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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 | G1 | H· | I· |
| Potential harm | D71 | E5 | F· |
| 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 | |
|---|---|---|---|---|---|---|
| Aug 28, 2026 | Health | Health Complaint | 2 | Potential harm | — | Open → |
| Jul 31, 2026 | Health | Health Complaint | 1 | Potential harm | — | Open → |
| Jul 7, 2026 | Health | Health Complaint | 2 | Potential harm | — | Open → |
| Mar 11, 2026 | Health | Health Complaint | 1 | Potential harm | — | Open → |
| Jan 23, 2026 | Fire safety | Fire Safety Standard | 1 | Potential harm | — | Open → |
| Jan 23, 2026 | Health | Health Standard | 14 | Potential harm | — | Open → |
| Aug 29, 2025 | Health | Health Complaint | 1 | Potential harm | — | Open → |
| Jul 31, 2025 | Health | Health Complaint | 1 | Potential harm | — | Open → |
| Jul 15, 2025 | Health | Health Complaint | 1 | Potential harm | — | Open → |
| May 16, 2025 | Health | Health Complaint | 1 | Potential harm | — | Open → |
| Feb 7, 2025 | Health | Health Complaint | 2 | Potential harm | — | Open → |
| Jan 13, 2025 | Fire safety | Fire Safety Standard | 1 | Potential harm | — | Open → |
| Jan 13, 2025 | Health | Health Standard | 11 | Potential harm | — | Open → |
| Dec 16, 2024 | Health | Health Complaint | 4 | Potential harm | — | Open → |
| Sep 19, 2024 | Health | Health Complaint | 2 | Actual harm | — | Open → |
| Jul 31, 2024 | Health | Health Complaint | 1 | Potential harm | — | Open → |
| Jul 10, 2024 | Health | Health Complaint | 4 | Potential harm | — | Open → |
| May 14, 2024 | Health | Health Complaint | 2 | Potential harm | — | Open → |
| May 10, 2024 | Health | Health Complaint | 3 | Potential harm | — | Open → |
| Jan 30, 2024 | Health | Health Complaint | 2 | Potential harm | — | Open → |
| Jan 12, 2024 | Health | Health Complaint | 2 | Potential harm | — | Open → |
| Dec 29, 2023 | Fire safety | Fire Safety Standard | 7 | Potential harm | — | Open → |
| Dec 29, 2023 | Health | Health Standard | 10 | Potential harm | — | Open → |
| Nov 9, 2023 | Health | Health Complaint, Infection Control | 1 | Potential harm | — | Open → |
| Date | Type | Amount | Payment denial | Record |
|---|---|---|---|---|
| Sep 19, 2024 | Civil money penalty (fine) | $17,088 | — | 555306|Fine|130898 |
| Issued | Class | Type | Category | Final amount | Flags | Record |
|---|---|---|---|---|---|---|
| Jun 14, 2024 violation Mar 14, 2024 | Class B | Citation Citation B (HSC 1424) | Abuse/Facility Not Self Reported | $3,000 | Closed | 910020322 |
| Jun 11, 2024 violation Apr 23, 2024 | Class B | Citation Citation B (HSC 1424) | Abuse/Facility Not Self Reported | $3,000 | Open | 910020300 |
| Dec 21, 2023 violation Nov 6, 2023 | Class B | Citation Citation B (HSC 1424) | Patient Care | $3,000 | Closed | 910019524 |
| Severity | Isolated | Pattern | Widespread |
|---|---|---|---|
| Immediate jeopardy | J· | K· | L· |
| Actual harm | G1 | H· | I· |
| Potential harm | D71 | E5 | F· |
| Minimal | A· | B· | C· |
| Date | Tag | Deficiency | Scope / severity | Correction | Flags |
|---|---|---|---|---|---|
| Aug 28, 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 Sep 23, 2026 | ComplaintIDR |
| Aug 28, 2026 | 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 |
“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.
35 facilities in 2 states. CMS chain ID 50.
