Oak Grove Post Acute
A nursing home in Stockton, California 95207
4545 Shelley Court, Stockton, California 95207. (209) 477-0271.
- Cited for abuse (CMS flag)
Watch and the shortlist are kept with a free account, on every device. Your watch list. CMS’s own record is on Care Compare.
The short answer
Record last released by CMS on Oct 28, 2026.
- 1of 5 CMS’s overall rating
- 46 health citations at the latest inspection cycle California average: 15.7
- 4.04 nurse hours per resident per day California average: 4.54
- 4 fines in the last three years (needs attention)
Each figure’s source sits beside it, in its section below.
What these words mean7
- Star ratings
- CMS rates some kinds of place from 1 to 5 stars, more stars meaning better on CMS’s own measures for that kind: for a nursing home, its health inspections, staffing and quality measures. A rating is CMS’s summary of those measures; it doesn’t promise good care. Source: CMS, Care Compare and the Five-Star Quality Rating System.
- Inspection (survey)
- A visit by state inspectors, often unannounced, who check a place against the rules it must meet. For nursing homes and other places Medicare pays, CMS calls these visits surveys: a standard survey of a nursing home comes at least every 15 months, and a complaint survey whenever a complaint calls for one. Source: CMS; 42 CFR 488.308.
- Deficiency, citation, violation
- What inspectors write up when a place didn’t meet a rule: the rule, what they saw, and when. CMS calls it a deficiency; states may say citation or violation. It is the inspectors’ finding, not a court’s, and the place is usually asked for a plan to correct it. Source: CMS, statement of deficiencies (Form CMS-2567); each state’s licensing agency.
- Scope and severity (A to L)
- CMS grades each nursing home deficiency with a letter. A to C: no actual harm, with potential for minimal harm. D to F: no actual harm, but potential for more. G to I: actual harm. J to L: immediate jeopardy. Within each band, the letter rises as more residents were affected or could be: one or a few, a pattern, or widespread. Source: CMS, nursing home scope and severity grid (State Operations Manual, chapter 7).
- Nurse staffing hours
- The hours registered nurses, licensed practical nurses and nurse aides worked, per resident per day, from the payroll records each home sends CMS. Source: CMS, Payroll-Based Journal.
- Fines and payment denials
- A fine (civil money penalty) is money CMS makes a nursing home pay when it falls short of federal rules. A payment denial means Medicare and Medicaid stop paying for new admissions until the home meets the rules again. Source: CMS; 42 CFR 488.430 and 488.417.
- Capacity
- The most people the licence or certification lets the place care for at once: residents, children, beds or apartments, as the state counts them. It isn’t how many are there now. Source: Each state’s licensing agency.
What did inspectors find?
46 health citations at the latest inspection cycle
The California average is 15.7.
Last standard inspection Apr 9, 2026.
Most serious in three years: actual harm (G), at a complaint inspection on Aug 1, 2025
CMS, Provider Information, State and US Averages and Health Deficiencies. Released Oct 28, 2026. Updated monthly.
When those citations happened
103 citations in 24 months of the last 36. Last cited Aug 2026. Most serious: actual harm (G). The last 3 years, to Nov 5, 2026.
| Jan | Feb | Mar | Apr | May | Jun | Jul | Aug | Sep | Oct | Nov | Dec | |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 2023 | Dec | |||||||||||
| 2024 | Jan | Feb | Mar | Apr | May | Jun | Jul | Aug | Sep | Oct | Nov | Dec |
| 2025 | Jan | Feb | Mar | Apr | May | Jun | Jul | Aug | Sep | Oct | Nov | Dec |
| 2026 | Jan | Feb | Mar | Apr | May | Jun | Jul | Aug | Sep | Oct | Nov |
Hover or focus a month to read it.
Hearth Record drew this from the dates and levels in the source’s own records.
All 107 citations in the last three years
Grouped by inspection, newest first. Each carries CMS grades each nursing home deficiency with a letter. A to C: no actual harm, with potential for minimal harm. D to F: no actual harm, but potential for more. G to I: actual harm. J to L: immediate jeopardy. Within each band, the letter rises as more residents were affected or could be: one or a few, a pattern, or widespread. Source: CMS, nursing home scope and severity grid (State Operations Manual, chapter 7)., from A, the least serious, to L, the most. 63 came from complaint inspections.
CMS, Health Deficiencies. Released Oct 28, 2026. Updated monthly.
Aug 21, 2026: complaint inspection1 citation
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Provide appropriate pressure ulcer care and prevent new ulcers from developing.
Aug 13, 2026: complaint inspection3 citations
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Provide safe, appropriate dialysis care/services for a resident who requires such services.
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Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
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Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public.
