The Royal Home

Location & what’s nearby

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Nearest of each type, straight-line distance. Hospitals come from the CMS Hospital General Information registry; everything else from Overture Maps (public data). Hospital and park hours are typical — call ahead to confirm.

Quality measures — how residents actually fare

Quality-measure stars summarize outcomes CMS tracks from the assessments each home submits — avoidable hospitalizations and ER visits, falls with injury, pressure ulcers, unplanned weight loss, and long-term antipsychotic use. Because the underlying data is self-reported, weigh a high score against the independent inspection record. Long-stay = permanent residents; short-stay = rehab and post-hospital stays.

Staffing

How full it usually is: this home is certified for 19 beds and averages 14.3 residents a day — about 75% occupied, or roughly 5 beds typically open. It usually has some room. This is a CMS average, not live availability — no public source publishes real-time vacancies, and a home can be full the day you call. Confirm with the home, and if you need a Medicaid bed specifically, ask about that separately: a home with open beds may still not have an open Medicaid bed.

Against a benchmark — not a legal minimum. In May 2024 CMS finalized the first federal staffing floor for nursing homes: 3.48 total nurse hours per resident per day, including 0.55 RN hours and 2.45 nurse-aide hours. Its hour requirements never took effect and are no longer on the books. Homes had until 2026 (2027 if rural) to comply, and that deadline never arrived: a federal court vacated the hour requirements in April 2025 (CMS has appealed), Congress then barred enforcement until 2034, and CMS formally repealed them by rule effective February 2026. This home is not required to meet these numbers, and is not violating anything by missing them. We still show the comparison because the figures are CMS’s own published estimate of adequate staffing, which makes them a useful yardstick — but they are our benchmark, not federal law: this home’s total nurse staffing of 4.18 hrs/resident/day is at or above the 3.48-hour benchmark and RN staffing of 0.57 is at or above the 0.55-hour RN benchmark and nurse-aide staffing of 2.49 is at or above the 2.45-hour aide benchmark. What federal law does require today is unchanged: “sufficient” nursing staff for residents’ needs and an RN on duty at least 8 consecutive hours a day, 7 days a week (42 CFR 483.35). Those are judged by inspectors on site, not by these averages, so read this comparison alongside the inspection record rather than as a pass/fail.

Weekend coverage: total nurse staffing is 3.79 hrs/resident/day on weekends vs 4.33 on weekdays — 13% thinner on weekends. RN hours go from 0.57 to 0.56 per resident-day. (Payroll-based daily records; the national median home is 15% thinner on weekends.)

This home’s total nursing-staff turnover of 74% is well above the national median of 45%.

Payroll-based (PBJ) staffing hours, as reported for Jan–Mar 2026 (CMS PBJ CY2026Q1) — the most recent quarter CMS has published, so they can lag a change of operator or staffing agency. Higher is generally better. Registered-nurse coverage and weekend staffing are the numbers families most often overlook — an RN on site matters most when something goes wrong, and coverage usually thins on weekends. High turnover means residents rarely see the same caregiver twice. One caveat: these are hours as reported, not adjusted for how sick or heavy-care this home’s residents are. CMS separately publishes a case-mix-adjusted view; we show the reported hours. A home caring for higher-acuity residents needs more hours to deliver the same care, so compare these figures against homes doing similar work, and read them next to the inspection record rather than alone.

Inspection trend

Deficiencies are fewer than at the previous inspection — improving. Fewer citations over time suggests a home is fixing problems; a rising count is a warning sign — though two surveys are a short record, and survey teams differ. These counts are from the standard annual health survey only; the full citation list below may also include findings from complaint investigations, so the two won’t always add up.

Inspection deficiencies

State health-inspection citations, most serious first. Each carries an F-code (the federal rule it cites, e.g. F-684 = quality of care) and a letter A–L marking how serious and how widespread the problem was — we translate that grid into the plain tiers shown here. Wording is the official federal description.

Each letter is a CMS scope-severity level; highlighted ones are where this home has citations. A–C = no harm found; D–F = potential for harm; G–I = actual harm; J–L = immediate jeopardy. Within each band the later letter is the more widespread finding (an isolated G is one resident; a widespread I is a pattern), so rightward and downward is worse.

31 citations, most serious first. The 10 most serious are shown; the remaining 21 are one tap away and print in full.