Chain average overall rating (CMS): 3.7
| Name | Type | Role (Carefield group) | CMS role text | Share | Since |
|---|---|---|---|---|---|
| Agva LLC | Organization | Direct owner | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 100% | Jan 9, 2015 |
| Aspen Skilled Healthcare Inc | Organization | Indirect owner | INDIRECT OWNERSHIP INTEREST | not provided | May 19, 2016 |
| Jacaranda Healthcare Group LLC | Organization | Indirect owner | INDIRECT OWNERSHIP INTEREST | not provided | Jan 1, 2023 |
| Peter Bradshaw | Individual | Indirect owner | INDIRECT OWNERSHIP INTEREST | not provided | Jul 7, 2023 |
| Eric Elsner | Individual | Indirect owner | INDIRECT OWNERSHIP INTEREST | not provided | May 19, 2016 |
| Jared Kirkwood | Individual | Indirect owner | INDIRECT OWNERSHIP INTEREST | not provided | Jan 1, 2019 |
| Craig Orgill | Individual | Indirect owner | INDIRECT OWNERSHIP INTEREST | not provided | Jan 1, 2019 |
| Rajesh Parti | Individual | Indirect owner | INDIRECT OWNERSHIP INTEREST | not provided | May 19, 2016 |
| Shruty Parti | Individual | Indirect owner | INDIRECT OWNERSHIP INTEREST | not provided | May 19, 2016 |
| Marcus Paxman | Individual | Indirect owner | INDIRECT OWNERSHIP INTEREST | not provided | Apr 1, 2022 |
| Name | Type | Role (Carefield group) | CMS role text | Share | Since |
|---|---|---|---|---|---|
| Agva LLC | Organization | Direct owner | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 100% | Jan 9, 2015 |
| Aspen Skilled Healthcare Inc | Organization | Indirect owner | INDIRECT OWNERSHIP INTEREST | not provided | May 19, 2016 |
| Jacaranda Healthcare Group LLC | Organization | Indirect owner | INDIRECT OWNERSHIP INTEREST | not provided | Jan 1, 2023 |
| Peter Bradshaw | Individual | Indirect owner | INDIRECT OWNERSHIP INTEREST | not provided |
| Facility | Beds | CMS overall | Last inspection | Citations (window) | Fines |
|---|---|---|---|---|---|
| South Marin Health & Wellness Center 1220 South Eliseo Drive, Greenbrae, CA 94904 CCN 055093 | 72 | Jan 23, 2026 | 57 | — | |
| Berkley West Healthcare Center 1623 Arizona Avenue, Santa Monica, CA 90404 CCN 055136 | 54 |
Coordinates as published by CMS.
| Facility | Distance | Beds | CMS overall | Last inspection | Citations (window) | Fines |
|---|---|---|---|---|---|---|
| Gardena Convalescent Center 14819 S. Vermont, Gardena, CA 90247 CCN 0560192 state class AA/A | 0.3 km | 74 | May 29, 2026 | 59 | — | |
| Rosecrans Care Center 1140 West Rosecrans Avenue, Gardena, CA 90247 CCN 0550722 state class AA/A | 0.8 km | 106 | Jun 5, 2026 | 612 harm | — | |
| Memorial Hospital of Gardena D/P SNF 1145 W. Redondo Beach, Gardena, CA 90247 CCN 5554411 state class AA/A | 1 km | 69 | Apr 10, 2026 | 481 harm | $13k | |
| Clear View Convalescent Center 15823 So. Western Ave., Gardena, CA 90247 CCN 555880 | 1.2 km | 99 | Mar 27, 2026 | 19 | — | |
| Clear View Sanitarium 15823 So. Western Ave., Gardena, CA 90247 CCN 555881 | 1.2 km | 73 | Aug 18, 2026 | 182 open | — | |
| West Gardena Post Acute 16530 S Broadway Street, Gardena, CA 90248 CCN 5554104 state class AA/A | 1.7 km | 50 | Nov 20, 2025 | 552 harm | $35k | |
| Las Flores Convalescent Hospital 14165 Purche Ave., Gardena, CA 90249 CCN 5550575 state class AA/AAbuse icon | 2.9 km | 144 | Aug 14, 2026 | 912 IJ3 harm | $107k | |
| View Heights Conv Hosp 12619 S. Avalon Blvd, Los Angeles, CA 90061 CCN 0564176 state class AA/A | 3.3 km | 163 | Jun 25, 2026 | 85 | — |
| Source | Record | Facts | Evidence | Source release | Retrieved |
|---|---|---|---|---|---|
| CMS Provider Information US-CMS | 555306 | name, address, phone, certification, certified_beds, ownership_type, legal_business_name, chain | Verified | Oct 1, 2026 | Nov 7, 2026 |
| CMS Provider Information US-CMS | 555306 | 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 | 910000276 | 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
