
Report
TheVardellReport
Mirage Post Acute
Skilled nursing facility and nursing facility
44445 15Th St W
Lancaster, CA 93534

TheVardellReport
Skilled nursing facility and nursing facility
44445 15Th St W
Lancaster, CA 93534
Life by Vardell Presents
The deeper story, beautifully organized. Available records, historical context, and questions worth asking.
This report is free. Vardell does not certify, grade or endorse; it shows what the record documents.
The Essentials
Across 65 inspections from October 2023 to August 2026, state surveyors documented 276 findings at Mirage Post Acute; 275 have a recorded correction and 1 awaits one; CMS lists 3 enforcement actions in the window.
* Partial year, through October 1, 2026.
| Year | Inspections | Findings | Of which, actual harm (level G or above) |
|---|---|---|---|
| 2023 | 6 | 18 | 0 |
| 2024 | 19 | 101 | 0 |
| 2025 | 24 | 93 | 6 |
| 2026 | 16 | 64 | 0 |
Chronology
Every inspection in the record window, newest first. A finding is a deficiency an inspector cited. CMS publishes what a complaint investigation cited, not what the complaint alleged.
1 finding
Source: Health inspection results, as published by CMS (Health Deficiencies and Inspection Dates, Provider Data Catalog)
1 finding
Source: Health inspection results, as published by CMS (Health Deficiencies and Inspection Dates, Provider Data Catalog)
1 finding
Source: Health inspection results, as published by CMS (Health Deficiencies and Inspection Dates, Provider Data Catalog)
7 findings
Source: Health inspection results, as published by CMS (Health Deficiencies and Inspection Dates, Provider Data Catalog)
2 findings
Source: Health inspection results, as published by CMS (Health Deficiencies and Inspection Dates, Provider Data Catalog)
2 findings
Source: Health inspection results, as published by CMS (Health Deficiencies and Inspection Dates, Provider Data Catalog)
9 findings
Source: Health inspection results, as published by CMS (Health Deficiencies and Inspection Dates, Provider Data Catalog)
1 finding
Source: Health inspection results, as published by CMS (Health Deficiencies and Inspection Dates, Provider Data Catalog)
1 finding
Source: Health inspection results, as published by CMS (Health Deficiencies and Inspection Dates, Provider Data Catalog)
3 findings
Source: Health inspection results, as published by CMS (Health Deficiencies and Inspection Dates, Provider Data Catalog)
2 findings
Source: Health inspection results, as published by CMS (Health Deficiencies and Inspection Dates, Provider Data Catalog)
23 findings
Source: Health inspection results, as published by CMS (Health Deficiencies and Inspection Dates, Provider Data Catalog)
1 finding
Source: Health inspection results, as published by CMS (Health Deficiencies and Inspection Dates, Provider Data Catalog)
1 finding
Source: Health inspection results, as published by CMS (Health Deficiencies and Inspection Dates, Provider Data Catalog)
7 findings
Source: Health inspection results, as published by CMS (Health Deficiencies and Inspection Dates, Provider Data Catalog)
2 findings
Source: Health inspection results, as published by CMS (Health Deficiencies and Inspection Dates, Provider Data Catalog)
1 finding
Source: Health inspection results, as published by CMS (Health Deficiencies and Inspection Dates, Provider Data Catalog)
1 finding
Source: Health inspection results, as published by CMS (Health Deficiencies and Inspection Dates, Provider Data Catalog)
4 findings
Source: Health inspection results, as published by CMS (Health Deficiencies and Inspection Dates, Provider Data Catalog)
5 findings
Source: Health inspection results, as published by CMS (Health Deficiencies and Inspection Dates, Provider Data Catalog)
7 findings
Source: Health inspection results, as published by CMS (Health Deficiencies and Inspection Dates, Provider Data Catalog)
4 findings
Source: Health inspection results, as published by CMS (Health Deficiencies and Inspection Dates, Provider Data Catalog)
1 finding
Source: Health inspection results, as published by CMS (Health Deficiencies and Inspection Dates, Provider Data Catalog)
1 finding
Source: Health inspection results, as published by CMS (Health Deficiencies and Inspection Dates, Provider Data Catalog)
4 findings
Source: Health inspection results, as published by CMS (Health Deficiencies and Inspection Dates, Provider Data Catalog)
2 findings
Source: Health inspection results, as published by CMS (Health Deficiencies and Inspection Dates, Provider Data Catalog)
4 findings
Source: Health inspection results, as published by CMS (Health Deficiencies and Inspection Dates, Provider Data Catalog)
6 findings
Source: Health inspection results, as published by CMS (Health Deficiencies and Inspection Dates, Provider Data Catalog)
4 findings
Source: Health inspection results, as published by CMS (Health Deficiencies and Inspection Dates, Provider Data Catalog)
2 findings
Source: Health inspection results, as published by CMS (Health Deficiencies and Inspection Dates, Provider Data Catalog)
3 findings
Source: Health inspection results, as published by CMS (Health Deficiencies and Inspection Dates, Provider Data Catalog)
2 findings
Source: Health inspection results, as published by CMS (Health Deficiencies and Inspection Dates, Provider Data Catalog)
2 findings
Source: Health inspection results, as published by CMS (Health Deficiencies and Inspection Dates, Provider Data Catalog)
1 finding
Source: Health inspection results, as published by CMS (Health Deficiencies and Inspection Dates, Provider Data Catalog)
2 findings
Source: Health inspection results, as published by CMS (Health Deficiencies and Inspection Dates, Provider Data Catalog)
3 findings
Source: Health inspection results, as published by CMS (Health Deficiencies and Inspection Dates, Provider Data Catalog)
3 findings
Source: Health inspection results, as published by CMS (Health Deficiencies and Inspection Dates, Provider Data Catalog)
26 findings
The same visit included a complaint investigation.
