 2024 | Complaint |
| Dec 13, 2023 | F-0609 | Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. Freedom from Abuse, Neglect, and Exploitation Deficiencies · Resident rights & abuse/neglect | D · Potential harm Isolated | Corrected Dec 29, 2023 | Complaint |
| Aug 4, 2023 | K-0321 | Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system. Smoke Deficiencies · Environment & life safety | D · Potential harm Isolated | Corrected Aug 26, 2023 |
| Aug 4, 2023 | K-0345 | Have approved installation, maintenance and testing program for fire alarm systems. Smoke Deficiencies · Environment & life safety | E · Potential harm Pattern | Corrected Aug 26, 2023 |
| Aug 4, 2023 | K-0355 | Properly select, install, inspect, or maintain portable fire extinguishes. Smoke Deficiencies · Environment & life safety | D · Potential harm Isolated | Corrected Aug 26, 2023 |
| Aug 4, 2023 | K-0363 | Install corridor and hallway doors that block smoke. Smoke Deficiencies · Environment & life safety | D · Potential harm Isolated | Corrected Aug 26, 2023 |
| Aug 4, 2023 | K-0711 | Provide a written emergency evacuation plan. Miscellaneous Deficiencies · Environment & life safety | D · Potential harm Isolated | Corrected Aug 26, 2023 |
| Aug 4, 2023 | K-0741 | Have posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed. Miscellaneous Deficiencies · Environment & life safety | D · Potential harm Isolated | Corrected Aug 26, 2023 |
| Aug 4, 2023 | K-0918 | Have generator or other power source capable of supplying service within 10 seconds. Gas, Vacuum, and Electrical Systems Deficiencies · Environment & life safety | E · Potential harm Pattern | Corrected Aug 26, 2023 |
| Aug 4, 2023 | K-0919 | Meet requirements for the use of electrical equipment. Gas, Vacuum, and Electrical Systems Deficiencies · Environment & life safety | D · Potential harm Isolated | Corrected Aug 26, 2023 |
| Aug 4, 2023 | K-0920 | Ensure proper usage of power strips and extension cords. Gas, Vacuum, and Electrical Systems Deficiencies · Environment & life safety | D · Potential harm Isolated | Corrected Aug 26, 2023 |
| Aug 4, 2023 | F-0584 | 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. Resident Rights Deficiencies · Resident rights & abuse/neglect | D · Potential harm Isolated | Corrected Aug 21, 2023 |
| Aug 4, 2023 | F-0637 | Assess the resident when there is a significant change in condition Resident Assessment and Care Planning Deficiencies · Clinical care | D · Potential harm Isolated | Corrected Aug 21, 2023 |
| Aug 4, 2023 | F-0657 | Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals. Resident Assessment and Care Planning Deficiencies · Clinical care | D · Potential harm Isolated | Corrected Aug 21, 2023 |
| Aug 4, 2023 | F-0727 | 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. Nursing and Physician Services Deficiencies · Staffing & supervision | E · Potential harm Pattern | Corrected Aug 21, 2023 |
| Aug 4, 2023 | F-0755 | Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. Pharmacy Service Deficiencies · Medication management | D · Potential harm Isolated | Corrected Aug 22, 2023 |
| Aug 4, 2023 | F-0804 | Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature. Nutrition and Dietary Deficiencies · Food, nutrition & hydration | E · Potential harm Pattern | Corrected Aug 23, 2023 |
| Aug 4, 2023 | F-0805 | Ensure each resident receives and the facility provides food prepared in a form designed to meet individual needs. Nutrition and Dietary Deficiencies · Food, nutrition & hydration | D · Potential harm Isolated | Corrected Aug 23, 2023 |
| Aug 4, 2023 | F-0812 | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. Nutrition and Dietary Deficiencies · Food, nutrition & hydration | D · Potential harm Isolated | Corrected Aug 23, 2023 |
Reported from Payroll-Based Journal (PBJ) data, as published by CMS. Case-mix adjusted total: 4.10 (case-mix index 1.30).
