The most serious citations on this record
Every nursing-home citation carries a scope-and-severity grade from A (least serious) to L (most serious). The five highest-graded citations at Avalon Villa Care Center are:
F-0689 · January 31, 2025 · Grade J — Immediate jeopardy
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Status: Deficient, Provider has date of correction · correction date February 24, 2025
F-0688 · January 8, 2026 · Grade G — Actual harm
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.
Status: Deficient, Provider has date of correction · correction date February 12, 2026
F-0656 · January 24, 2024 · Grade G — Actual harm
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Found during a complaint investigation. Status: Deficient, Provider has date of correction · correction date February 23, 2024
K-0345 · January 8, 2026 · Grade F — Potential for more than minimal harm
Have approved installation, maintenance and testing program for fire alarm systems.
Status: Deficient, Provider has date of correction · correction date February 2, 2026
K-0511 · January 8, 2026 · Grade F — Potential for more than minimal harm
Have properly installed electrical wiring and gas equipment.
Status: Deficient, Provider has date of correction · correction date February 2, 2026
What surveyors cited, theme by theme
Grouping the citations by subject shows whether a home's problems are isolated or concentrated in one part of care. At Avalon Villa Care Center, 16 subject areas appear across health and fire-safety inspections.
Quality of life and daily care
29 citations between December 29, 2023 and April 30, 2026. The most serious was graded J — immediate jeopardy, affecting one or a very small number of residents. Surveyors found a situation that caused — or was likely to cause — serious injury, harm, impairment, or death, and that needed immediate correction. 15 of these citations came out of complaint investigations. Correction record: 29 citations show a recorded correction date.
This group covers the basics of daily care — help with eating, bathing, toileting, repositioning, and timely treatment. Repeated citations here often match what families notice first: call lights unanswered, soiled briefs, missed care.
F-0689 · January 31, 2025 · Grade J — Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
F-0688 · January 8, 2026 · Grade G — 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.
F-0689 · April 30, 2026 · Grade E — Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Assessments and care planning
24 citations between October 16, 2023 and June 6, 2026. The most serious was graded G (actual harm). 15 of these citations came out of complaint investigations. Correction record: 24 citations show a recorded correction date.
Care-plan citations mean the written plan did not match the resident's known risks. Ask whether the care plan changed after each fall, wound, infection, or hospital return — or whether the same plan stayed in place while the resident declined.
F-0656 · January 24, 2024 · Grade G — Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
F-0644 · January 8, 2026 · Grade E — Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.
F-0656 · January 8, 2026 · Grade E — Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Resident rights
20 citations between December 29, 2023 and April 30, 2026. The most serious was graded F (potential for more than minimal harm). 11 of these citations came out of complaint investigations. Correction record: 20 citations show a recorded correction date.
Rights citations cover dignity, choice, privacy, grievances, and being told about changes in condition or care. Ask how the home notifies family of changes and how grievances are logged and answered.
F-0622 · January 31, 2025 · Grade F — Not transfer or discharge a resident without an adequate reason; and must provide documentation and convey specific information when a resident is transferred or discharged.
F-0623 · January 31, 2025 · Grade F — Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.
F-0550 · December 29, 2023 · Grade E — Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
Fire, smoke, and emergency safety
17 citations between December 29, 2023 and January 8, 2026. The most serious was graded F (potential for more than minimal harm). Correction record: 17 citations show a recorded correction date.
Life-safety citations cover alarms, sprinklers, exits, and evacuation readiness. Ask for the date each item was corrected and whether the local fire authority re-inspected.
K-0345 · January 8, 2026 · Grade F — Have approved installation, maintenance and testing program for fire alarm systems.
K-0353 · January 8, 2026 · Grade E — Inspect, test, and maintain automatic sprinkler systems.
K-0363 · January 8, 2026 · Grade E — Install corridor and hallway doors that block smoke.
Food, nutrition, and hydration
16 citations between December 29, 2023 and January 8, 2026. The most serious was graded F (potential for more than minimal harm). 7 of these citations came out of complaint investigations. Correction record: 16 citations show a recorded correction date.
Nutrition failures connect directly to weight loss, dehydration, and slow wound healing. Ask for weight records, intake logs, and whether a dietitian reviewed the resident after any decline.
F-0812 · September 11, 2025 · Grade F — Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
F-0803 · January 8, 2026 · Grade E — 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.
F-0805 · January 8, 2026 · Grade E — Ensure each resident receives and the facility provides food prepared in a form designed to meet individual needs.
Infection prevention and control
8 citations between September 1, 2023 and January 8, 2026. The most serious was graded F (potential for more than minimal harm). 5 of these citations came out of complaint investigations. Correction record: 8 citations show a recorded correction date.
Infection citations matter because infections are a leading cause of hospital transfer and death in nursing homes. Families should ask how the home tracks infections, isolates sick residents, and tells families when an outbreak starts.