Enforcement Action
Civil money penalty, $18,351 imposed February 7, 2025. CMS publishes the fine, not whether it has been paid. CMS does not tie a penalty to a survey; listed with the standard health inspection of January 17, 2025, the nearest before the penalty date.
Enforcement Action
Civil money penalty, $99,263 imposed March 10, 2025. CMS publishes the fine, not whether it has been paid. CMS does not tie a penalty to a survey; listed with the standard health inspection of January 17, 2025, the nearest before the penalty date.
Enforcement Action
Civil money penalty, $36,377 imposed July 22, 2025. CMS publishes the fine, not whether it has been paid. CMS does not tie a penalty to a survey; listed with the standard health inspection of January 17, 2025, the nearest before the penalty date.
Source: Health inspection results, as published by CMS (Health Deficiencies and Inspection Dates, Provider Data Catalog)
1 finding
Source: Health inspection results, as published by CMS (Health Deficiencies and Inspection Dates, Provider Data Catalog)
4 findings
Source: Health inspection results, as published by CMS (Health Deficiencies and Inspection Dates, Provider Data Catalog)
4 findings
Source: Health inspection results, as published by CMS (Health Deficiencies and Inspection Dates, Provider Data Catalog)
1 finding
Source: Health inspection results, as published by CMS (Health Deficiencies and Inspection Dates, Provider Data Catalog)
1 finding
Source: Health inspection results, as published by CMS (Health Deficiencies and Inspection Dates, Provider Data Catalog)
3 findings
Source: Health inspection results, as published by CMS (Health Deficiencies and Inspection Dates, Provider Data Catalog)
3 findings
Source: Health inspection results, as published by CMS (Health Deficiencies and Inspection Dates, Provider Data Catalog)
1 finding
Source: Health inspection results, as published by CMS (Health Deficiencies and Inspection Dates, Provider Data Catalog)
5 findings
Source: Health inspection results, as published by CMS (Health Deficiencies and Inspection Dates, Provider Data Catalog)
3 findings
Source: Health inspection results, as published by CMS (Health Deficiencies and Inspection Dates, Provider Data Catalog)
2 findings
Source: Health inspection results, as published by CMS (Health Deficiencies and Inspection Dates, Provider Data Catalog)
12 findings
Source: Health inspection results, as published by CMS (Health Deficiencies and Inspection Dates, Provider Data Catalog)
1 finding
Source: Health inspection results, as published by CMS (Health Deficiencies and Inspection Dates, Provider Data Catalog)
2 findings
Source: Health inspection results, as published by CMS (Health Deficiencies and Inspection Dates, Provider Data Catalog)
1 finding
Source: Health inspection results, as published by CMS (Health Deficiencies and Inspection Dates, Provider Data Catalog)
3 findings
Source: Health inspection results, as published by CMS (Health Deficiencies and Inspection Dates, Provider Data Catalog)
2 findings
Source: Health inspection results, as published by CMS (Health Deficiencies and Inspection Dates, Provider Data Catalog)
1 finding
Source: Health inspection results, as published by CMS (Health Deficiencies and Inspection Dates, Provider Data Catalog)
9 findings
Source: Health inspection results, as published by CMS (Health Deficiencies and Inspection Dates, Provider Data Catalog)
41 findings
The same visit included a complaint investigation.
Source: Health inspection results, as published by CMS (Health Deficiencies and Inspection Dates, Provider Data Catalog)
6 findings
Source: Health inspection results, as published by CMS (Health Deficiencies and Inspection Dates, Provider Data Catalog)
4 findings
Source: Health inspection results, as published by CMS (Health Deficiencies and Inspection Dates, Provider Data Catalog)
5 findings
Source: Health inspection results, as published by CMS (Health Deficiencies and Inspection Dates, Provider Data Catalog)
3 findings
Source: Health inspection results, as published by CMS (Health Deficiencies and Inspection Dates, Provider Data Catalog)
3 findings
Source: Health inspection results, as published by CMS (Health Deficiencies and Inspection Dates, Provider Data Catalog)
2 findings
Source: Health inspection results, as published by CMS (Health Deficiencies and Inspection Dates, Provider Data Catalog)
1 finding
Source: Health inspection results, as published by CMS (Health Deficiencies and Inspection Dates, Provider Data Catalog)
Severity levels follow the CMS scope and severity grid. A–C: potential for minimal harm. D–F: no actual harm, potential for more than minimal harm. G–I: actual harm. J–L: immediate jeopardy.
