01 / INSPECTION LEDGER
Survey cycles in this release
| Cycle | Health date | Health deficiencies | Fire date | Fire deficiencies |
|---|---|---|---|---|
| Cycle 1 | 2025-12-18 | 4 | 2025-12-18 | 11 |
| Cycle 2 | 2024-10-17 | 6 | 2024-10-17 | 4 |
| Cycle 3 | 2022-01-10 | 13 | 2022-01-10 | 13 |
CMS CCN 5554762026-08-01 PROCESSING DATE
NURSING HOME PUBLIC RECORD
Apple Valley Care Center
11959 Apple Valley Rd · Apple Valley, CA 92308 · San Bernardino County
Certified beds99CMS provider file
Recent citation rows51current CMS citation release
Penalty rows1current CMS penalties file
Read this record carefully.
The citation files cover the three most recent standard inspections plus qualifying complaint and infection-control inspections in the prior three years. A correction date is a CMS field; this site does not independently verify conditions. Absence from a file is not proof that no issue exists.
02 / CITATION DETAIL
51 rows in the current release
1 rows carry G–L scope/severity codes; 1 carry J–L. 11 tag codes appear on more than one survey date. These counts describe citation rows, not residents or incidents.
2026-03-12 · HEALTHF0675Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Honor each resident's preferences, choices, values and beliefs.
Correction field: Deficient, Provider has date of correction · 2026-03-30 · complaint2026-01-21 · HEALTHF0684Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Correction field: Deficient, Provider has date of correction · 2026-01-30 · complaint2025-12-18 · HEALTHF0880Severity E · pattern; potential for more than minimal harm
Infection Control Deficiencies
Provide and implement an infection prevention and control program.
Correction field: Deficient, Provider has date of correction · 2026-01-162025-12-18 · FIREK0161Severity D · isolated; potential for more than minimal harm
Construction Deficiencies
Use approved construction type or materials.
Correction field: Deficient, Provider has date of correction · 2026-01-152025-12-18 · FIREK0293Severity F · widespread; potential for more than minimal harm
Egress Deficiencies
Have properly located and lighted "Exit" signs.
Correction field: Deficient, Provider has date of correction · 2026-01-152025-12-18 · FIREK0324Severity D · isolated; potential for more than minimal harm
Smoke Deficiencies
Provide properly protected cooking facilities.
Correction field: Deficient, Provider has date of correction · 2026-01-152025-12-18 · FIREK0345Severity F · widespread; potential for more than minimal harm
Smoke Deficiencies
Have approved installation, maintenance and testing program for fire alarm systems.
Correction field: Deficient, Provider has date of correction · 2026-01-152025-12-18 · FIREK0347Severity F · widespread; potential for more than minimal harm
Smoke Deficiencies
Properly provide smoke detection systems in areas open to corridors.
Correction field: Deficient, Provider has date of correction · 2026-01-152025-12-18 · FIREK0353Severity F · widespread; potential for more than minimal harm
Smoke Deficiencies
Inspect, test, and maintain automatic sprinkler systems.
Correction field: Deficient, Provider has date of correction · 2026-01-222025-12-18 · FIREK0355Severity F · widespread; potential for more than minimal harm
Smoke Deficiencies
Properly select, install, inspect, or maintain portable fire extinguishes.
Correction field: Deficient, Provider has date of correction · 2025-12-302025-12-18 · FIREK0511Severity F · widespread; potential for more than minimal harm
Services Deficiencies
Have properly installed electrical wiring and gas equipment.
Correction field: Deficient, Provider has date of correction · 2026-01-152025-12-18 · FIREK0712Severity F · widespread; potential for more than minimal harm
Miscellaneous Deficiencies
Have simulated fire drills held at unexpected times.
Correction field: Deficient, Provider has date of correction · 2026-01-152025-12-18 · FIREK0741Severity D · isolated; potential for more than minimal harm
Miscellaneous Deficiencies
Have posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed.
Correction field: Deficient, Provider has date of correction · 2026-01-152025-12-18 · FIREK0918Severity F · widespread; potential for more than minimal harm
Gas, Vacuum, and Electrical Systems Deficiencies
Have generator or other power source capable of supplying service within 10 seconds.
Correction field: Deficient, Provider has date of correction · 2026-01-262025-11-18 · HEALTHF0919Severity D · isolated; potential for more than minimal harm
Environmental Deficiencies
Make sure that a working call system is available in each resident's bathroom and bathing area.
