SURPRISE VALLEY COMMUNITY HOSPITAL D/P SNF

CEDARVILLE, CA

CMS provider ID 555221CMS source updated July 29, 2026

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CMS overview

CMS rating overview

CMS overall

4 of 5 CMS stars

Health inspection

4 of 5 CMS stars

Staffing

1 of 5 CMS stars

Quality-measure

5 of 5 CMS stars

No proprietary TrustHub score. These ratings are published separately by CMS.

How CMS describes these ratings
CMS overall rating
The CMS overall rating summarizes health inspections, staffing, and quality measures within Medicare's Five-Star system.
Health inspection rating
The CMS health inspection rating reflects findings from standard and complaint inspections used in Medicare's Five-Star system.
Staffing rating
The CMS staffing rating reflects staffing levels and related measures used in Medicare's Five-Star system.
Quality-measure rating
The CMS quality-measure rating summarizes selected resident assessment and claims-based measures used in Medicare's Five-Star system.
CMS certified beds
22
Ownership descriptor
Government - Hospital district
Medicare participation
Yes
Medicaid participation
Yes

Facility information

Contact

CMS remains the primary federal record. Public website and additional contact details appear only when independently verified.

Phone
5302796111Verified public information · checked Aug 2026

State regulatory evidence

State License & Oversight

California Department of Public Health is the state source for this license record. It does not replace CMS federal certification, ratings, or certified-bed counts.

California Department of Public Health

State license
230000025
License status
ACTIVE
License type
SNF
State licensed capacity
22 bedsCMS certified beds: 22
Licensee
SURPRISE VALLEY HEALTH CARE DISTRICTLegal entity holding the state license — not automatically the owner or chain
Administrator
HANNAH, FRANCESNamed on the state license record

State regulatory data · checked Aug 2026

View source details · Official CA source

Decision guide

What to review

Factual evidence to examine before you decide. These summaries are not a score or recommendation.

Staffing

CMS publishes a 1-star staffing rating for this facility.

RN staffing was 0.03 hours per resident day in 2026Q1, calculated from CMS PBJ records.

View staffing evidence

Ownership & operation

Ownership & Operation

Operator, licensee, owner, manager, and chain stay separate. A connected organization is not automatically the party that runs daily operations.

Ownership type
Government - Hospital districtCMS
Licensee
SURPRISE VALLEY HEALTH CARE DISTRICTCalifornia Department of Public Health

Who is behind this facility?

SeniorTrustHub found evidence connecting this facility to:

  • a state licensee

Ownership

Who CMS records show is connected to this facility

These are CMS-published ownership disclosures. Medicare enrollment ownership and managerial-control information is reported by enrolled providers through CMS forms; it is not an independent determination of beneficial ownership.

Reported party records
0
Organizations shown
0
Individuals shown
0
Latest ownership source update
Not reported

CMS-published ownership and control parties

No matched current ownership party records were found in the loaded CMS sources.

What this means

Roles are shown as CMS publishes them. Different CMS sources can describe different enrollment, ownership, and control concepts, so TrustHub keeps each source-specific disclosure distinct.

Inspections & deficiencies

What CMS inspection records show

Scope and severity terms below are CMS classifications. They are not a TrustHub score.

Latest recorded inspection

Date
Feb 26, 2026
Survey type
Health Complaint
Linked findings
1
Highest linked CMS classification
D — Isolated; No actual harm with potential for more than minimal harm that is not immediate jeopardy
View source details
Dataset
Inspection Dates
CMS dataset ID
svdt-c123
CMS source updated
Jul 1, 2026
CMS provider ID
555221
Source record locator
csv-row:132545:ccn:555221
View official CMS source
Feb 26, 2026Health Complaint 1 linked finding
  • F0684Quality of Life and Care Deficiencies

    Provide appropriate treatment and care according to orders, resident’s preferences and goals.

    CMS scope/severity D: Isolated; No actual harm with potential for more than minimal harm that is not immediate jeopardy.