Context
A repeated citation can merit attention, but context and corrective action must be reviewed before drawing a conclusion.
Inspectors cited F842 in November 2023, January 2024, January 2024, July 2024, September 2024, November 2024, November 2024, November 2024, January 2025, March 2025, July 2025, August 2025, December 2025, January 2026, January 2026, March 2026, April 2026, June 2026, July 2026 and August 2026. This citation covers whether resident records are complete, accurate and kept confidential. None rose above level E (no actual harm, potential for more). Each citation has a recorded correction, and a repeat after correction is worth a direct question.
Inspectors cited F755 in November 2023, January 2024, January 2024, September 2024, October 2024, January 2025, January 2025, January 2025, February 2025, April 2025, May 2025, July 2025, August 2025, September 2025, June 2026 and July 2026. This citation covers pharmacy services and the licensed pharmacist who oversees them. None rose above level E (no actual harm, potential for more). Each citation has a recorded correction, and a repeat after correction is worth a direct question.
Inspectors cited F656 in November 2023, January 2024, April 2024, May 2024, September 2024, November 2024, January 2025, March 2025, April 2025, August 2025, November 2025, January 2026, April 2026, April 2026 and July 2026. This citation covers whether each resident has a written care plan that meets their needs, with goals that can be measured. None rose above level E (no actual harm, potential for more). Each citation has a recorded correction, and a repeat after correction is worth a direct question.
Inspectors cited F880 in November 2023, January 2024, January 2024, March 2024, September 2024, November 2024, November 2024, January 2025, January 2025, August 2025, November 2025, January 2026, April 2026, June 2026 and June 2026. This citation covers hand hygiene, isolation practice and the home’s infection-prevention program. The most serious of these was recorded at level G (actual harm). Each citation has a recorded correction, and a repeat after correction is worth a direct question.
Inspectors cited F689 in October 2023, March 2024, September 2024, November 2024, December 2024, January 2025, July 2025, August 2025, September 2025, November 2025, January 2026 and April 2026. This citation covers whether residents are protected from accident hazards and supervised closely enough to prevent accidents, including falls. The most serious of these was recorded at level G (actual harm). Each citation has a recorded correction, and a repeat after correction is worth a direct question.
Inspectors cited F684 in January 2024, January 2024, March 2024, September 2024, March 2025, March 2025, April 2025, May 2025, June 2025, August 2025 and July 2026. This citation covers whether residents receive the treatment their orders, preferences and goals call for. The most serious of these was recorded at level J (immediate jeopardy). Each citation has a recorded correction, and a repeat after correction is worth a direct question.
Inspectors cited F686 in January 2024, January 2024, March 2024, September 2024, January 2025, January 2025, March 2025, April 2025, May 2025, June 2026 and July 2026. This citation covers how the home prevents and treats pressure injuries (bedsores). None rose above level E (no actual harm, potential for more). Each citation has a recorded correction, and a repeat after correction is worth a direct question.
Inspectors cited F550 in January 2024, May 2024, September 2024, December 2024, September 2025, April 2026, May 2026, June 2026 and June 2026. This citation covers residents’ right to dignity, to make their own choices and to communicate. None rose above level E (no actual harm, potential for more). Each citation has a recorded correction, and a repeat after correction is worth a direct question.
Inspectors cited F584 in October 2023, March 2024, November 2024, December 2024, January 2025, April 2025, November 2025, April 2026 and June 2026. This citation covers whether rooms and shared spaces are kept safe, clean, comfortable and homelike. None rose above level E (no actual harm, potential for more). Each citation has a recorded correction, and a repeat after correction is worth a direct question.
Inspectors cited F580 in October 2023, October 2024, November 2024, November 2024, March 2025, May 2026, June 2026 and July 2026. This citation covers whether the resident, their doctor and a family member are told promptly about an injury, a decline or another significant change. The most serious of these was recorded at level J (immediate jeopardy). Each citation has a recorded correction, and a repeat after correction is worth a direct question.
Inspectors cited F600 in November 2023, January 2024, December 2024, February 2025, February 2025, March 2025 and March 2025. This citation covers whether residents are protected from abuse and neglect by anyone. The most serious of these was recorded at level J (immediate jeopardy). Each citation has a recorded correction, and a repeat after correction is worth a direct question.