| Manhattan Five Partners LLC | Organization | Indirect owner | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | 7% | Nov 1, 2006 |
| Bering Properties LLC | Organization | Indirect owner | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | 6% | Feb 1, 2007 |
| Bh Alliance | Organization | Indirect owner | INDIRECT OWNERSHIP INTEREST | not provided | Nov 1, 2006 |
| The Jacob Wintner Trust | Organization | Indirect owner | INDIRECT OWNERSHIP INTEREST | not provided | Nov 1, 2006 |
| The Wintner Living Trust Dated 7/08/1992 | Organization | Indirect owner | INDIRECT OWNERSHIP INTEREST | not provided | Feb 1, 2007 |
| Jacob Wintner | Individual | Indirect owner | INDIRECT OWNERSHIP INTEREST | not provided | Feb 1, 2007 |
| Gregory Bretsch | Individual | Operational / managerial control | MANAGING CONTROL - GOVERNING BODY | not provided | Feb 25, 2019 |
| Lorrie Fitzgerald | Individual | Operational / managerial control | MANAGING CONTROL - GOVERNING BODY | not provided | Feb 4, 2024 |
| Cambridge Healthcare Services LLC | Organization | Operational / managerial control | OPERATIONAL/MANAGERIAL CONTROL | not provided | Apr 1, 2014 |
| Gregory Bretsch | Individual | Operational / managerial control | OPERATIONAL/MANAGERIAL CONTROL | not provided | Feb 25, 2019 |
| Julie Butenko | Individual | Operational / managerial control | OPERATIONAL/MANAGERIAL CONTROL | not provided | Jul 24, 2023 |
| Heidi Capela | Individual | Operational / managerial control | OPERATIONAL/MANAGERIAL CONTROL | not provided | Apr 3, 2023 |
| Lorrie Fitzgerald | Individual | Operational / managerial control | OPERATIONAL/MANAGERIAL CONTROL | not provided | Feb 4, 2024 |
| Lance Hassell | Individual | Operational / managerial control | OPERATIONAL/MANAGERIAL CONTROL | not provided | Apr 25, 2022 |
| Linda Lutz | Individual | Operational / managerial control | OPERATIONAL/MANAGERIAL CONTROL | not provided | Feb 1, 2012 |
| Paulina Salazar | Individual | Operational / managerial control | OPERATIONAL/MANAGERIAL CONTROL | not provided | Dec 14, 2020 |
| Aishwarya Sharma | Individual | Operational / managerial control | OPERATIONAL/MANAGERIAL CONTROL | not provided | Nov 1, 2025 |
| Ira Smedra | Individual | Operational / managerial control | OPERATIONAL/MANAGERIAL CONTROL | not provided | Jan 1, 2007 |
| Melissa Swartz | Individual | Operational / managerial control | OPERATIONAL/MANAGERIAL CONTROL | not provided | Jul 2, 2019 |
| Jacob Wintner | Individual | Operational / managerial control | OPERATIONAL/MANAGERIAL CONTROL | not provided | Feb 1, 2007 |
| Ira Smedra | Individual | Corporate officer / director | CORPORATE OFFICER | not provided | Feb 1, 2007 |
| Jacob Wintner | Individual | Corporate officer / director | CORPORATE OFFICER | not provided | Feb 1, 2007 |
| 2005 River, LLC | Organization | Additional disclosable party | ADP OF THE SNF | not provided | Dec 1, 2010 |
| Cambridge Healthcare Services LLC | Organization | Additional disclosable party | ADP OF THE SNF | not provided | Jul 17, 2025 |
| Jenmax Enterprises LLC | Organization | Additional disclosable party | ADP OF THE SNF | not provided | Feb 1, 2007 |
| Jk-Csh Jv LLC | Organization | Additional disclosable party | ADP OF THE SNF | not provided | Nov 1, 2006 |
| Win Win Enterprises, LLC | Organization | Additional disclosable party | ADP OF THE SNF | not provided | Feb 1, 2007 |
| Gregory Bretsch | Individual | Additional disclosable party | ADP OF THE SNF | not provided | Feb 25, 2019 |
| Julie Butenko | Individual | Additional disclosable party | ADP OF THE SNF | not provided | Jul 24, 2023 |
| Heidi Capela | Individual | Additional disclosable party | ADP OF THE SNF | not provided | Apr 3, 2023 |
| Lorrie Fitzgerald | Individual | Additional disclosable party | ADP OF THE SNF | not provided | Jul 16, 2025 |
| Lance Hassell | Individual | Additional disclosable party | ADP OF THE SNF | not provided | Apr 25, 2022 |
| Linda Lutz | Individual | Additional disclosable party | ADP OF THE SNF | not provided | Feb 1, 2012 |
| Paulina Salazar | Individual | Additional disclosable party | ADP OF THE SNF | not provided | Dec 14, 2020 |
| Aishwarya Sharma | Individual | Additional disclosable party | ADP OF THE SNF | not provided | Nov 1, 2025 |
| Ira Smedra | Individual | Additional disclosable party | ADP OF THE SNF | not provided | Feb 1, 2007 |
| Jacob Wintner | Individual | Additional disclosable party | ADP OF THE SNF | not provided | Feb 1, 2007 |
| 87 |
| Jan 9, 2026 |
56 |
| — |
| Merced Nursing & Rehabilitation Ctr 510 West 26th Street, Merced, CA 95340 CCN 055249 | 79 | Jul 17, 2026 | 46 | — |
| La Sierra Care Center 2424 M Street, Merced, CA 95340 CCN 055271 | 68 | Jan 23, 2026 | 61 | — |
| Valley Palms Care Center 13400 Sherman Way, N Hollywood, CA 91605 CCN 0552871 state class AA/A | 99 | May 18, 2026 | 1371 IJ1 harm | $34k |
| Monrovia Gardens Healthcare Center 615 W. Duarte Rd., Monrovia, CA 91016 CCN 0553673 state class AA/A | 96 | Jul 15, 2026 | 1191 harm | — |
| Huntington Drive Health and Rehabilitation Center 400 W. Huntinton Dr., Arcadia, CA 91007 CCN 0553763 state class AA/A | 99 | Jul 24, 2026 | 99 | — |
| Buena Vista Care Center 1440 S Euclid Avenue, Anaheim, CA 92802 CCN 055459 | 99 | May 11, 2026 | 1011 open | — |