    Correction status: Deficient, Provider has date of correction (Feb 27, 2026)

    View source details
    Dataset
    Health Deficiencies
    CMS dataset ID
    r5ix-sfxw
    CMS source updated
    Jul 1, 2026
    CMS provider ID
    555221
    Source record locator
    csv-row:375229:ccn:555221
    View official CMS source
Dec 19, 2025Health Complaint 1 linked finding
  • F0609Freedom from Abuse, Neglect, and Exploitation Deficiencies

    Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.

    CMS scope/severity D: Isolated; No actual harm with potential for more than minimal harm that is not immediate jeopardy.

    Correction status: Deficient, Provider has date of correction (Jan 8, 2026)

    View source details
    Dataset
    Health Deficiencies
    CMS dataset ID
    r5ix-sfxw
    CMS source updated
    Jul 1, 2026
    CMS provider ID
    555221
    Source record locator
    csv-row:375230:ccn:555221
    View official CMS source
May 8, 2025Fire Safety Standard 0 linked findings

No health-deficiency rows were deterministically linked to this inspection.

May 8, 2025Health Standard 2 linked findings
  • F0657Resident Assessment and Care Planning Deficiencies

    Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.

    CMS scope/severity D: Isolated; No actual harm with potential for more than minimal harm that is not immediate jeopardy.

    Correction status: Deficient, Provider has date of correction (May 30, 2025)

    View source details
    Dataset
    Health Deficiencies
    CMS dataset ID
    r5ix-sfxw
    CMS source updated
    Jul 1, 2026
    CMS provider ID
    555221
    Source record locator
    csv-row:375232:ccn:555221
    View official CMS source
  • F0812Nutrition and Dietary Deficiencies

    Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.

    CMS scope/severity F: Widespread; No actual harm with potential for more than minimal harm that is not immediate jeopardy.

    Correction status: Deficient, Provider has date of correction (Jun 2, 2025)

    View source details
    Dataset
    Health Deficiencies
    CMS dataset ID
    r5ix-sfxw
    CMS source updated
    Jul 1, 2026
    CMS provider ID
    555221
    Source record locator
    csv-row:375231:ccn:555221
    View official CMS source
Apr 18, 2024Fire Safety Standard 0 linked findings

No health-deficiency rows were deterministically linked to this inspection.

Apr 18, 2024Health Standard 4 linked findings
  • F0692Quality of Life and Care Deficiencies

    Provide enough food/fluids to maintain a resident's health.

    CMS scope/severity D: Isolated; No actual harm with potential for more than minimal harm that is not immediate jeopardy.

    Correction status: Deficient, Provider has date of correction (May 8, 2024)

    View source details
    Dataset
    Health Deficiencies
    CMS dataset ID
    r5ix-sfxw
    CMS source updated
    Jul 1, 2026
    CMS provider ID
    555221
    Source record locator
    csv-row:375235:ccn:555221
    View official CMS source
  • F0761Pharmacy Service Deficiencies

    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.

    CMS scope/severity D: Isolated; No actual harm with potential for more than minimal harm that is not immediate jeopardy.

    Correction status: Deficient, Provider has date of correction (May 2, 2024)

    View source details
    Dataset
    Health Deficiencies
    CMS dataset ID
    r5ix-sfxw
    CMS source updated
    Jul 1, 2026
    CMS provider ID
    555221
    Source record locator
    csv-row:375236:ccn:555221
    View official CMS source
  • F0851Administration Deficiencies

    Electronically submit to CMS complete and accurate direct care staffing information, based on payroll and other verifiable and auditable data.

    CMS scope/severity F: Widespread; No actual harm with potential for more than minimal harm that is not immediate jeopardy.

    Correction status: Deficient, Provider has date of correction (May 6, 2024)

    View source details
    Dataset
    Health Deficiencies
    CMS dataset ID
    r5ix-sfxw
    CMS source updated
    Jul 1, 2026
    CMS provider ID
    555221
    Source record locator
    csv-row:375233:ccn:555221
    View official CMS source
  • F0880Infection Control Deficiencies

    Provide and implement an infection prevention and control program.