| Nov 30, 2023 violation Feb 3, 2023 | Class B | Citation Citation B (HSC 1424) | Patient Care | $3,000 | Closed | 910019419 |
| Jun 30, 2023 violation May 12, 2023 | Class B | Citation Citation B (HSC 1424) | Patient Rights | $3,000 | Closed | 910018918 |
| May 10, 2023 violation Mar 19, 2023 | Class A | Citation Citation A (HSC 1424) | Other · QualityOfCare/NursingSvcs | $20,000 | Open | 910018737 |
| Mar 14, 2023 violation Oct 1, 2020 | AP NHPPD | Administrative Penalty AP - 3.2 Nursing-Hours-per-Patient-Day AP (HSC 1276.5) | DHPPD: 2 - 11 Days | $25,000 | Closed | 810018468 |
| Jan 20, 2022 violation Jul 6, 2021 | Class B | Citation Citation B (HSC 1424) | Patient Care | $2,000 | Closed | 910017281 |
| Apr 3, 2020 violation Feb 14, 2020 | Class B | Citation Citation B (HSC 1424) | Patient Care | $2,300 initial $2,000 | Closed | 910015833 |
| Oct 24, 2019 violation Jun 10, 2019 | Class A | Citation Citation A (HSC 1424) | Patient Care | $20,000 | Closed | 910015479 |
| Jun 21, 2019 violation Mar 27, 2019 | Class A | Citation Citation A (HSC 1424) | Patient Care | $60,000 initial $20,000 | Closed | 910015180 |
| Jan 18, 2019 violation Jul 18, 2018 | Class B | Citation Citation A (HSC 1424) | Patient Care | $9,000 initial $15,000 | Death relatedAppealed Closed | 910014726 |
| Jul 20, 2018 violation Mar 26, 2018 | Class B | Citation Citation B (HSC 1424) | Patient Care | $2,000 | Closed | 910014245 |
| Apr 2, 2018 violation Oct 18, 2017 | Class A | Citation Citation A (HSC 1424) | Patient Care | $16,000 | Closed | 910013948 |
| Mar 16, 2007 violation Mar 13, 2007 | Class B | Citation Citation B (HSC 1424) | Administration | $1,000 | Closed | 910003824 |
| Aug 29, 2002 violation May 17, 2002 | Class B | Citation Citation B (HSC 1424) | Patient Care | $700 | Closed | 910001481 |
| Corrected Sep 23, 2026 |
| Complaint |
| Jul 31, 2026 | F-0689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. Quality of Life and Care Deficiencies · Clinical care | D · Potential harm Isolated | Corrected Aug 14, 2026 | Complaint |
| Jul 7, 2026 | F-0628 | Provide the required documentation or notification related to the resident's needs, appeal rights, or bed-hold policies. Resident Rights Deficiencies · Resident rights & abuse/neglect | D · Potential harm Isolated | Corrected Jul 24, 2026 | Complaint |
| Jul 7, 2026 | 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 Jul 24, 2026 | Complaint |
| Mar 11, 2026 | 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 Mar 27, 2026 | Complaint |
| Jan 23, 2026 | K-0355 | Properly select, install, inspect, or maintain portable fire extinguishes. Smoke Deficiencies · Environment & life safety | D · Potential harm Isolated | Corrected Feb 13, 2026 |
| Jan 23, 2026 | 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 Feb 13, 2026 |
| Jan 23, 2026 | F-0552 | Ensure that residents are fully informed and understand their health status, care and treatments. Resident Rights Deficiencies · Resident rights & abuse/neglect | D · Potential harm Isolated | Corrected Feb 13, 2026 |
| Jan 23, 2026 | F-0636 | Assess the resident completely in a timely manner when first admitted, and then periodically, at least every 12 months. Resident Assessment and Care Planning Deficiencies · Clinical care | D · Potential harm Isolated | Corrected Feb 13, 2026 |
| Jan 23, 2026 | 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 Feb 13, 2026 |
| Jan 23, 2026 | 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 Feb 13, 2026 |
| Jan 23, 2026 | F-0684 | Provide appropriate treatment and care according to orders, resident’s preferences and goals. Quality of Life and Care Deficiencies · Clinical care | D · Potential harm Isolated | Corrected Feb 13, 2026 |
| Jan 23, 2026 | F-0686 | Provide appropriate pressure ulcer care and prevent new ulcers from developing. Quality of Life and Care Deficiencies · Clinical care | D · Potential harm Isolated | Corrected Feb 13, 2026 |