Inspectors cited F760 in November 2023, January 2024, August 2024, January 2025, January 2025, March 2025 and April 2026. This citation covers whether residents are free from significant medication errors. None rose above level E (no actual harm, potential for more). Each citation has a recorded correction, and a repeat after correction is worth a direct question.
Inspectors cited F558 in January 2024, September 2024, January 2025, March 2025, June 2025 and July 2025. This citation covers whether the home reasonably accommodates each resident’s needs and preferences. None rose above level E (no actual harm, potential for more). Each citation has a recorded correction, and a repeat after correction is worth a direct question.
Inspectors cited F609 in November 2023, December 2024, December 2024, March 2025, August 2025 and April 2026. This citation covers whether suspected abuse, neglect or theft is reported to the authorities on time, with the results of the home’s investigation. None rose above level D (no actual harm, potential for more). Each citation has a recorded correction, and a repeat after correction is worth a direct question.
Inspectors cited F693 in January 2024, September 2024, October 2024, January 2025 and August 2025. The agency describes it this way: Ensure that feeding tubes are not used unless there is a medical reason and the resident agrees; and provide appropriate care for a resident with a feeding tube. None rose above level D (no actual harm, potential for more). Each citation has a recorded correction, and a repeat after correction is worth a direct question.
Inspectors cited F697 in January 2024, May 2025, July 2025, January 2026 and May 2026. The agency describes it this way: Provide safe, appropriate pain management for a resident who requires such services. None rose above level E (no actual harm, potential for more). Each citation has a recorded correction, and a repeat after correction is worth a direct question.
Inspectors cited F585 in October 2023, September 2024, January 2025 and August 2025. This citation covers residents’ right to voice grievances without reprisal, and the home’s process for resolving them. None rose above level D (no actual harm, potential for more). Each citation has a recorded correction, and a repeat after correction is worth a direct question.
Inspectors cited F657 in January 2024, August 2025, November 2025 and April 2026. This citation covers whether care plans are written on time and revised by a team that includes the resident’s caregivers. None rose above level D (no actual harm, potential for more). Each citation has a recorded correction, and a repeat after correction is worth a direct question.
Inspectors cited F677 in November 2023, October 2024, November 2024 and April 2025. This citation covers help with bathing, dressing, eating and toileting for residents who cannot manage alone. None rose above level D (no actual harm, potential for more). Each citation has a recorded correction, and a repeat after correction is worth a direct question.
Inspectors cited F690 in January 2024, January 2025, January 2025 and April 2026. This citation covers continence care, catheter care and preventing urinary tract infections. None rose above level E (no actual harm, potential for more). Each citation has a recorded correction, and a repeat after correction is worth a direct question.
Inspectors cited F921 in January 2025, September 2025, February 2026 and August 2026. The agency describes it this way: Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public. None rose above level E (no actual harm, potential for more). Each citation has a recorded correction, and a repeat after correction is worth a direct question.
Inspectors cited F604 in January 2024, January 2025 and April 2026. The agency describes it this way: Ensure that each resident is free from the use of physical restraints, unless needed for medical treatment. None rose above level E (no actual harm, potential for more). Each citation has a recorded correction, and a repeat after correction is worth a direct question.
Inspectors cited F658 in January 2024, January 2025 and April 2026. This citation covers whether the home’s services meet professional standards of quality. None rose above level E (no actual harm, potential for more). Each citation has a recorded correction, and a repeat after correction is worth a direct question.
Inspectors cited F679 in September 2024, October 2024 and August 2025. The agency describes it this way: Provide activities to meet all resident's needs. None rose above level D (no actual harm, potential for more). Each citation has a recorded correction, and a repeat after correction is worth a direct question.
Inspectors cited F694 in January 2024, November 2024 and January 2025. The agency describes it this way: Provide for the safe, appropriate administration of IV fluids for a resident when needed. None rose above level E (no actual harm, potential for more). Each citation has a recorded correction, and a repeat after correction is worth a direct question.
Inspectors cited F757 in January 2024, September 2024 and June 2026. The agency describes it this way: Ensure each resident’s drug regimen must be free from unnecessary drugs. None rose above level E (no actual harm, potential for more). Each citation has a recorded correction, and a repeat after correction is worth a direct question.
Inspectors cited F758 in January 2024, May 2024 and January 2025. This citation covers how psychotropic drugs are used, including dose reductions and limits on as-needed orders. None rose above level E (no actual harm, potential for more). Each citation has a recorded correction, and a repeat after correction is worth a direct question.
Inspectors cited F803 in November 2023, January 2025 and April 2026. The agency describes it this way: Ensure menus must meet the nutritional needs of residents, be prepared in advance, be followed, be updated, be reviewed by dietician, and meet the needs of the resident. None rose above level E (no actual harm, potential for more). Each citation has a recorded correction, and a repeat after correction is worth a direct question.