Jul 9, 2026: complaint inspection1 citation
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Follow rules about disclosure of ownership requirements and tell the state agency about changes in ownership and/or administrative personnel.
Apr 22, 2026: complaint inspection1 citation
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Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Apr 9, 2026: standard inspection19 citations
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Ensure that residents are fully informed and understand their health status, care and treatments.
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Reasonably accommodate the needs and preferences of each resident.
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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.
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Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
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Assess the resident when there is a significant change in condition
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Develop and implement a complete care plan that meets all the resident’s needs, with timetables and actions that can be measured.
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Ensure services provided by the nursing facility meet professional standards of quality.
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Provide care and assistance to perform activities of daily living for any resident who is unable.
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Provide activities to meet all resident’s needs.
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Provide safe and appropriate respiratory care for a resident when needed.
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Provide safe, appropriate dialysis care/services for a resident who requires such services.
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Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
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Ensure that residents are free from significant medication errors.
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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.
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Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
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Dispose of garbage and refuse properly.
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Provide and implement an infection prevention and control program.
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Develop and implement policies and procedures for flu and pneumonia vaccinations.
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Educate residents and staff on COVID-19 vaccination, offer the COVID-19 vaccine to eligible residents and staff after education, and properly document each resident and staff member’s vaccination status.
Apr 9, 2026: standard and complaint inspection1 citation
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Honor the resident’s right to and the facility must promote and facilitate resident self-determination through support of resident choice.
Mar 11, 2026: complaint inspection2 citations
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Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
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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.
Mar 4, 2026: complaint inspection1 citation
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Provide and implement an infection prevention and control program.
Feb 20, 2026: complaint inspection1 citation
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Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Feb 11, 2026: complaint inspection3 citations
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Provide care and assistance to perform activities of daily living for any resident who is unable.
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Provide appropriate foot care.
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Make sure there is a pest control program to prevent/deal with mice, insects, or other pests.
Jan 16, 2026: complaint inspection2 citations
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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.
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Dispose of garbage and refuse properly.
Dec 12, 2025: complaint inspection2 citations
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Develop and implement a complete care plan that meets all the resident’s needs, with timetables and actions that can be measured.
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Provide appropriate pressure ulcer care and prevent new ulcers from developing.
Dec 8, 2025: complaint inspection1 citation
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Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
Dec 3, 2025: complaint inspection2 citations
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Develop and implement a complete care plan that meets all the resident’s needs, with timetables and actions that can be measured.
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Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
Dec 2, 2025: complaint inspection1 citation
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Provide safe, appropriate pain management for a resident who requires such services.
Nov 26, 2025: complaint inspection3 citations
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Protect each resident from separation (from other residents, his/her room, or confinement to his/her room).
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Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
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Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Nov 20, 2025: complaint inspection2 citations
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Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
-
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
Aug 21, 2025: complaint inspection2 citations
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Provide appropriate pressure ulcer care and prevent new ulcers from developing.
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Provide the appropriate treatment and services to a resident who displays or is diagnosed with mental disorder or psychosocial adjustment difficulty, or who has a history of trauma and/or post-traumatic stress disorder.
Aug 15, 2025: complaint inspection2 citations
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Keep residents’ personal and medical records private and confidential.
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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.
Aug 1, 2025: complaint inspection1 citation
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Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
Jul 22, 2025: complaint inspection1 citation
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Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Jul 16, 2025: complaint inspection1 citation
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Provide enough food/fluids to maintain a resident’s health.
Jun 24, 2025: complaint inspection1 citation
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Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
May 22, 2025: complaint inspection1 citation
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Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
May 19, 2025: complaint inspection1 citation
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Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
Apr 14, 2025: complaint inspection1 citation
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Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Mar 13, 2025: complaint inspection2 citations
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Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
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Respond appropriately to all alleged violations.
Feb 13, 2025: complaint inspection1 citation
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Protect each resident from separation (from other residents, his/her room, or confinement to his/her room).
Jan 6, 2025: complaint inspection2 citations
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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.
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Develop and implement a complete care plan that meets all the resident’s needs, with timetables and actions that can be measured.
Dec 12, 2024: standard inspection25 citations
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Honor the resident’s right to a dignified existence, self-determination, communication, and to exercise his or her rights.
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Keep residents’ personal and medical records private and confidential.
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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.
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Honor the resident’s right to voice grievances without discrimination or reprisal and the facility must establish a grievance policy and make prompt efforts to resolve grievances.
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Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
-
Provide care and assistance to perform activities of daily living for any resident who is unable.
-
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
-
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
-
Provide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM and/or mobility, unless a decline is for a medical reason.
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Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
-
Provide enough food/fluids to maintain a resident’s health.
-
Provide safe and appropriate respiratory care for a resident when needed.