| Jan 23, 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 Feb 13, 2026 |
| Jan 23, 2026 | F-0694 | Provide for the safe, appropriate administration of IV fluids for a resident when needed. Quality of Life and Care Deficiencies · Clinical care | D · Potential harm Isolated | Corrected Feb 13, 2026 |
| Jan 23, 2026 | F-0711 | Ensure the resident's doctor reviews the resident's care, writes, signs and dates progress notes and orders, at each required visit. Nursing and Physician Services Deficiencies · Staffing & supervision | D · Potential harm Isolated | Corrected Feb 13, 2026 |
| Jan 23, 2026 | 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 Feb 13, 2026 |
| Jan 23, 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 | E · Potential harm Pattern | Corrected Feb 13, 2026 |
| Jan 23, 2026 | F-0814 | Dispose of garbage and refuse properly. Nutrition and Dietary Deficiencies · Food, nutrition & hydration | D · Potential harm Isolated | Corrected Feb 13, 2026 |
| Jan 23, 2026 | F-0880 | Provide and implement an infection prevention and control program. Infection Control Deficiencies · Infection prevention | D · Potential harm Isolated | Corrected Feb 13, 2026 |
| Aug 29, 2025 | F-0628 | Provide the required documentation or notification related to the resident's needs, appeal rights, or bed-hold policies. Resident Rights Deficiencies · Resident rights & abuse/neglect | D · Potential harm Isolated | Corrected Sep 15, 2025 | Complaint |
| Jul 31, 2025 | F-0689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. Quality of Life and Care Deficiencies · Clinical care | D · Potential harm Isolated | Corrected Aug 11, 2025 | Complaint |
| Jul 15, 2025 | F-0641 | Ensure each resident receives an accurate assessment. Resident Assessment and Care Planning Deficiencies · Clinical care | D · Potential harm Isolated | Corrected Aug 6, 2025 | Complaint |
| May 16, 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 Jun 9, 2025 | Complaint |
| Feb 7, 2025 | F-0623 | Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights. Resident Rights Deficiencies · Resident rights & abuse/neglect | E · Potential harm Pattern | Corrected Feb 23, 2025 | Complaint |
| Feb 7, 2025 | F-0712 | Ensure that the resident and his/her doctor meet face-to-face at all required visits. Nursing and Physician Services Deficiencies · Staffing & supervision | D · Potential harm Isolated | Corrected Feb 23, 2025 | Complaint |
| Jan 13, 2025 | K-0355 | Properly select, install, inspect, or maintain portable fire extinguishes. Smoke Deficiencies · Environment & life safety | D · Potential harm Isolated | Corrected Feb 2, 2025 |
| Jan 13, 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 Feb 2, 2025 |
| Jan 13, 2025 | F-0558 | Reasonably accommodate the needs and preferences of each resident. Resident Rights Deficiencies · Resident rights & abuse/neglect | D · Potential harm Isolated | Corrected Feb 2, 2025 |
| Jan 13, 2025 | 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 Feb 2, 2025 |
| Jan 13, 2025 | F-0686 | Provide appropriate pressure ulcer care and prevent new ulcers from developing. Quality of Life and Care Deficiencies · Clinical care | D · Potential harm Isolated | Corrected Feb 2, 2025 |
| Jan 13, 2025 | F-0711 | Ensure the resident's doctor reviews the resident's care, writes, signs and dates progress notes and orders, at each required visit. Nursing and Physician Services Deficiencies · Staffing & supervision | D · Potential harm Isolated | Corrected Feb 2, 2025 |
| Jan 13, 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 | D · Potential harm Isolated | Corrected Feb 2, 2025 |
| Jan 13, 2025 | F-0759 | Ensure medication error rates are not 5 percent or greater. Pharmacy Service Deficiencies · Medication management | D · Potential harm Isolated | Corrected Feb 2, 2025 |