F-0880 · January 31, 2025 · Grade F — Provide and implement an infection prevention and control program.
F-0880 · January 8, 2026 · Grade E — Provide and implement an infection prevention and control program.
F-0880 · December 29, 2023 · Grade E — Provide and implement an infection prevention and control program.
Nursing and Physician Services
7 citations between December 29, 2023 and January 8, 2026. The most serious was graded F (potential for more than minimal harm). 4 of these citations came out of complaint investigations. Correction record: 7 citations show a recorded correction date.
Ask the facility what this citation required it to change, when the correction was verified, and what monitoring is in place so the same failure does not recur.
F-0726 · January 31, 2025 · Grade F — 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.
F-0725 · December 29, 2023 · Grade E — Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.
F-0726 · January 8, 2026 · Grade D — 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.
Gas, Vacuum, and Electrical Systems
7 citations between December 29, 2023 and January 8, 2026. The most serious was graded F (potential for more than minimal harm). Correction record: 7 citations show a recorded correction date.
Ask the facility what this citation required it to change, when the correction was verified, and what monitoring is in place so the same failure does not recur.
K-0916 · January 8, 2026 · Grade F — Have a battery powered remote alarm panel in a location accessible by operating personnel.
K-0918 · January 8, 2026 · Grade F — Have generator or other power source capable of supplying service within 10 seconds.
K-0920 · January 8, 2026 · Grade F — Ensure proper usage of power strips and extension cords.
Miscellaneous
6 citations between December 29, 2023 and January 8, 2026. The most serious was graded F (potential for more than minimal harm). Correction record: 6 citations show a recorded correction date.
Ask the facility what this citation required it to change, when the correction was verified, and what monitoring is in place so the same failure does not recur.
K-0712 · January 8, 2026 · Grade F — Have simulated fire drills held at unexpected times.
K-0741 · December 29, 2023 · Grade E — Have posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed.
K-0741 · January 8, 2026 · Grade D — Have posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed.
Administration and leadership
4 citations between December 29, 2023 and August 19, 2025. The most serious was graded F (potential for more than minimal harm). 3 of these citations came out of complaint investigations. Correction record: 4 citations show a recorded correction date.
Administrative citations suggest the problem sits with management systems, not one staff member. Ask who is responsible for quality oversight and what the home's own quality committee changed afterward.
F-0865 · December 29, 2023 · Grade F — Have a plan that describes the process for conducting QAPI and QAA activities.
F-0835 · August 19, 2025 · Grade D — Administer the facility in a manner that enables it to use its resources effectively and efficiently.
F-0839 · August 19, 2025 · Grade D — Employ staff that are licensed, certified, or registered in accordance with state laws.
Physical environment and safety
3 citations between February 25, 2025 and December 23, 2025. The most serious was graded F (potential for more than minimal harm). 3 of these citations came out of complaint investigations. Correction record: 3 citations show a recorded correction date.
Environmental citations cover the building itself — safe water temperatures, clean and working equipment, hazard-free spaces. Ask what was repaired, when, and what checks are in place now.
F-0925 · September 11, 2025 · Grade F — Make sure there is a pest control program to prevent/deal with mice, insects, or other pests.
F-0907 · December 23, 2025 · Grade D — Provide enough space and equipment to meet each resident's needs
F-0921 · February 25, 2025 · Grade D — Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public.
Services
3 citations between January 31, 2025 and January 8, 2026. The most serious was graded F (potential for more than minimal harm). Correction record: 3 citations show a recorded correction date.
Ask the facility what this citation required it to change, when the correction was verified, and what monitoring is in place so the same failure does not recur.
K-0511 · January 8, 2026 · Grade F — Have properly installed electrical wiring and gas equipment.
K-0521 · January 8, 2026 · Grade F — Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.
K-0511 · January 31, 2025 · Grade D — Have properly installed electrical wiring and gas equipment.
Egress
2 citations between December 29, 2023 and January 8, 2026. The most serious was graded F (potential for more than minimal harm). Correction record: 2 citations show a recorded correction date.
Ask the facility what this citation required it to change, when the correction was verified, and what monitoring is in place so the same failure does not recur.
K-0291 · December 29, 2023 · Grade F — Install emergency lighting that can last at least 1 1/2 hours.
K-0293 · January 8, 2026 · Grade E — Have properly located and lighted "Exit" signs.
Medication and pharmacy services
10 citations between December 29, 2023 and January 8, 2026. The most serious was graded E (potential for more than minimal harm). 4 of these citations came out of complaint investigations. Correction record: 10 citations show a recorded correction date.
Medication citations can involve wrong doses, unnecessary drugs, or poor monitoring. Ask for the medication administration record and whether a pharmacist reviewed the resident's drug regimen each month.