Inspectors cited F812 in January 2024, January 2025 and April 2026. This citation covers how food is stored, prepared and served. None rose above level E (no actual harm, potential for more). Each citation has a recorded correction, and a repeat after correction is worth a direct question.
Inspectors cited F908 in January 2024, March 2024 and April 2026. The agency describes it this way: Keep all essential equipment working safely. None rose above level E (no actual harm, potential for more). Each citation has a recorded correction, and a repeat after correction is worth a direct question.
Inspectors cited F552 in January 2024 and August 2024. The agency describes it this way: Ensure that residents are fully informed and understand their health status, care and treatments. None rose above level E (no actual harm, potential for more). Each citation has a recorded correction, and a repeat after correction is worth a direct question.
Inspectors cited F578 in January 2024 and April 2026. This citation covers residents’ right to accept or refuse treatment and to make an advance directive. None rose above level E (no actual harm, potential for more). Each citation has a recorded correction, and a repeat after correction is worth a direct question.
Inspectors cited F605 in January 2026 and April 2026. The agency describes it this way: Prevent the use of unnecessary psychotropic medications or use medications that may restrain a resident's ability to function. None rose above level E (no actual harm, potential for more). Each citation has a recorded correction, and a repeat after correction is worth a direct question.
Inspectors cited F641 in January 2024 and July 2026. This citation covers whether each resident’s assessment correctly records their condition. None rose above level D (no actual harm, potential for more). Each citation has a recorded correction, and a repeat after correction is worth a direct question.
Inspectors cited F676 in January 2025 and February 2025. The agency describes it this way: Ensure residents do not lose the ability to perform activities of daily living unless there is a medical reason. None rose above level D (no actual harm, potential for more). Each citation has a recorded correction, and a repeat after correction is worth a direct question.
Inspectors cited F685 in January 2024 and April 2026. The agency describes it this way: Assist a resident in gaining access to vision and hearing services. None rose above level D (no actual harm, potential for more). Each citation has a recorded correction, and a repeat after correction is worth a direct question.
Inspectors cited F688 in March 2024 and April 2026. This citation covers care that keeps or improves a resident’s movement and mobility. None rose above level D (no actual harm, potential for more). Each citation has a recorded correction, and a repeat after correction is worth a direct question.
Inspectors cited F692 in November 2023 and April 2026. This citation covers whether residents get enough food and fluids to stay healthy. None rose above level D (no actual harm, potential for more). Each citation has a recorded correction, and a repeat after correction is worth a direct question.
Inspectors cited F700 in January 2025 and April 2026. The agency describes it this way: Try different approaches before using a bed rail. If a bed rail is needed, the facility must (1) assess a resident for safety risk; (2) review these risks and benefits with the resident/representative; (3) get informed consent; and (4) Correctly install and maintain the bed rail. None rose above level E (no actual harm, potential for more). Each citation has a recorded correction, and a repeat after correction is worth a direct question.
Inspectors cited F732 in November 2023 and January 2025. The agency describes it this way: Post nurse staffing information every day. None rose above level E (no actual harm, potential for more). Each citation has a recorded correction, and a repeat after correction is worth a direct question.
Inspectors cited F761 in January 2024 and January 2025. This citation covers how drugs are labeled and kept locked, including controlled drugs. None rose above level E (no actual harm, potential for more). Each citation has a recorded correction, and a repeat after correction is worth a direct question.
Inspectors cited F804 in November 2023 and January 2025. This citation covers whether food and drink are palatable, attractive and served at a safe temperature. None rose above level E (no actual harm, potential for more). Each citation has a recorded correction, and a repeat after correction is worth a direct question.
Inspectors cited F849 in January 2024 and June 2026. The agency describes it this way: Arrange for the provision of hospice services or assist the resident in transferring to a facility that will arrange for the provision of hospice services. None rose above level E (no actual harm, potential for more). Each citation has a recorded correction, and a repeat after correction is worth a direct question.
Inspectors cited F881 in April 2026 and June 2026. This citation covers the home’s program for monitoring antibiotic use. None rose above level E (no actual harm, potential for more). Each citation has a recorded correction, and a repeat after correction is worth a direct question.
F695 was cited in January 2025, July 2025, January 2026, April 2026 and August 2026. This citation covers oxygen, breathing treatments and other respiratory care. The most serious was level E (no actual harm, potential for more). The August 2026 citation has no recorded correction date; its status reads “Deficient, Provider has no plan of correction.” The record does not show whether the problem was fixed.
For Your Next Visit
Bring these to the tour. Each one comes from something in the record; the reason is under the question.
How can a family request a resident’s records, and how are they kept accurate?
Medical Records: cited in 20 inspections, most seriously at level E.
How often does the consultant pharmacist review each resident’s medications?
Pharmacy Services: cited in 16 inspections, most seriously at level E.
How is a care plan written and reviewed here, and how do families take part in it?
Care Plans: cited in 15 inspections, most seriously at level E.