Correction field: Deficient, Provider has date of correction · 2025-12-01 · complaint2025-06-09 · HEALTHF0684Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Correction field: Deficient, Provider has date of correction · 2025-06-19 · complaint2025-01-30 · HEALTHF0842Severity D · isolated; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
Correction field: Deficient, Provider has date of correction · 2025-02-14 · complaint2024-10-17 · HEALTHF0585Severity F · widespread; potential for more than minimal harm
Resident Rights Deficiencies
Honor the resident's right to voice grievances without discrimination or reprisal and the facility must establish a grievance policy and make prompt efforts to resolve grievances.
Correction field: Deficient, Provider has date of correction · 2024-11-152024-10-17 · HEALTHF0641Severity D · isolated; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Ensure each resident receives an accurate assessment.
Correction field: Deficient, Provider has date of correction · 2024-11-152024-10-17 · HEALTHF0756Severity D · isolated; potential for more than minimal harm
Pharmacy 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.
Correction field: Deficient, Provider has date of correction · 2024-11-152024-10-17 · HEALTHF0759Severity D · isolated; potential for more than minimal harm
Pharmacy Service Deficiencies
Ensure medication error rates are not 5 percent or greater.
Correction field: Deficient, Provider has date of correction · 2024-11-152024-10-17 · FIREK0345Severity F · widespread; potential for more than minimal harm
Smoke Deficiencies
Have approved installation, maintenance and testing program for fire alarm systems.
Correction field: Deficient, Provider has date of correction · 2024-11-082024-10-17 · FIREK0521Severity F · widespread; potential for more than minimal harm
Services Deficiencies
Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.
Correction field: Deficient, Provider has date of correction · 2024-11-082024-10-17 · FIREK0712Severity F · widespread; potential for more than minimal harm
Miscellaneous Deficiencies
Have simulated fire drills held at unexpected times.
Correction field: Deficient, Provider has date of correction · 2024-11-0803 / ENFORCEMENT FILE
Penalties reported by CMS
Fine amounts and payment-denial days are shown exactly as aggregated from the current penalties file. They do not imply an unpaid balance.
| Date | Type | Fine amount | Payment-denial days |
|---|---|---|---|
| 2024-01-17 | Fine | $8,021 | 0 |
04 / OWNERSHIP DISCLOSURES
Who appears in the CMS file
- LEHMANN, KENNETHIndividual · 5% OR GREATER DIRECT OWNERSHIP INTEREST28% · since 10/01/2019
- BAK, ABRAHAMIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 05/13/2020
- ESCOBAR, JAY ANNEIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 03/09/2015
- GASTWIRTH, MENACHEMIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 05/13/2020
- LEHMANN, KENNETHIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 05/13/2020
- SIDDIQUI, IMRANIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 05/13/2020
- 11959 APPLE VALLEY ROAD, LLCOrganization · ADP OF THE SNFNOT APPLICABLE · since 09/26/2013
- ABAK CONSULTING LLCOrganization · ADP OF THE SNFNOT APPLICABLE · since 12/27/2021
- MAYER 2005 REVOCABLE TRUSTOrganization · ADP OF THE SNFNOT APPLICABLE · since 07/01/2014
- MGAZ CONSULTING LLCOrganization · ADP OF THE SNFNOT APPLICABLE · since 12/27/2021
- BAK, ABRAHAMIndividual · ADP OF THE SNFNOT APPLICABLE · since 09/26/2013
- ESCOBAR, JAY ANNEIndividual · ADP OF THE SNFNOT APPLICABLE · since 04/08/2025
- GASTWIRTH, MENACHEMIndividual · ADP OF THE SNFNOT APPLICABLE · since 09/26/2013
- GEWIRTZ, CHONOCHIndividual · ADP OF THE SNFNOT APPLICABLE · since 05/13/2020
- LEHMANN, KENNETHIndividual · ADP OF THE SNFNOT APPLICABLE · since 05/13/2020
- MAYER, HELENEIndividual · ADP OF THE SNFNOT APPLICABLE · since 09/26/2013
- MAYER, RONALDIndividual · ADP OF THE SNFNOT APPLICABLE · since 09/26/2013
- SIDDIQUI, IMRANIndividual · ADP OF THE SNFNOT APPLICABLE · since 05/13/2020
Names and roles are self-reported CMS disclosure fields. Exact-name pages do not prove that similarly named people or organizations are the same entity.
05 / CMS STAFFING FIELDS
Reported hours and turnover
Staffing fields are provider-reported and case-mix context matters. CMS applies footnotes and exclusions not reproduced as a new score here.
Total nurse hours4.85per resident day
RN hours0.56per resident day
Weekend nurse hours4.01per resident day
Staff turnover35.1%CMS reported field
06 / LOCAL RECORDS
Open the California ledger →Other published facilities nearby
No second facility in the same city met the directory rule.