    CMS scope/severity F: Widespread; No actual harm with potential for more than minimal harm that is not immediate jeopardy.

    Correction status: Deficient, Provider has date of correction (May 13, 2024)

    View source details
    Dataset
    Health Deficiencies
    CMS dataset ID
    r5ix-sfxw
    CMS source updated
    Jul 1, 2026
    CMS provider ID
    555221
    Source record locator
    csv-row:375234:ccn:555221
    View official CMS source
Dec 28, 2023Health Complaint 1 linked finding
  • F0600Freedom from Abuse, Neglect, and Exploitation Deficiencies

    Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.

    CMS scope/severity D: Isolated; No actual harm with potential for more than minimal harm that is not immediate jeopardy.

    Correction status: Deficient, Provider has date of correction (Dec 28, 2023)

    View source details
    Dataset
    Health Deficiencies
    CMS dataset ID
    r5ix-sfxw
    CMS source updated
    Jul 1, 2026
    CMS provider ID
    555221
    Source record locator
    csv-row:375237:ccn:555221
    View official CMS source
Dec 5, 2023Health Complaint 1 linked finding
  • F0600Freedom from Abuse, Neglect, and Exploitation Deficiencies

    Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.

    CMS scope/severity D: Isolated; No actual harm with potential for more than minimal harm that is not immediate jeopardy.

    Correction status: Deficient, Provider has date of correction (Dec 18, 2023)

    View source details
    Dataset
    Health Deficiencies
    CMS dataset ID
    r5ix-sfxw
    CMS source updated
    Jul 1, 2026
    CMS provider ID
    555221
    Source record locator
    csv-row:375238:ccn:555221
    View official CMS source
May 12, 2022Fire Safety Standard 0 linked findings

No health-deficiency rows were deterministically linked to this inspection.

May 12, 2022Health Standard 12 linked findings
  • F0552Resident Rights Deficiencies

    Ensure that residents are fully informed and understand their health status, care and treatments.

    CMS scope/severity E: Pattern; No actual harm with potential for more than minimal harm that is not immediate jeopardy.

    Correction status: Deficient, Provider has date of correction (Jul 13, 2022)

    View source details
    Dataset
    Health Deficiencies
    CMS dataset ID
    r5ix-sfxw
    CMS source updated
    Jul 1, 2026
    CMS provider ID
    555221
    Source record locator
    csv-row:375244:ccn:555221
    View official CMS source
  • F0604Freedom from Abuse, Neglect, and Exploitation Deficiencies

    Ensure that each resident is free from the use of physical restraints, unless needed for medical treatment.

    CMS scope/severity D: Isolated; No actual harm with potential for more than minimal harm that is not immediate jeopardy.

    Correction status: Deficient, Provider has date of correction (Jul 13, 2022)

    View source details
    Dataset
    Health Deficiencies
    CMS dataset ID
    r5ix-sfxw
    CMS source updated
    Jul 1, 2026
    CMS provider ID
    555221
    Source record locator
    csv-row:375249:ccn:555221
    View official CMS source
  • F0656Resident Assessment and Care Planning Deficiencies

    Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.

    CMS scope/severity F: Widespread; No actual harm with potential for more than minimal harm that is not immediate jeopardy.

    Correction status: Deficient, Provider has date of correction (Jul 13, 2022)

    View source details
    Dataset
    Health Deficiencies
    CMS dataset ID
    r5ix-sfxw
    CMS source updated
    Jul 1, 2026
    CMS provider ID
    555221
    Source record locator
    csv-row:375239:ccn:555221
    View official CMS source
  • F0741Quality of Life and Care Deficiencies

    Ensure that the facility has sufficient staff members who possess the competencies and skills to meet the behavioral health needs of residents.