Who leads infection control here, and how often are hand-hygiene and isolation practices audited?
Infection Control: cited in 15 inspections, most seriously at level G.
What changed in fall prevention and supervision after the last citation, and how do you check that it is still working?
Accident Hazards and Supervision: cited in 12 inspections, most seriously at level G.
How do nurses make sure a doctor’s orders are carried out, and how are families told when something is missed?
Quality of Care: cited in 11 inspections, most seriously at level J.
How often are residents checked for pressure injuries and repositioned, and who is responsible for it?
Pressure Injury Care: cited in 11 inspections, most seriously at level E.
How do staff learn each resident’s preferences, and how is a complaint about dignity handled?
Dignity and Resident Rights: cited in nine inspections, most seriously at level E.
What was done about the cleanliness citation, and how are rooms and shared spaces checked now?
A Clean, Homelike Setting: cited in nine inspections, most seriously at level E.
How quickly will we hear about a fall, an injury or a change in condition, and from whom?
Telling Families About Changes: cited in eight inspections, most seriously at level J.
What happened after the abuse or neglect citation, and what changed in training or supervision?
Protection From Abuse and Neglect: cited in seven inspections, most seriously at level J.
What happened after the medication error citation, and how are high-risk drugs double-checked?
Significant Medication Errors: cited in seven inspections, most seriously at level E.
How do you adjust rooms, schedules and routines to a resident’s needs and preferences?
Needs and Preferences: cited in six inspections, most seriously at level E.
How are staff trained to report suspected abuse or neglect, and who reports it to the state?
Reporting Suspected Abuse: cited in six inspections, most seriously at level D.
What changed after F693 was cited, and how do you check it now?
Citation F693: cited in five inspections, most seriously at level D.
What changed after F697 was cited, and how do you check it now?
Citation F697: cited in five inspections, most seriously at level E.
How do we file a grievance, who answers it, and how quickly?
Grievances: cited in four inspections, most seriously at level D.
How often are care plans revised, and who takes part in the review?
Care Plan Timing and Review: cited in four inspections, most seriously at level D.
How long do residents usually wait for help with bathing, dressing or the bathroom, and how is that tracked?
Help With Daily Living: cited in four inspections, most seriously at level D.
How is continence care scheduled, and how do you prevent urinary infections?
Continence and Catheter Care: cited in four inspections, most seriously at level E.
What changed after F921 was cited, and how do you check it now?
Citation F921: cited in four inspections, most seriously at level E.
What changed after F604 was cited, and how do you check it now?
Citation F604: cited in three inspections, most seriously at level E.
How do you check that nurses and aides follow professional standards, and what happens when they do not?
Professional Standards: cited in three inspections, most seriously at level E.
What changed after F679 was cited, and how do you check it now?
Provide activities to meet all resident's needs: cited in three inspections, most seriously at level D.
What changed after F694 was cited, and how do you check it now?
Citation F694: cited in three inspections, most seriously at level E.
What changed after F757 was cited, and how do you check it now?
Citation F757: cited in three inspections, most seriously at level E.
How many residents take psychotropic medications, and how often are doses reviewed for reduction?
Psychotropic Medications: cited in three inspections, most seriously at level E.
What changed after F803 was cited, and how do you check it now?
Citation F803: cited in three inspections, most seriously at level E.
May we see the kitchen, and what do your own sanitation checks look like week to week?
Kitchen and Food Safety: cited in three inspections, most seriously at level E.
What changed after F908 was cited, and how do you check it now?
Keep all essential equipment working safely: cited in three inspections, most seriously at level E.
What changed after F552 was cited, and how do you check it now?
Citation F552: cited in two inspections, most seriously at level E.
How are a resident’s advance directive and treatment wishes recorded and shared with every shift?
Treatment Choices and Advance Directives: cited in two inspections, most seriously at level E.
What changed after F605 was cited, and how do you check it now?
Citation F605: cited in two inspections, most seriously at level E.
Who completes resident assessments, and how are they checked for accuracy?
Accurate Assessments: cited in two inspections, most seriously at level D.
What changed after F676 was cited, and how do you check it now?
Citation F676: cited in two inspections, most seriously at level D.
What changed after F685 was cited, and how do you check it now?
Citation F685: cited in two inspections, most seriously at level D.
What do you do to keep residents moving, and who provides range-of-motion care?
Mobility and Range of Motion: cited in two inspections, most seriously at level D.
How are weight and fluid intake tracked, and what happens when a resident starts losing weight?
Nutrition and Hydration: cited in two inspections, most seriously at level D.
What changed after F700 was cited, and how do you check it now?
Citation F700: cited in two inspections, most seriously at level E.
What changed after F732 was cited, and how do you check it now?
Post nurse staffing information every day: cited in two inspections, most seriously at level E.
How are medications stored and secured, and who checks the medication carts?