| Jan 13, 2025 | F-0760 | Ensure that residents are free from significant medication errors. Pharmacy Service Deficiencies · Medication management | D · Potential harm Isolated | Corrected Feb 2, 2025 |
| Jan 13, 2025 | 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 Feb 2, 2025 |
| Jan 13, 2025 | F-0790 | Provide routine and 24-hour emergency dental care for each resident. Quality of Life and Care Deficiencies · Clinical care | D · Potential harm Isolated | Corrected Feb 2, 2025 |
| Jan 13, 2025 | F-0880 | Provide and implement an infection prevention and control program. Infection Control Deficiencies · Infection prevention | D · Potential harm Isolated | Corrected Feb 2, 2025 |
| Dec 16, 2024 | F-0580 | Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. Resident Rights Deficiencies · Resident rights & abuse/neglect | D · Potential harm Isolated | Corrected Jan 3, 2025 | Complaint |
| Dec 16, 2024 | 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 Jan 3, 2025 | Complaint |
| Dec 16, 2024 | F-0684 | Provide appropriate treatment and care according to orders, resident’s preferences and goals. Quality of Life and Care Deficiencies · Clinical care | D · Potential harm Isolated | Corrected Jan 3, 2025 | Complaint |
| Dec 16, 2024 | F-0880 | Provide and implement an infection prevention and control program. Infection Control Deficiencies · Infection prevention | D · Potential harm Isolated | Corrected Jan 3, 2025 | Complaint |
| Sep 19, 2024 | F-0684 | Provide appropriate treatment and care according to orders, resident’s preferences and goals. Quality of Life and Care Deficiencies · Clinical care | G · Actual harm Isolated | Corrected Oct 11, 2024 | Complaint |
| Sep 19, 2024 | 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 | D · Potential harm Isolated | Corrected Oct 11, 2024 | Complaint |
| Jul 31, 2024 | F-0880 | Provide and implement an infection prevention and control program. Infection Control Deficiencies · Infection prevention | D · Potential harm Isolated | Corrected Aug 20, 2024 | Complaint |
| Jul 10, 2024 | 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 Aug 3, 2024 | Complaint |
| Jul 10, 2024 | F-0684 | Provide appropriate treatment and care according to orders, resident’s preferences and goals. Quality of Life and Care Deficiencies · Clinical care | D · Potential harm Isolated | Corrected Aug 3, 2024 | Complaint |
| Jul 10, 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 Aug 3, 2024 | Complaint |
| Jul 10, 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 Aug 3, 2024 | Complaint |
| May 14, 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 Jun 13, 2024 | Complaint |
| May 14, 2024 | F-0610 | Respond appropriately to all alleged violations. Freedom from Abuse, Neglect, and Exploitation Deficiencies · Resident rights & abuse/neglect | D · Potential harm Isolated | Corrected Jun 13, 2024 | Complaint |
| May 10, 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 Jun 3, 2024 | Complaint |
| May 10, 2024 | F-0610 | Respond appropriately to all alleged violations. Freedom from Abuse, Neglect, and Exploitation Deficiencies · Resident rights & abuse/neglect | D · Potential harm Isolated | Corrected Jun 3, 2024 | Complaint |
| May 10, 2024 | 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 Jun 3, 2024 | Complaint |
| Jan 30, 2024 | F-0684 | Provide appropriate treatment and care according to orders, resident’s preferences and goals. Quality of Life and Care Deficiencies · Clinical care | D · Potential harm Isolated | Corrected Feb 28, 2024 | Complaint |
| Jan 30, 2024 | F-0686 | Provide appropriate pressure ulcer care and prevent new ulcers from developing. Quality of Life and Care Deficiencies · Clinical care | D · Potential harm Isolated | Corrected Feb 28, 2024 | Complaint |
| Jan 12, 2024 | F-0624 | Prepare residents for a safe transfer or discharge from the nursing home. Resident Rights Deficiencies · Resident rights & abuse/neglect | D · Potential harm Isolated | Corrected Feb 8, 2024 | Complaint |