-
Provide safe, appropriate pain management for a resident who requires such services.
-
Provide the appropriate treatment and services to a resident who displays or is diagnosed with mental disorder or psychosocial adjustment difficulty, or who has a history of trauma and/or post-traumatic stress disorder.
-
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
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Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited.
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Ensure medication error rates are not 5 percent or greater.
-
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.
-
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
-
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.
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Provide and implement an infection prevention and control program.
-
Develop and implement policies and procedures for flu and pneumonia vaccinations.
-
Educate residents and staff on COVID-19 vaccination, offer the COVID-19 vaccine to eligible residents and staff after education, and properly document each resident and staff member’s vaccination status.
-
Make sure that a working call system is available in each resident’s bathroom and bathing area.
-
Make sure there is a pest control program to prevent/deal with mice, insects, or other pests.
Dec 12, 2024: standard and complaint inspection1 citation
-
Develop and implement a complete care plan that meets all the resident’s needs, with timetables and actions that can be measured.
Dec 12, 2024: complaint inspection1 citation
-
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
Dec 2, 2024: complaint inspection1 citation
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Provide and implement an infection prevention and control program.
Nov 22, 2024: complaint inspection1 citation
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Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Oct 23, 2024: complaint inspection2 citations
-
Develop and implement a complete care plan that meets all the resident’s needs, with timetables and actions that can be measured.
-
Provide and implement an infection prevention and control program.
Aug 14, 2024: complaint inspection1 citation
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Honor the resident’s right to share a room with spouse or roommate of choice and receive written notice before a change is made.
Jul 21, 2024: complaint inspection2 citations
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Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
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Provide or get specialized rehabilitative services as required for a resident.
Jul 2, 2024: complaint inspection1 citation
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Provide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM and/or mobility, unless a decline is for a medical reason.
Jun 10, 2024: complaint inspection1 citation
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Provide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM and/or mobility, unless a decline is for a medical reason.
Jan 29, 2024: complaint inspection1 citation
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Honor the resident’s right to a dignified existence, self-determination, communication, and to exercise his or her rights.
Dec 28, 2023: complaint inspection1 citation
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Honor the resident’s right to a dignified existence, self-determination, communication, and to exercise his or her rights.
Dec 19, 2023: complaint inspection3 citations
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Provide and implement an infection prevention and control program.
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Designate a qualified infection preventionist to be responsible for the infection prevent and control program in the nursing home.
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Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public.
Nov 18, 2023: complaint inspection1 citation
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Keep all essential equipment working safely.
Nov 16, 2023: complaint inspection1 citation
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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.
Nov 15, 2023: complaint inspection2 citations
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Let each resident or the resident’s legal representative access or purchase copies of all the resident’s records.
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Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Is it certified, and in good standing?
- Certified for Medicare and Medicaid since Jan 1, 1967.
- Not on CMS’s special focus list.
- CMS marks it with its abuse icon: cited for abuse or neglect that harmed a resident.
- No change of ownership in the last 12 months.
- CMS lists its ownership as for profit, limited liability company.
- 119 certified beds.
CMS, Provider Information. Released Oct 28, 2026. Updated monthly.
Has it been fined or penalized?
- 4 fines in the last three years, $40,283 in all.
- No Medicare payment denials in the last three years.
- 63 citations in the last three years came from complaint inspections.
CMS, Penalties and Health Deficiencies. Released Oct 28, 2026. Updated monthly.
| Date | Kind | Amount |
|---|---|---|
| Feb 20, 2024 | Fine | $4,938 |
| Feb 12, 2024 | Fine | $7,527 |
| Jan 22, 2024 | Fine | $19,107 |
| Dec 26, 2023 | Fine | $8,711 |
Who does the caring?
4.04 nurse hours per resident per day
The California average is 4.54.
CMS publishes staffing about four months after the fact.
CMS, Provider Information and State and US Averages. Released Oct 28, 2026. Updated monthly.
| Measure | This home | California average |
|---|---|---|
| Nurse hours per resident per day | 4.04 | 4.54 |
| Of which registered nurses | 0.47 | 0.68 |
| At weekends | 3.70 | 4.10 |
| Nursing staff turnover | 47.4% | 36.6% |
| Registered nurse turnover | 54.5% | 37.8% |
| Administrators who left | 0 | Not given |
Who owns it?
- Sapphire Operations, LLC owns 100% directly since Sep 1, 2024.
- 8 owners or officers are people: Avrohom L Tress (owns 5% or more through other companies, 50%); Aaron H Robin (owns 5% or more through other companies, 50%); Atul Verma (runs it (operational or managerial control)); Atul Verma (additional disclosable party (controls, leases property to, or provides services to the home)); Martha Glavan-Martinez (runs it (operational or managerial control)); Martha Glavan-Martinez (additional disclosable party (controls, leases property to, or provides services to the home)); Rafileiry Jimenez (runs it (operational or managerial control)); Rafileiry Jimenez (additional disclosable party (controls, leases property to, or provides services to the home)).