Medication Labeling and Storage: cited in two inspections, most seriously at level E.
May we try a meal, and how do you check food temperature by the time it reaches residents?
Food Quality and Temperature: cited in two inspections, most seriously at level E.
What changed after F849 was cited, and how do you check it now?
Citation F849: cited in two inspections, most seriously at level E.
How do you track antibiotic use and decide when one is needed?
Antibiotic Use: cited in two inspections, most seriously at level E.
Who manages oxygen and breathing treatments on each shift, and how is the equipment checked?
Respiratory Care: cited in five inspections, most seriously at level E. The August 21, 2026 citation has no recorded correction date.
How many nurses and aides are on each shift, including nights and weekends, for the unit we are considering?
No staffing citation appears in this window. Staffing levels are published separately by CMS and are worth asking about directly.
What led to the 2025 fine, and has it been paid?
A $36,377 civil money penalty was imposed July 22, 2025. CMS publishes the fine, not whether it has been paid. The record holds three enforcement actions in the window.
The Evidence
Inspection results and penalties are published by the Centers for Medicare & Medicaid Services from surveys conducted by the California state survey agency.
California state survey agency
Inspection Oct 5, 2023 · Published Oct 1, 2026 · Retrieved Nov 1, 2026
California state survey agency
Inspection Oct 17, 2023 · Published Oct 1, 2026 · Retrieved Nov 1, 2026
California state survey agency
Inspection Oct 29, 2023 · Published Oct 1, 2026 · Retrieved Nov 1, 2026
California state survey agency
Inspection Nov 1, 2023 · Published Oct 1, 2026 · Retrieved Nov 1, 2026
California state survey agency
Inspection Nov 7, 2023 · Published Oct 1, 2026 · Retrieved Nov 1, 2026
California state survey agency
Inspection Nov 29, 2023 · Published Oct 1, 2026 · Retrieved Nov 1, 2026
California state survey agency
Inspection Jan 11, 2024 · Published Oct 1, 2026 · Retrieved Nov 1, 2026
California state survey agency
Inspection Jan 26, 2024 · Published Oct 1, 2026 · Retrieved Nov 1, 2026
California state survey agency
Inspection Mar 18, 2024 · Published Oct 1, 2026 · Retrieved Nov 1, 2026
California state survey agency
Inspection Apr 16, 2024 · Published Oct 1, 2026 · Retrieved Nov 1, 2026
California state survey agency
Inspection May 1, 2024 · Published Oct 1, 2026 · Retrieved Nov 1, 2026
California state survey agency
Inspection May 6, 2024 · Published Oct 1, 2026 · Retrieved Nov 1, 2026
California state survey agency
Inspection Jul 11, 2024 · Published Oct 1, 2026 · Retrieved Nov 1, 2026
California state survey agency
Inspection Aug 8, 2024 · Published Oct 1, 2026 · Retrieved Nov 1, 2026
California state survey agency
Inspection Sep 3, 2024 · Published Oct 1, 2026 · Retrieved Nov 1, 2026
California state survey agency
Inspection Sep 28, 2024 · Published Oct 1, 2026 · Retrieved Nov 1, 2026
California state survey agency
Inspection Oct 3, 2024 · Published Oct 1, 2026 · Retrieved Nov 1, 2026
California state survey agency
Inspection Oct 8, 2024 · Published Oct 1, 2026 · Retrieved Nov 1, 2026
California state survey agency
Inspection Nov 13, 2024 · Published Oct 1, 2026 · Retrieved Nov 1, 2026
California state survey agency
Inspection Nov 14, 2024 · Published Oct 1, 2026 · Retrieved Nov 1, 2026
California state survey agency
Inspection Nov 15, 2024 · Published Oct 1, 2026 · Retrieved Nov 1, 2026
California state survey agency
Inspection Nov 25, 2024 · Published Oct 1, 2026 · Retrieved Nov 1, 2026
California state survey agency
Inspection Dec 6, 2024 · Published Oct 1, 2026 · Retrieved Nov 1, 2026
California state survey agency
Inspection Dec 12, 2024 · Published Oct 1, 2026 · Retrieved Nov 1, 2026
California state survey agency
Inspection Dec 19, 2024 · Published Oct 1, 2026 · Retrieved Nov 1, 2026
California state survey agency
Inspection Jan 6, 2025 · Published Oct 1, 2026 · Retrieved Nov 1, 2026
California state survey agency
Inspection Jan 7, 2025 · Published Oct 1, 2026 · Retrieved Nov 1, 2026
California state survey agency
Inspection Jan 17, 2025 · Published Oct 1, 2026 · Retrieved Nov 1, 2026
California state survey agency