• Potential for harm · F2025-12-03 · tag F0727 — failed to provide required RN coverage — widespread
  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.
  What the surveyor found here — an excerpt from the official record, may be distressing

  Based on interview and record review the facility failed to schedule a Registered Nurse for at least 8 consecutive hours a day for April, May, and June of 2025.This failure had the potential to affect all residents in the facility by limiting access to professional nursing assessments, care and supervision of staff which could place the residents at risk for unmet medical needs, delayed response to emergencies and treatment, and poor quality of care. During a review of the facility's Payroll-Based Journal (PBJ) Staffing Data Report from [name of oversight agency], the FY Quarter 3 2025 (April 1 - June 30) report indicated that the facility had no Registered Nurse (RN) onsite on the following dates: A. APRIL 2025 - 04/06, 04/11, 04/13 - 3 Days B. MAY 2025- 05/19, 05/20, 05/21, 05/22, 05/23, 05/26, 05/27, 05/28, 05/29, 05/30 - 10 Days C. JUNE 2025- 06/02, 06/03, 06/04, 06/05, 06/06, 06/09, 06/10, 06/11, 06/12, 06/13, 06/16, 06/17, 06/18, 06/19, 06/20, 06/23, 06/24, 06/25, 06/26, 06/27, 06/30 - 21 DaysDuring an interview with the Assistant Administrator (A-ADM), on 09/24/2025 at 4:32…

  This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

  Nursing and Physician Services Deficiencies · Deficient, Provider has date of correction
• Potential for harm · F2025-12-03 · tag F0801 — widespread
  Employ sufficient staff with the appropriate competencies and skills sets to carry out the functions of the food and nutrition service, including a qualified dietician.
  What the surveyor found here — an excerpt from the official record, may be distressing

  Based on interview and record review the facility failed to designate a qualified Director of Food Services to provide the daily oversight of the dietary department which includes implementing menus, purchasing food, training staff, and ensuring compliance with all state and federal regulations.This failure had the potential to result in a lack of oversight into the operations of the dietary department and supervision of staff, which could lead to poor quality of services in the department which could affect residents' health and wellbeing.During an interview with the Dietary Kitchen Supervisor (DKS) on 09/24/2025, at 10:35 AM, the DKS stated she is the Director of Food Services and runs the day-to-day operations of the kitchen. The DKS stated she is not a certified dietary manager because she failed to complete her school two years ago due to personal reasons but attended online training about food protection and management in 2023. The DKS also stated she had no bachelor's degree in food and nutrition and had not completed an approved dietary service training program as required…

  This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

  Nutrition and Dietary Deficiencies · Deficient, Provider has date of correction
• Potential for harm · Fcited before2025-12-03 · tag F0812 — failed to store, cook, and serve food safely — widespread
  Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
  What the surveyor found here — an excerpt from the official record, may be distressing

  Based on observation, interview, and record review, the facility failed to ensure safe and sanitary food preparation and storage practices in the kitchen when there were six opened and unlabeled food packages and bottles found inside the kitchen's refrigerator, freezer, and tray condiments area.This failure had the potential to cause foodborne illnesses (any illness resulting from eating contaminated/spoiled foods) to 19 of 19 medically compromised residents who receive food served by the kitchen.During an initial observation tour of the kitchen and interview with Dietary Kitchen Supervisor (DKS), on 09/23/2025, at 8:25 AM, the DKS inspected the kitchen condiments area, refrigerators, and freezer, and found the following food items: I. One gallon of soy sauce half empty, opened, undated II. One gallon of cooking oil half empty, opened, undated III. Two half gallons of milk more than half empty, opened, undatedIV. One bag of frozen cauliflower, undatedV. One bag of frozen mixed vegetables, undatedVI. One bag of frozen green beans, undatedDuring a phone interview with the Registered…

  This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

  Nutrition and Dietary Deficiencies · Deficient, Provider has date of correction
• Potential for harm · Fcited before2025-12-03 · tag F0880 — failed to prevent and control infections — widespread
  Provide and implement an infection prevention and control program.
  What the surveyor found here — an excerpt from the official record, may be distressing

  NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observation, interview, and record review, the facility failed to implement infection control and prevention measures when: 1. Certified Nursing Assistant (CNA) 2 did not perform hand hygiene in between assisting Residents 7 and 18 with the feeding.2. Uncovered soiled linen was placed in the clean area of the laundry room. These failures had the potential for cross contamination and spread of infection which can adversely affect the health and wellbeing of 19 residents, staff, and visitors.1. During dining observation, on 9/23/25, at 11:56 AM, Certified Nursing Assistant (CNA) 2 was noted assisting Residents 7 and 18 simultaneously, who were seated across from each other at the same table. CNA 2 did not perform hand hygiene in between assisting Residents 7 and 18 with the feeding. During an interview with CNA 2, on 9/23/25, at 12:28 PM, CNA 2 stated that handwashing between assisting residents was important to prevent cross contamination. During an interview with the Director of Nursing (DON), on…

  This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

  Infection Control Deficiencies · Deficient, Provider has date of correction
• Potential for harm · E2025-12-03 · tag F0578 — failed to honor advance directives / code status — pattern
  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.
  What the surveyor found here — an excerpt from the official record, may be distressing

  NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on interview and record review, the facility failed to ensure Physician Orders for Life Sustaining Treatment (POLST - form that documents an individual's preferences for end-of-life care ) were completed for four of nine sampled residents (Residents 1, 4, 12, and 19).This failure had the potential for residents receiving unnecessary treatment in the event of an emergency.1. A review of Resident 1's Face Sheet (front page of the chart that contains a summary of basic information about the resident), indicated that resident was admitted to the facility on [DATE], with diagnoses which included Schizophrenia (a severe brain disorder in which people interpret reality abnormally) and Type II Diabetes Mellitus (a long term condition that causes high blood sugar levels).A review of Resident 1's POLST form indicated that Section D (Information and Signatures) included the physician's signature without a date and was missing the patient or legal decision-maker's signature.2. A review of Resident 4's Face Sheet…

  This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

  Resident Rights Deficiencies · Deficient, Provider has date of correction
• Potential for harm · D2025-12-03 · tag F0550 — failed to protect resident dignity and rights — isolated
  Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
  What the surveyor found here — an excerpt from the official record, may be distressing

  NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observation, interview, and record review, the facility failed to promote independence and dignity to two of two residents (Resident 7 & 18) when Certified Nursing Assistant (CNA) 2 was standing and not seated at eye level while assisting both residents with feeding. This failure had the potential to cause residents to feel disrespected, undignified, as well as experience psychological discomfort.During dining observation on 9/23/25 at 11:56 AM, Certified Nursing Assistant (CNA) 2 was observed assisting Residents 7 and 18 simultaneously as they were seated across from each other at the same table. CNA 2 was standing while helping Residents 7 and 18 with their meals.During an interview with CNA 2, on 9/23/25, at 12:28 PM, CNA 2 stated that residents might not finish their meals when assisted in a sitting position. During an interview with the Director of Nursing (DON), on 9/25/25, at 9:04 AM, the DON stated that staff were expected to be at eye level with residents when rendering care. During an…

  This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

  Resident Rights Deficiencies · Deficient, Provider has date of correction
• Potential for harm · D2025-12-03 · tag F0805 — failed to prepare food in a form residents can eat — isolated
  Ensure each resident receives and the facility provides food prepared in a form designed to meet individual needs.
  What the surveyor found here — an excerpt from the official record, may be distressing

  Based on observation, interview, and record review, the facility failed to prepare food in a form designed to meet the needs of one of 19 residents (Resident 8) when resident's lunch on 09/23/2025 had visible chunks of food. This failure had the potential to result in Resident 8 choking during meals. During an observation on 09/23/2025, at 12:20 AM, in the dining room, Resident 8's tray consisted of chicken barbeque, seasoned potato and corn with notable lumps present. Resident 8's diet ticket stated fortified puree. During an interview with the Dietary Kitchen Supervisor (DKS) in the kitchen, on 09/23/2025, at 2:40 PM, the DKS stated that Resident 8's diet order is puree. The DKS further stated that the meal should have had a smooth texture with no lumps. During a review of the Physician Orders for Resident 8, the diet order indicated a Fortified Pureed Texture with Thin Liquids.During a telephone interview and record review with the Registered Dietitian (RD) on 09/24/2025, at 11:23 AM, the RD notes titled, Nutritional Quarterly Review indicated that Resident 8 has swallowing…