    CMS scope/severity D: Isolated; No actual harm with potential for more than minimal harm that is not immediate jeopardy.

    Correction status: Deficient, Provider has date of correction (Jul 13, 2022)

    View source details
    Dataset
    Health Deficiencies
    CMS dataset ID
    r5ix-sfxw
    CMS source updated
    Jul 1, 2026
    CMS provider ID
    555221
    Source record locator
    csv-row:375250:ccn:555221
    View official CMS source
  • F0756Pharmacy Service Deficiencies

    Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures.

    CMS scope/severity F: Widespread; No actual harm with potential for more than minimal harm that is not immediate jeopardy.

    Correction status: Deficient, Provider has date of correction (Jul 13, 2022)

    View source details
    Dataset
    Health Deficiencies
    CMS dataset ID
    r5ix-sfxw
    CMS source updated
    Jul 1, 2026
    CMS provider ID
    555221
    Source record locator
    csv-row:375240:ccn:555221
    View official CMS source
  • F0758Pharmacy Service Deficiencies

    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.

    CMS scope/severity F: Widespread; No actual harm with potential for more than minimal harm that is not immediate jeopardy.

    Correction status: Deficient, Provider has date of correction (Jul 13, 2022)

    View source details
    Dataset
    Health Deficiencies
    CMS dataset ID
    r5ix-sfxw
    CMS source updated
    Jul 1, 2026
    CMS provider ID
    555221
    Source record locator
    csv-row:375241:ccn:555221
    View official CMS source
  • F0838Administration Deficiencies

    Conduct and document a facility-wide assessment to determine what resources are necessary to care for residents competently during both day-to-day operations (including nights and weekends) and emergencies.

    CMS scope/severity E: Pattern; No actual harm with potential for more than minimal harm that is not immediate jeopardy.

    Correction status: Deficient, Provider has date of correction (Jul 13, 2022)

    View source details
    Dataset
    Health Deficiencies
    CMS dataset ID
    r5ix-sfxw
    CMS source updated
    Jul 1, 2026
    CMS provider ID
    555221
    Source record locator
    csv-row:375245:ccn:555221
    View official CMS source
  • F0867Administration Deficiencies

    Set up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action.

    CMS scope/severity E: Pattern; No actual harm with potential for more than minimal harm that is not immediate jeopardy.

    Correction status: Deficient, Provider has date of correction (Jul 13, 2022)

    View source details
    Dataset
    Health Deficiencies
    CMS dataset ID
    r5ix-sfxw
    CMS source updated
    Jul 1, 2026
    CMS provider ID
    555221
    Source record locator
    csv-row:375246:ccn:555221
    View official CMS source
  • F0868Administration Deficiencies

    Have the Quality Assessment and Assurance group have the required members and meet at least quarterly

    CMS scope/severity E: Pattern; No actual harm with potential for more than minimal harm that is not immediate jeopardy.

    Correction status: Deficient, Provider has date of correction (Jul 13, 2022)

    View source details
    Dataset
    Health Deficiencies
    CMS dataset ID
    r5ix-sfxw
    CMS source updated
    Jul 1, 2026
    CMS provider ID
    555221
    Source record locator
    csv-row:375247:ccn:555221
    View official CMS source
  • F0880Infection Control Deficiencies

    Provide and implement an infection prevention and control program.

    CMS scope/severity F: Widespread; No actual harm with potential for more than minimal harm that is not immediate jeopardy.

    Correction status: Deficient, Provider has date of correction (Jul 13, 2022)

    View source details
    Dataset
    Health Deficiencies
    CMS dataset ID
    r5ix-sfxw
    CMS source updated
    Jul 1, 2026
    CMS provider ID
    555221
    Source record locator
    csv-row:375242:ccn:555221
    View official CMS source
  • F0881Infection Control Deficiencies

    Implement a program that monitors antibiotic use.

    CMS scope/severity E: Pattern; No actual harm with potential for more than minimal harm that is not immediate jeopardy.