| Jan 12, 2024 | 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 Feb 8, 2024 | Complaint |
| Dec 29, 2023 | K-0223 | Provide exit doors that are held open by devices that will automatically close on the activation of a fire alarm or smoke detector. Egress Deficiencies · Environment & life safety | D · Potential harm Isolated | Corrected Jan 18, 2024 |
| Dec 29, 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 Jan 18, 2024 |
| Dec 29, 2023 | K-0341 | Install a fire alarm system that can be heard throughout the facility. Smoke Deficiencies · Environment & life safety | D · Potential harm Isolated | Corrected Jan 18, 2024 |
| Dec 29, 2023 | K-0351 | Install an approved automatic sprinkler system. Smoke Deficiencies · Environment & life safety | D · Potential harm Isolated | Corrected Jan 18, 2024 |
| Dec 29, 2023 | K-0363 | Install corridor and hallway doors that block smoke. Smoke Deficiencies · Environment & life safety | D · Potential harm Isolated | Corrected Jan 18, 2024 |
| Dec 29, 2023 | K-0521 | Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions. Services Deficiencies · Environment & life safety | D · Potential harm Isolated | Corrected Jan 18, 2024 |
| Dec 29, 2023 | K-0925 | Ensure that sources of ignition are removed from patients receiving respiratory therapy. Gas, Vacuum, and Electrical Systems Deficiencies · Environment & life safety | D · Potential harm Isolated | Corrected Jan 18, 2024 |
| Dec 29, 2023 | F-0558 | Reasonably accommodate the needs and preferences of each resident. Resident Rights Deficiencies · Resident rights & abuse/neglect | D · Potential harm Isolated | Corrected Jan 27, 2024 |
| Dec 29, 2023 | F-0578 | Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive. Resident Rights Deficiencies · Resident rights & abuse/neglect | E · Potential harm Pattern | Corrected Jan 27, 2024 |
| Dec 29, 2023 | F-0646 | Notify the appropriate authorities when residents with MD or ID services has a significant change in condition. Resident Assessment and Care Planning Deficiencies · Clinical care | D · Potential harm Isolated | Corrected Jan 27, 2024 |
| Dec 29, 2023 | 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 Jan 27, 2024 |
| Dec 29, 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 Jan 27, 2024 |
| Dec 29, 2023 | 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 Jan 27, 2024 |
| Dec 29, 2023 | 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 Jan 27, 2024 |
| Dec 29, 2023 | 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 Jan 27, 2024 |
| Dec 29, 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 | Past non-compliance Jan 27, 2024 |
| Dec 29, 2023 | F-0880 | Provide and implement an infection prevention and control program. Infection Control Deficiencies · Infection prevention | D · Potential harm Isolated | Corrected Jan 27, 2024 |
| Nov 9, 2023 | F-0880 | Provide and implement an infection prevention and control program. Infection Control Deficiencies · Infection prevention | D · Potential harm Isolated | Corrected Dec 9, 2023 | ComplaintInfection control |
Reported from Payroll-Based Journal (PBJ) data, as published by CMS. Case-mix adjusted total: 3.77 (case-mix index 1.54).
| Jul 7, 2023 |
| Eric Elsner | Individual | Indirect owner | INDIRECT OWNERSHIP INTEREST | not provided | May 19, 2016 |
| Jared Kirkwood | Individual | Indirect owner | INDIRECT OWNERSHIP INTEREST | not provided | Jan 1, 2019 |
| Craig Orgill | Individual | Indirect owner | INDIRECT OWNERSHIP INTEREST | not provided | Jan 1, 2019 |
| Rajesh Parti | Individual | Indirect owner | INDIRECT OWNERSHIP INTEREST | not provided | May 19, 2016 |
| Shruty Parti | Individual | Indirect owner | INDIRECT OWNERSHIP INTEREST | not provided | May 19, 2016 |
| Marcus Paxman | Individual | Indirect owner | INDIRECT OWNERSHIP INTEREST | not provided | Apr 1, 2022 |