  This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

  Nutrition and Dietary Deficiencies · Deficient, Provider has date of correction
• Potential for harm · F2023-12-15 · tag F0802 — failed to prepare enough nourishing food — widespread
  Provide sufficient support personnel to safely and effectively carry out the functions of the food and nutrition service.
  What the surveyor found here — an excerpt from the official record, may be distressing

  Based on observation, interview, and document review, the facility did not ensure food and nutrition service staff were able to competently carry out their job duties when: 1. DA 11 did not contain all her hair within a hairnet; 2. DA 11 did not wash her hands upon entering the kitchen; 3. DA 11 did not know how to prepare a red bucket for sanitation purposes. As a result, this could have led to foodborne illness to all 19 residents at the facility. (Cross Reference F-812) Findings: 1. On 12/12/23 at 12:02 P.M., an observation outside the kitchen area of the kitchen staff was conducted, during the initial resident dining room observation. DA 11 was inside the kitchen, wearing a hairnet, which partially covered the back of her head. The hairnet came to the middle of her back scalp, and 4-5 inches of straight dark hair was hanging down, to her neck, uncovered and uncontained. On 12/12/23 at 2:44 P.M., an interview was conducted with DA 11. DA 11 stated she was usually the housekeeper, but was asked to help out in the kitchen his week since the regular DA was on vacation. DA 11 stated…

  This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

  Nutrition and Dietary Deficiencies · Deficient, Provider has date of correction
• Potential for harm · Fcited before2023-12-15 · tag F0812 — failed to store, cook, and serve food safely — widespread
  Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
  What the surveyor found here — an excerpt from the official record, may be distressing

  Based on observation, interview, and record review, the facility did not maintain sanitary conditions for food safety in the kitchen according to Federal Food and Drug Administration's standards of practice when: 1. Food was not dated and stored properly in two of two refrigerators; 2. A hairnet was not worn properly by one of two kitchen staff (DA 11); 3. Handwashing was not performed by one of two kitchen staff (DA 11), when entering the kitchen to perform kitchen duties; and 4. One of two sanitation red buckets was not prepared properly for cleaning and disinfecting. As a result, there was the potential to spread food borne illnesses to 19 residents. Findings: 1. On 12/12/23 at 7:35 A.M., an initial tour was conducted with CK 11 of the refrigerator within the kitchen. a. Cut celery sticks were inside a clear plastic zip bag, with no date labeled. b. An opened package of hotdog's was inside a clear unsealed plastic bag, with no date labeled and juice leaked out when picked up. c. Slices of white cheese (approximately 15 slices) were wrapped within cellophane wrap, with no date…

  This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

  Nutrition and Dietary Deficiencies · Deficient, Provider has date of correction
• Potential for harm · Fcited before2023-12-15 · tag F0867 — failed to act on quality-improvement findings — widespread
  Set up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action.
  What the surveyor found here — an excerpt from the official record, may be distressing

  Based on observation, interview, and record review, the facility's Quality Assurance Performance Improvement program (QAPI - a data driven and proactive approach to quality improvement) failed to identify areas of improvement related to: 1. Developing a water management program (see F-880). 2. Competency of kitchen staff (see F-802). 3. Kitchen sanitation (see F-812). These failures had the potential to affect the health and safety of the facility staff and 19 of 19 residents. Findings: On 12/15/23 at 10:10 A.M., an interview was conducted with the administrator (ADM), the director of nursing (DON), and the administrative assistant. The ADM stated the QAPI committee did not review and discuss the Centers for Medicare and Medicaid Services (CMS) Quality, Safety, Oversight group (QSO) letters unless they were pertinent enough and related to resident care and safety. The ADM stated since having a water management program was a requirement in the State Operations Manual and on QSO letters, it should have been discussed and identified as an area of improvement by the facility's QAPI and…

  This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

  Administration Deficiencies · Deficient, Provider has date of correction

“Cited before” means this same F-tag appears on at least one other survey date in the record we hold — counting complaint investigations as well as standard surveys, with no time limit. It is our own read of the data, not CMS’s: CMS uses repeat deficiency as a formal term tied to consecutive standard surveys, and that is a narrower test than this one. A tag marked here may or may not meet it.

Fines & penalties

No federal fines in the current CMS record.

Who owns this facility

The source lists no ownership percentage for any party here — PECOS records a share only for equity interests, not for board or management roles.

What families pay in CA