F-0755 · January 8, 2026 · Grade E — Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
F-0755 · August 19, 2025 · Grade E — Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
F-0761 · January 8, 2026 · Grade D — 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.
Freedom from abuse, neglect, and exploitation
8 citations between October 19, 2023 and December 23, 2025. The most serious was graded D (potential for more than minimal harm). 7 of these citations came out of complaint investigations. Correction record: 8 citations show a recorded correction date.
These citations go to the core duty to protect residents. Ask how the home screens and trains staff, how allegations are investigated, and whether the same staff or unit appears in more than one report.
F-0605 · December 23, 2025 · Grade D — Prevent the use of unnecessary psychotropic medications or use medications that may restrain a resident's ability to function.
F-0605 · August 6, 2025 · Grade D — Prevent the use of unnecessary psychotropic medications or use medications that may restrain a resident's ability to function.
F-0609 · August 6, 2025 · Grade D — Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
Fire, smoke, and emergency safety
4 citations between December 29, 2023 and January 8, 2026. The most serious was graded D (potential for more than minimal harm). Correction record: 4 citations show a recorded correction date.
Life-safety citations cover alarms, sprinklers, exits, and evacuation readiness. Ask for the date each item was corrected and whether the local fire authority re-inspected.
E-0041 · December 29, 2023 · Grade D — Implement emergency and standby power systems.
E-0041 · January 8, 2026 · Grade C — Implement emergency and standby power systems.
E-0030 · December 29, 2023 · Grade C — List the names and contact information of those in the facility.
How to read the severity grades
CMS grades combine how many residents were affected with how much harm occurred. Grades J–L are immediate jeopardy: a situation that caused, or was likely to cause, serious injury or death. Grades G–I mean a resident was actually harmed. Grades D–F mean no harm was found but the failure could have caused more than minimal harm, and A–C carry only minimal-harm potential. The second dimension matters too: the grade also tells you whether surveyors saw an isolated case, a pattern, or a facility-wide problem.
Survey and penalty timeline
Avalon Villa Care Center appears in CMS data on 31 survey dates between September 1, 2023 and June 6, 2026. Complaint surveys happen because someone reported a problem; standard surveys are the routine inspections every home receives.
June 6, 2026
Complaint health survey — 1 citation, worst grade D (potential for more than minimal harm)
April 30, 2026
Complaint health survey — 2 citations, worst grade E (potential for more than minimal harm)
March 12, 2026
Complaint health survey — 1 citation, worst grade D (potential for more than minimal harm)
January 27, 2026
Complaint health survey — 1 citation, worst grade D (potential for more than minimal harm)
January 8, 2026
Standard health survey — 25 citations, worst grade G (actual harm)
January 8, 2026
Fire-safety survey — 19 citations, worst grade F (potential for more than minimal harm)
December 23, 2025
Complaint health survey — 3 citations, worst grade D (potential for more than minimal harm)
December 12, 2025
Complaint health survey — 6 citations, worst grade D (potential for more than minimal harm)
November 21, 2025
Complaint health survey — 1 citation, worst grade D (potential for more than minimal harm)
September 19, 2025
Complaint health survey — 2 citations, worst grade D (potential for more than minimal harm)
September 11, 2025
Complaint health survey — 4 citations, worst grade F (potential for more than minimal harm)
August 19, 2025
Complaint health survey — 3 citations, worst grade E (potential for more than minimal harm)
August 6, 2025
Complaint health survey — 4 citations, worst grade D (potential for more than minimal harm)
July 29, 2025
Complaint health survey — 2 citations, worst grade D (potential for more than minimal harm)
June 17, 2025
Complaint health survey — 2 citations, worst grade D (potential for more than minimal harm)
June 6, 2025
Complaint health survey — 2 citations, worst grade D (potential for more than minimal harm)
May 21, 2025
Complaint health survey — 2 citations, worst grade E (potential for more than minimal harm)
April 16, 2025
Complaint health survey — 2 citations, worst grade D (potential for more than minimal harm)
February 25, 2025
Complaint health survey — 5 citations, worst grade D (potential for more than minimal harm)
January 31, 2025
Standard health survey — 30 citations, worst grade J (immediate jeopardy)
January 31, 2025
Fire-safety survey — 6 citations, worst grade F (potential for more than minimal harm)
March 6, 2024
Complaint health survey — 1 citation, worst grade D (potential for more than minimal harm)
January 24, 2024
Complaint health survey — 3 citations, worst grade G (actual harm)
December 29, 2023
Complaint health survey — 21 citations, worst grade F (potential for more than minimal harm)
December 29, 2023
Fire-safety survey — 14 citations, worst grade F (potential for more than minimal harm)
December 19, 2023
Complaint health survey — 1 citation, worst grade D (potential for more than minimal harm)
December 1, 2023
Complaint health survey — 1 citation, worst grade D (potential for more than minimal harm)
November 1, 2023
Complaint health survey — 1 citation, worst grade D (potential for more than minimal harm)
October 19, 2023
Complaint health survey — 1 citation, worst grade D (potential for more than minimal harm)
October 16, 2023
Complaint health survey — 1 citation, worst grade D (potential for more than minimal harm)
September 1, 2023
Complaint health survey — 1 citation, worst grade D (potential for more than minimal harm)
Penalties imposed
November 21, 2025 — Fine of $45,325
November 21, 2025 — Payment denial · Medicare/Medicaid payments denied for 5 days from February 7, 2026
January 31, 2025 — Fine of $41,457
January 31, 2025 — Payment denial · Medicare/Medicaid payments denied for 24 days from March 1, 2025
October 16, 2023 — Fine of $25,155
October 16, 2023 — Payment denial · Medicare/Medicaid payments denied for 38 days from January 16, 2024
Payment denials are the stronger federal sanction: CMS stops paying for new admissions until the home corrects the problems. Avalon Villa Care Center has 3 denial periods on record totalling 67 days.