- Part of Windsor (22 homes in CMS’s data).
- A private-equity firm is among the owners CMS lists.
- No real-estate investment trust among the owners CMS lists.
CMS, All Owners. Checked Nov 5, 2026. Updated monthly.
CMS, Provider Information. Released Oct 28, 2026. Updated monthly.
| Organisation | Role | Share | Since |
|---|---|---|---|
| Sapphire Operations, LLC | Owns 5% or more directly | 100% | Sep 1, 2024 |
| Newgen LLC | Owns 5% or more through other companies | 100% | Sep 1, 2024 |
| 9560 Pico LLC | Owns 5% or more through other companies | 50% | Sep 1, 2024 |
| Pico AR LLC | Owns 5% or more through other companies | 50% | Sep 1, 2024 |
| Newgen Administrative Services, LLC | Additional disclosable party (controls, leases property to, or provides services to the home) | Sep 1, 2024 |
How do residents fare?
- CMS rates its quality measures 2 of 5 (California average 4.2).
CMS, Provider Information and State and US Averages. Released Oct 28, 2026. Updated monthly.
| Measure | Rating |
|---|---|
| Overall rating | 1 of 5 |
| Health inspections | 1 of 5 |
| Staffing | 4 of 5 |
| Quality measures | 2 of 5 |
How does it compare nearby?
- Among the 12 nearest homes, within 3.2 miles, this one had the 2nd most health citations at the latest inspection cycle (46; the middle value was 20.5).
CMS, Provider Information. Released Oct 28, 2026. Updated monthly.
| Place | Miles away | Citations, latest cycle |
|---|---|---|
| Oak Grove Post Acute This nursing home | 46 | |
| Fulton Gardens Post Acute, LLC | 0.8 | 14 |
| Riverwood Health Care | 1.0 | 20 |
| Crestwood Manor - 104 | 1.1 | 14 |
| Brookside Care Center | 1.2 | 60 |
| Noble Care Center | 1.2 | 21 |
| Hampton Post Acute | 1.4 | 35 |
| Delta Oaks Post Acute | 1.7 | 37 |
| Good Samaritan Rehab and Care Center | 1.9 | 16 |
| Lincoln Square Post Acute Care | 2.2 | 17 |
| Clearwater Healthcare Center | 2.2 | 26 |
| Creekside Center | 3.2 | 16 |
What the record doesn’t say
- Complaints that didn’t lead to a citation aren’t published.
- Inspections reach CMS’s data about six weeks after they happen, and staffing about four months after.
- CMS publishes the inspectors’ full written findings in a separate monthly file, which isn’t loaded yet.
- Fines and Medicare payment denials are the only enforcement CMS publishes; state licence actions aren’t included.
Sources
-
Centers for Medicare & Medicaid Services, Provider Information (4pq5-n9py).
Released Oct 28, 2026 and checked Nov 5, 2026. Updated monthly. Public domain (U.S. Government work).
-
Centers for Medicare & Medicaid Services, Health Deficiencies (r5ix-sfxw).
Released Oct 28, 2026 and checked Nov 5, 2026. Updated monthly. Public domain (U.S. Government work).
-
Centers for Medicare & Medicaid Services, Penalties (g6vv-u9sr).
Released Oct 28, 2026 and checked Nov 5, 2026. Updated monthly. Public domain (U.S. Government work).
-
Centers for Medicare & Medicaid Services, All Owners (afe44b85-cc6d-40d7-b5df-00ae8910d1d2).
Checked Nov 5, 2026. Updated monthly. Public domain (U.S. Government work).
-
Centers for Medicare & Medicaid Services, State and US Averages (xcdc-v8bm).
Released Oct 28, 2026 and checked Nov 5, 2026. Updated monthly. Public domain (U.S. Government work).
If you believe something here is wrong, a correction starts with the agency whose record this copies: CMS. CMS’s own record is on Care Compare. If Hearth Record copied something wrongly, it will fix it and log the correction publicly, with its date: how corrections work.
This copy of the record was made on Nov 5, 2026.
From the home
The public record above comes first. Anything the home adds will appear here, below it, and say who wrote it.
Replies
None. Replies aren’t open yet. When they open, the home will be able to answer any finding for free, and the reply will show beside that finding, unedited and dated.
Paid listing
None. Paid listings aren’t open yet. When they open, anything paid for will say “Paid by the home”, and paying will never change a finding, a rating or the order of results.