Federal nursing home survey record · CMS-certified nursing home· Not a state assisted-living licensing record

PACIFIC HAVEN SUBACUTE AND HEALTHCARE CENTER

GARDEN GROVE, CA · 99 certified beds · Last Life Safety survey May 5, 2025

CMS Certification Number 055575 · first certified January 1980

Ownership

Operated by THE ENSIGN GROUP · For profit - Limited Liability company

  • New ownershipOwnership changed May 1, 2025 (change of ownership)from 12072 TRASK, INC.
12
Citations on file
Rolling three-year window
3
Life Safety surveys
In the same window
4
Tags cited more than once
Across separate surveys
8
Inspection & testing records
Of the citations on file

Position within CA

12 citations — more than 17% of the 1,165 certified nursing homes in CA. Compared within CA rather than nationally because which state a facility is in explains about 30% of the variation in citation counts between facilities, while bed count explains under 1%. State survey agencies differ far more than the buildings do. How this is calculated

Slippingmore citations at the latest survey than at its earlier surveys in the window.

The latest survey found 6 citations; the earlier surveys in the window averaged 3. With 3 surveys on file this is a direction of travel, not a conclusion.

When is the next survey likely?

The window is open now: May 2026 to October 2026. This facility’s last Life Safety survey was May 2025. Facilities in CA are typically surveyed 12–18 months after the last one (median 14), measured over 1,766 consecutive surveys in the last two years of CMS records.

A range the record supports, not a prediction of a date. State agencies vary widely — from about 11 months in Pennsylvania to three years in Maryland. How the window is measured

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Which alerts

3 inspection-and-testing tags have been cited here at more than one survey. Nationally, that pattern is common: about three quarters of cited facilities have at least one repeated tag, and half of the facilities ever cited for sprinkler inspection and testing are cited for it again. A repeat is usually a recordkeeping gap rather than a new hazard.

Physical environment (health survey)

3 physical-environment citations on the health survey. Cited by the health surveyors under Appendix PP, not the Life Safety Code surveyor: equipment in safe operating condition, the call system, bed rails, pest control, hazards, the environment. Counted separately from the 12 Life Safety citations above. The Physical Environment Index

  • F-0880 Provide and implement an infection prevention and control program.
  • F-0908 Keep all essential equipment working safely.

How that compares

Citations on file over three years

Compared with the median facility in CA, and nationally. Surveyors differ markedly between states, so the CA figure is the meaningful one.

This facility12CA median19National median11
Citations on file over three years, compared
MeasureCitations
This facility12
Median facility in CA19
Median facility nationally11

Survey history

Citations at each Life Safety survey
42022-1122024-0462025-05
Citations at each Life Safety survey
Survey dateCitations
November 23, 20224
April 11, 20242
May 5, 20256

Most-cited tags

Most-cited tags at this facility
K-03632K-03742K-03532K-05112K-03421K-09111K-07121K-03551
Most-cited tags at this facility
TagWhat the surveyor checksTimes citedLast cited
K-0363Install corridor and hallway doors that block smoke.22025-05-05
K-0374Install smoke barrier doors that can resist smoke for at least 20 minutes.22025-05-05
K-0353Inspect, test, and maintain automatic sprinkler systems.22025-05-05
K-0511Have properly installed electrical wiring and gas equipment.22024-04-11
K-0342Have a complete alarm system manually initiated and initiated by fire sprinkler system connection.12025-05-05
K-0911Meet requirements for the installation and maintenance of electrical systems.12025-05-05
K-0712Have simulated fire drills held at unexpected times.12024-04-11
K-0355Properly select, install, inspect, or maintain portable fire extinguishes.12025-05-05

What the citations cover

Citations by CMS category
  • Smoke Deficiencies 8
  • Services Deficiencies 2
  • Gas, Vacuum, and Electrical Systems Deficiencies 1
  • Miscellaneous Deficiencies 1
Citations by CMS category
CategoryCitations
Smoke Deficiencies8
Services Deficiencies2
Gas, Vacuum, and Electrical Systems Deficiencies1
Miscellaneous Deficiencies1

Every citation on file

As published by CMS, newest survey first. Descriptions are CMS’s own wording.

May 5, 2025 — 6 citations

Citations issued on May 5, 2025
TagWhat the surveyor checksStatus
K-0342Have a complete alarm system manually initiated and initiated by fire sprinkler system connection.Deficient, Provider has date of correction (May 24, 2025)
K-0353Inspect, test, and maintain automatic sprinkler systems.Deficient, Provider has date of correction (May 24, 2025)
K-0355Properly select, install, inspect, or maintain portable fire extinguishes.Deficient, Provider has date of correction (May 24, 2025)
K-0363Install corridor and hallway doors that block smoke.Deficient, Provider has date of correction (May 24, 2025)
K-0374Install smoke barrier doors that can resist smoke for at least 20 minutes.Deficient, Provider has date of correction (May 24, 2025)
K-0911Meet requirements for the installation and maintenance of electrical systems.Deficient, Provider has date of correction (May 24, 2025)

April 11, 2024 — 2 citations

Citations issued on April 11, 2024
TagWhat the surveyor checksStatus
K-0511Have properly installed electrical wiring and gas equipment.Deficient, Provider has date of correction (April 26, 2024)
K-0712Have simulated fire drills held at unexpected times.Deficient, Provider has date of correction (April 26, 2024)

November 23, 2022 — 4 citations

Citations issued on November 23, 2022
TagWhat the surveyor checksStatus
K-0353Inspect, test, and maintain automatic sprinkler systems.Deficient, Provider has date of correction (December 9, 2022)
K-0363Install corridor and hallway doors that block smoke.Deficient, Provider has date of correction (December 9, 2022)
K-0374Install smoke barrier doors that can resist smoke for at least 20 minutes.Deficient, Provider has date of correction (December 9, 2022)
K-0511Have properly installed electrical wiring and gas equipment.Deficient, Provider has date of correction (December 9, 2022)

Reflects the CMS posting of August 1, 2026. Surveys conducted in the last few months may not appear yet.