| Timothy Caslmon | Individual | Operational / managerial control | MANAGING CONTROL - GOVERNING BODY | not provided | Jan 1, 2023 |
| Stephen Thompson | Individual | Operational / managerial control | MANAGING CONTROL - GOVERNING BODY | not provided | Jan 1, 2023 |
| Agva LLC | Organization | Operational / managerial control | OPERATIONAL/MANAGERIAL CONTROL | not provided | May 19, 2016 |
| Timothy Caslmon | Individual | Operational / managerial control | OPERATIONAL/MANAGERIAL CONTROL | not provided | Jan 1, 2023 |
| Sohail Davoudian | Individual | Operational / managerial control | OPERATIONAL/MANAGERIAL CONTROL | not provided | Mar 1, 2024 |
| Imelda Punzalan | Individual | Operational / managerial control | OPERATIONAL/MANAGERIAL CONTROL | not provided | Aug 18, 2022 |
| Stephen Thompson | Individual | Operational / managerial control | OPERATIONAL/MANAGERIAL CONTROL | not provided | Jan 1, 2023 |
| Jason Varley | Individual | Operational / managerial control | OPERATIONAL/MANAGERIAL CONTROL | not provided | Jun 26, 2024 |
| Aspen Skilled Healthcare Inc | Organization | Mortgage / security interest | 5% OR GREATER MORTGAGE INTEREST | not provided | Feb 9, 2022 |
| White Oak Healthcare Finance LLC | Organization | Mortgage / security interest | 5% OR GREATER MORTGAGE INTEREST | not provided | Feb 9, 2022 |
| Agva LLC | Organization | Additional disclosable party | ADP OF THE SNF | not provided | May 19, 2016 |
| Aspen Skilled Healthcare Inc | Organization | Additional disclosable party | ADP OF THE SNF | not provided | Feb 9, 2022 |
| Cgva, LLC | Organization | Additional disclosable party | ADP OF THE SNF | not provided | Feb 9, 2022 |
| Jacaranda Healthcare Group LLC | Organization | Additional disclosable party | ADP OF THE SNF | not provided | Jan 1, 2023 |
| White Oak Healthcare Finance LLC | Organization | Additional disclosable party | ADP OF THE SNF | not provided | May 19, 2016 |
| Jeffrey Bradshaw | Individual | Additional disclosable party | ADP OF THE SNF | not provided | Feb 9, 2022 |
| Vern Brady | Individual | Additional disclosable party | ADP OF THE SNF | not provided | Feb 9, 2022 |
| Ryan Case | Individual | Additional disclosable party | ADP OF THE SNF | not provided | Feb 9, 2022 |
| Timothy Caslmon | Individual | Additional disclosable party | ADP OF THE SNF | not provided | Jan 1, 2023 |
| Sohail Davoudian | Individual | Additional disclosable party | ADP OF THE SNF | not provided | Mar 1, 2024 |
| Frank Jurado | Individual | Additional disclosable party | ADP OF THE SNF | not provided | Jan 1, 2023 |
| Marcus Paxman | Individual | Additional disclosable party | ADP OF THE SNF | not provided | Jan 1, 2023 |
| Imelda Punzalan | Individual | Additional disclosable party | ADP OF THE SNF | not provided | Aug 18, 2022 |
| Stephen Thompson | Individual | Additional disclosable party | ADP OF THE SNF | not provided | Jan 1, 2023 |
| Jason Varley | Individual | Additional disclosable party | ADP OF THE SNF | not provided | Jun 26, 2024 |
| Jun 25, 2026 |
841 IJ |
| $101k |
| Ocean Pointe Healthcare Center 1330 17th Street, Santa Monica, CA 90404 CCN 0551551 state class AA/A | 72 | Jun 5, 2026 | 791 IJ | $55k |
| Woodlands Healthcare Center 14966 Terreno De Flores Lane, Los Gatos, CA 95032 CCN 0555172 state class AA/A | 65 | Sep 19, 2025 | 60 | — |
| Stonebrook Health and Rehabilitation 350 De Soto Drive, Los Gatos, CA 95032 CCN 0558002 state class AA/A | 73 | Mar 5, 2026 | 49 | — |
| The Avenues Transitional Care Center 2043 19th Avenue, San Francisco, CA 94116 CCN 055963 | 140 | Oct 2, 2025 | 461 harm | $13k |
| Petaluma Post-Acute Rehabilitation 1115 B Street, Petaluma, CA 94952 CCN 0560722 state class AA/A | 90 | Dec 19, 2025 | 36 | — |
| Cottonwood Healthcare Center 625 Cottonwood Street, Woodland, CA 95695 CCN 0560982 state class AA/A | 98 | Jul 24, 2026 | 50 | — |