How Avalon Villa Care Center compares with peer homes
Raw citation counts mean more in context. The table below compares Avalon Villa Care Center with the median reviewed facility in Los Angeles County (181 homes in this research set) and across California (350 homes), using the same CMS data. On health citations alone, Avalon Villa Care Center sits above 92% of its reviewed county peers — near the top of the county for citation volume.
Measure
This home
Los Angeles Co. median
California median
Health citations on record
129
84
74
Citations from complaint investigations
74
31
27
Citations at actual-harm level or worse
3
3
2
Immediate-jeopardy citations
1
1
0
Total fines in CMS penalty records
$111,937
$57,906
$43,467
Penalty records (fines + payment denials)
6
3
2
What families should ask Avalon Villa Care Center
- Ask for the plan of correction and follow-up monitoring for the quality of life and daily care citations — most recently F-0689 on January 31, 2025 — and the records showing the fix held.
- Ask for the plan of correction and follow-up monitoring for the assessments and care planning citations — most recently F-0656 on January 24, 2024 — and the records showing the fix held.
- Ask for the plan of correction and follow-up monitoring for the resident rights citations — most recently F-0622 on January 31, 2025 — and the records showing the fix held.
- Ask for the plan of correction and follow-up monitoring for the food, nutrition, and hydration citations — most recently F-0812 on September 11, 2025 — and the records showing the fix held.
- Ask what conduct led to the fines — CMS records 3 totalling $111,937, the most recent dated November 21, 2025 — and what changed afterward.
- What changed in the resident's condition, and when did staff at Avalon Villa Care Center first document the change?
- Were recent complaint-related citations at Avalon Villa Care Center connected to the same kind of issue your family noticed?
Records to preserve
Connect this record to what your family saw
A citation record is context. The warning sign your family noticed is the starting point for a resident-specific review — match the two, then preserve the records listed above. Start with how facility research works.
Warning sign
Bed sores
Warning sign
Falls
Warning sign
Bruises
Warning sign
Weight loss
Facility research
Inspection deficiencies
Facility research
Civil penalties
Facility research
Abuse citations
Facility research
Complaint surveys
CMS facility facts
CMS certification number
056023
Legal business name
AVALON VILLA HEALTH CARE LLC
Ownership type
For profit - Limited Liability company
Provider type
Medicare and Medicaid
First approved for Medicare/Medicaid
November 22, 1968
Chain name
Not listed
Certified beds
131
Average residents per day
117.8
Overall CMS rating
1 star
Health inspection rating
1 star
Staffing rating
2 star
Reported nurse staffing hours per resident day
3.86357
Total nursing staff turnover
46.3%
Public records are a starting point, not a conclusion
This profile of Avalon Villa Care Center uses official CMS provider data as a research starting point. It does not state that Avalon Villa Care Center abused or neglected any resident. A citation, fine, or rating becomes meaningful only when it is compared with the resident's own chart, the facility's explanation, and source documents with dates and outcome status.
Citation and penalty detail on this page comes from the CMS Provider Data health-deficiency, fire-safety, and penalties datasets, pulled October 12, 2026. Figures describe the facility's public inspection record; they do not by themselves prove what happened to any individual resident.
Sources for Avalon Villa Care Center
Senior Justice Help is a public-information and facility-research website. We are not a law firm, medical provider, government agency, or nursing home regulator. We may help families understand what kind of lawyer to contact or connect with legal resources, but this site does not provide legal or medical advice.
Editorial review
Written and editorially reviewed for family clarity
Written by: Senior Justice Help Editorial Team, Family questions and nursing home records research team
Pages are written for families, checked against public agency sources, and reviewed for clarity, sourcing, and overclaiming. The site does not provide medical advice or legal advice.