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

COUNTRY MANOR HEALTHCARE

LAKE VIEW TERRACE, CA · 99 certified beds · Last Life Safety survey February 12, 2026

CMS Certification Number 055002 · first certified September 1968

Ownership

Operated by CHARIS TRUST DTD 12/22/16 · For profit - Limited Liability company

No change of ownership on CMS record since January 1, 2016, when the records begin.

14
Citations on file
Rolling three-year window
3
Life Safety surveys
In the same window
3
Tags cited more than once
Across separate surveys
6
Inspection & testing records
Of the citations on file

Position within CA

14 citations — more than 26% 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 9 citations; the earlier surveys in the window averaged 2.5. With 3 surveys on file this is a direction of travel, not a conclusion.

When is the next survey likely?

The window opens February 2027 — about 5 months from now. This facility’s last Life Safety survey was February 2026. 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

1 inspection-and-testing tag has 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.

Emergency preparedness

1 of the 14 citations on file is Emergency Preparedness E-tags. E-tags are cited under 42 CFR §483.73 and concern the emergency plan, training, drills, communications and supplies. Nationally about half of certified facilities have at least one. The Emergency Preparedness Index

Physical environment (health survey)

9 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 14 Life Safety citations above. The Physical Environment Index

  • F-0584 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.
  • F-0689 Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
  • 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 facility14CA median19National median11
Citations on file over three years, compared
MeasureCitations
This facility14
Median facility in CA19
Median facility nationally11

Survey history

Citations at each Life Safety survey
32023-1122024-1192026-02
Citations at each Life Safety survey
Survey dateCitations
November 3, 20233
November 8, 20242
February 12, 20269

Most-cited tags

Most-cited tags at this facility
K-09202K-03532K-03212K-03451K-03511K-02911K-03001E-00411
Most-cited tags at this facility
TagWhat the surveyor checksTimes citedLast cited
K-0920Ensure proper usage of power strips and extension cords.22026-02-12
K-0353Inspect, test, and maintain automatic sprinkler systems.22026-02-12
K-0321Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.22026-02-12
K-0345Have approved installation, maintenance and testing program for fire alarm systems.12026-02-12
K-0351Install an approved automatic sprinkler system.12024-11-08
K-0291Install emergency lighting that can last at least 1 1/2 hours.12026-02-12
K-0300Meet other general requirements that are deficient.12023-11-03
E-0041Implement emergency and standby power systems.12026-02-12

What the citations cover

Citations by CMS category
  • Smoke Deficiencies 6
  • Egress Deficiencies 3
  • Gas, Vacuum, and Electrical Systems Deficiencies 2
  • Miscellaneous Deficiencies 1
  • Other 2
Citations by CMS category
CategoryCitations
Smoke Deficiencies6
Egress Deficiencies3
Gas, Vacuum, and Electrical Systems Deficiencies2
Miscellaneous Deficiencies1
Services Deficiencies1
Emergency Preparedness Deficiencies1

Every citation on file

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

February 12, 2026 — 9 citations

Citations issued on February 12, 2026
TagWhat the surveyor checksStatus
E-0041Implement emergency and standby power systems.Deficient, Provider has date of correction (March 12, 2026)
K-0291Install emergency lighting that can last at least 1 1/2 hours.Deficient, Provider has date of correction (March 12, 2026)
K-0293Have properly located and lighted "Exit" signs.Deficient, Provider has date of correction (March 12, 2026)
K-0321Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.Deficient, Provider has date of correction (March 12, 2026)
K-0345Have approved installation, maintenance and testing program for fire alarm systems.Deficient, Provider has date of correction (March 12, 2026)
K-0353Inspect, test, and maintain automatic sprinkler systems.Deficient, Provider has date of correction (March 12, 2026)
K-0511Have properly installed electrical wiring and gas equipment.Deficient, Provider has date of correction (March 12, 2026)
K-0712Have simulated fire drills held at unexpected times.Deficient, Provider has date of correction (March 12, 2026)
K-0920Ensure proper usage of power strips and extension cords.Deficient, Provider has date of correction (March 12, 2026)

November 8, 2024 — 2 citations

Citations issued on November 8, 2024
TagWhat the surveyor checksStatus
K-0351Install an approved automatic sprinkler system.Deficient, Provider has date of correction (December 5, 2024)
K-0920Ensure proper usage of power strips and extension cords.Deficient, Provider has date of correction (December 5, 2024)

November 3, 2023 — 3 citations

Citations issued on November 3, 2023
TagWhat the surveyor checksStatus
K-0300Meet other general requirements that are deficient.Deficient, Provider has date of correction (November 28, 2023)
K-0321Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.Deficient, Provider has date of correction (November 28, 2023)
K-0353Inspect, test, and maintain automatic sprinkler systems.Deficient, Provider has date of correction (November 28, 2023)

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