Inspection Jan 22, 2025 · Published Oct 1, 2026 · Retrieved Nov 1, 2026
California state survey agency
Inspection Jan 28, 2025 · Published Oct 1, 2026 · Retrieved Nov 1, 2026
California state survey agency
Inspection Feb 4, 2025 · Published Oct 1, 2026 · Retrieved Nov 1, 2026
California state survey agency
Inspection Feb 7, 2025 · Published Oct 1, 2026 · Retrieved Nov 1, 2026
California state survey agency
Inspection Feb 25, 2025 · Published Oct 1, 2026 · Retrieved Nov 1, 2026
California state survey agency
Inspection Mar 10, 2025 · Published Oct 1, 2026 · Retrieved Nov 1, 2026
California state survey agency
Inspection Mar 11, 2025 · Published Oct 1, 2026 · Retrieved Nov 1, 2026
California state survey agency
Inspection Mar 12, 2025 · Published Oct 1, 2026 · Retrieved Nov 1, 2026
California state survey agency
Inspection Mar 28, 2025 · Published Oct 1, 2026 · Retrieved Nov 1, 2026
California state survey agency
Inspection Apr 3, 2025 · Published Oct 1, 2026 · Retrieved Nov 1, 2026
California state survey agency
Inspection May 16, 2025 · Published Oct 1, 2026 · Retrieved Nov 1, 2026
California state survey agency
Inspection Jun 5, 2025 · Published Oct 1, 2026 · Retrieved Nov 1, 2026
California state survey agency
Inspection Jul 9, 2025 · Published Oct 1, 2026 · Retrieved Nov 1, 2026
California state survey agency
Inspection Jul 15, 2025 · Published Oct 1, 2026 · Retrieved Nov 1, 2026
California state survey agency
Inspection Jul 22, 2025 · Published Oct 1, 2026 · Retrieved Nov 1, 2026
California state survey agency
Inspection Aug 7, 2025 · Published Oct 1, 2026 · Retrieved Nov 1, 2026
California state survey agency
Inspection Aug 21, 2025 · Published Oct 1, 2026 · Retrieved Nov 1, 2026
California state survey agency
Inspection Sep 5, 2025 · Published Oct 1, 2026 · Retrieved Nov 1, 2026
California state survey agency
Inspection Nov 24, 2025 · Published Oct 1, 2026 · Retrieved Nov 1, 2026
California state survey agency
Inspection Nov 25, 2025 · Published Oct 1, 2026 · Retrieved Nov 1, 2026
California state survey agency
Inspection Dec 17, 2025 · Published Oct 1, 2026 · Retrieved Nov 1, 2026
California state survey agency
Inspection Jan 20, 2026 · Published Oct 1, 2026 · Retrieved Nov 1, 2026
California state survey agency
Inspection Jan 30, 2026 · Published Oct 1, 2026 · Retrieved Nov 1, 2026
California state survey agency
Inspection Feb 2, 2026 · Published Oct 1, 2026 · Retrieved Nov 1, 2026
California state survey agency
Inspection Mar 6, 2026 · Published Oct 1, 2026 · Retrieved Nov 1, 2026
California state survey agency
Inspection Apr 24, 2026 · Published Oct 1, 2026 · Retrieved Nov 1, 2026
California state survey agency
Inspection Apr 28, 2026 · Published Oct 1, 2026 · Retrieved Nov 1, 2026
California state survey agency
Inspection May 22, 2026 · Published Oct 1, 2026 · Retrieved Nov 1, 2026
California state survey agency
Inspection May 29, 2026 · Published Oct 1, 2026 · Retrieved Nov 1, 2026
California state survey agency
Inspection Jun 2, 2026 · Published Oct 1, 2026 · Retrieved Nov 1, 2026
California state survey agency
Inspection Jun 9, 2026 · Published Oct 1, 2026 · Retrieved Nov 1, 2026
California state survey agency
Inspection Jun 13, 2026 · Published Oct 1, 2026 · Retrieved Nov 1, 2026
California state survey agency
Inspection Jun 17, 2026 · Published Oct 1, 2026 · Retrieved Nov 1, 2026
California state survey agency
Inspection Jul 1, 2026 · Published Oct 1, 2026 · Retrieved Nov 1, 2026
California state survey agency
Inspection Aug 10, 2026 · Published Oct 1, 2026 · Retrieved Nov 1, 2026
California state survey agency
Inspection Aug 21, 2026 · Published Oct 1, 2026 · Retrieved Nov 1, 2026
California state survey agency
Inspection Aug 25, 2026 · Published Oct 1, 2026 · Retrieved Nov 1, 2026
Centers for Medicare & Medicaid Services
Published Oct 1, 2026 · Retrieved Nov 1, 2026
Centers for Medicare & Medicaid Services · 056039
Published Oct 1, 2026 · Retrieved Nov 1, 2026
Record windowOctober 5, 2023 – October 1, 2026
Historical coverage varies by agency and location. Missing records do not mean that no complaint or violation occurred.
Data architecture: Cierto supplies the source-backed machine-readable bundle. Life by Vardell independently creates the narrative, design, and consumer report.