    Correction status: Deficient, Provider has date of correction (Jul 13, 2022)

    View source details
    Dataset
    Health Deficiencies
    CMS dataset ID
    r5ix-sfxw
    CMS source updated
    Jul 1, 2026
    CMS provider ID
    555221
    Source record locator
    csv-row:375248:ccn:555221
    View official CMS source
  • F0883Infection Control Deficiencies

    Develop and implement policies and procedures for flu and pneumonia vaccinations.

    CMS scope/severity F: Widespread; No actual harm with potential for more than minimal harm that is not immediate jeopardy.

    Correction status: Deficient, Provider has date of correction (Jul 13, 2022)

    View source details
    Dataset
    Health Deficiencies
    CMS dataset ID
    r5ix-sfxw
    CMS source updated
    Jul 1, 2026
    CMS provider ID
    555221
    Source record locator
    csv-row:375243:ccn:555221
    View official CMS source

Tags appearing across inspections

  • F0600 appears in 2 linked inspections.
  • F0880 appears in 2 linked inspections.

Penalties & enforcement

CMS penalty records in the loaded three-year dataset

No penalty records were found for this provider in the currently loaded CMS Penalties dataset.

Questions to ask

Questions generated from the evidence above

  • CMS records show F0600 in 2 inspections in the available record. What changes has the facility made to address this issue?
  • CMS records show F0880 in 2 inspections in the available record. What changes has the facility made to address this issue?

Facility history

Facility History

16 historical events available. Dates and values come from published CMS and official state regulator evidence, not a score.

What changed recently?

  • Complaint inspection recorded1 deficiency was recorded.

2026

  1. Complaint inspection recorded

    1 deficiency was recorded.

    CMS · Recorded event date · View related evidence

2025

  1. Complaint inspection recorded

    1 deficiency was recorded.

    CMS · Recorded event date · View related evidence

  2. Health inspection completed

    2 deficiencies were recorded.

    CMS · Recorded event date · View related evidence

2024

  1. Health inspection completed

    4 deficiencies were recorded.

    CMS · Recorded event date · View related evidence

2023

  1. Complaint inspection recorded

    1 deficiency was recorded.

    CMS · Recorded event date · View related evidence

  2. Complaint inspection recorded

    1 deficiency was recorded.

    CMS · Recorded event date · View related evidence

  3. State fine recorded

    California Department of Public Health recorded a state fine of $25,000 on 2023-08-01.

    California Department of Public Health · Recorded event date · View related evidence

2022

  1. Health inspection completed

    12 deficiencies were recorded.

    CMS · Recorded event date · View related evidence

2021

  1. State regulatory action recorded

    California Department of Public Health recorded an enforcement action on 2021-06-30. AP - 3.2 Nursing-Hours-per-Patient-Day AP (HSC 1276.5).

    California Department of Public Health · Recorded event date · View related evidence

2009

  1. State fine recorded

    California Department of Public Health recorded a state fine of $600 on 2009-05-20.

    California Department of Public Health · Recorded event date · View related evidence

  2. State fine recorded

    California Department of Public Health recorded a state fine of $300 on 2009-03-17.

    California Department of Public Health · Recorded event date · View related evidence

2008

  1. State fine recorded

    California Department of Public Health recorded a state fine of $250 on 2008-08-20.

    California Department of Public Health · Recorded event date · View related evidence

Staffing

Reported nursing staffing at a glance

CMS staffing rating: 1 of 5 stars. CMS calculates that rating separately using its published methodology. The values below are calculations from daily PBJ records for 2026Q1 (current source quarter).

Inspect a PBJ quarter
Total nursing
4.871
reported hours per resident day
RN categories
0.026
reported hours per resident day
LPN/LVN categories
1.583
reported hours per resident day
CNA
3.036
reported hours per resident day

Weekday and weekend calculations

2026Q1 reported hours per resident day
MeasureMonday–FridaySaturday–Sunday
Total nursing4.9074.782
RN categories0.0270.025

Contract staff accounted for 19.5% of reported nursing hours included in this quarter calculation.

PBJ reports zero combined RN-category hours on 86 days with a positive MDS census in this quarter.

Questions to ask

  • PBJ records show lower calculated RN-category hours per resident day on weekends this quarter. How does the facility plan RN coverage on Saturdays and Sundays?
  • PBJ records show that some reported nursing hours were contract hours. How does the facility orient and integrate contract staff?
Staffing source and calculation details
Source
Centers for Medicare & Medicaid Services (CMS)
Dataset
Payroll Based Journal Daily Nurse Staffing
CMS dataset ID
7e0d53ba-8f02-4c66-98a5-14a1c997c50d
Quarter
2026Q1
Coverage
Jan 1, 2026Mar 31, 2026
Days represented
90 (90 with positive MDS census)
CMS source updated
Jul 29, 2026
Calculation version
pbj-quarter-ratio-of-sums-v1

Hours-per-resident-day values are calculated by this platform from CMS-published daily PBJ hours and MDS census. For each displayed period, included hours are summed and divided by the summed census for days with a positive census. They are not CMS case-mix-adjusted staffing measures or a staffing rating.

View official CMS PBJ source

What we can verify today

Current Provider Information facts

These measures come from the current successfully ingested CMS Nursing Home Provider Information release.

  • CMS reports a 4-star overall rating.
  • CMS reports a 4-star health inspection rating.
  • CMS reports a 1-star staffing rating.
  • CMS reports a 5-star quality-measure rating.

Planned evidence layers

Additional public-source research

These areas require separate authoritative CMS datasets. No findings are shown until those sources are ingested and reviewed.

  • Chain / portfolio intelligence

Trust participation

See something that needs correction?

Claims, corrections, and factual context are free. Submissions never replace CMS evidence or affect ranking.

How corrections work

Source register

See where this record came from

Provider Information
Source organization
Centers for Medicare & Medicaid Services (CMS)
Dataset identifier
4pq5-n9py
Source updated
Jul 29, 2026
Retrieved
Aug 14, 2026
Supports
Overview, facility facts, and CMS ratings
View official CMS source
Inspection Dates
Source organization
Centers for Medicare & Medicaid Services (CMS)
Dataset identifier
svdt-c123
Source updated
Jul 1, 2026
Retrieved
Aug 14, 2026
Supports
Inspections and facility history
View official CMS source
Health Deficiencies
Source organization
Centers for Medicare & Medicaid Services (CMS)
Dataset identifier
r5ix-sfxw
Source updated
Jul 1, 2026
Retrieved
Aug 14, 2026
Supports
Health deficiencies and facility history
View official CMS source
Payroll Based Journal Daily Nurse Staffing
Source organization
Centers for Medicare & Medicaid Services (CMS)
Dataset identifier
7e0d53ba-8f02-4c66-98a5-14a1c997c50d
Coverage
Jan 1, 2026–Mar 31, 2026
Source updated
Jul 29, 2026
Retrieved
Aug 15, 2026
Supports
PBJ staffing cards, history, and transparent calculations
View official CMS source
Verified public facility information
Source organization
Public facility listing
Dataset identifier
commercial-corroboration:public-listing
Source updated
Aug 18, 2026
Retrieved
Aug 18, 2026
Supports
Independently verified public website, phone, or publicly used name. Not a CMS rating or regulatory status.
How sources work
Licensed and Certified Healthcare Facility Listing
Source organization
California Department of Public Health
Dataset identifier
state-regulator:ca
Coverage
State license 230000025
Source updated
Aug 18, 2026
Retrieved
Aug 18, 2026
Supports
state license, license status, license type, state licensed capacity, licensee, and administrator. Separate from CMS certification, ratings, and ownership.
View official state source

No paid placements. Facilities cannot pay to rank higher. We cite. You decide.