01 / INSPECTION LEDGER
Survey cycles in this release
| Cycle | Health date | Health deficiencies | Fire date | Fire deficiencies |
|---|---|---|---|---|
| Cycle 1 | 2025-08-14 | 40 | 2025-08-14 | 15 |
| Cycle 2 | 2024-09-12 | 24 | 2024-09-12 | 16 |
| Cycle 3 | 2023-03-09 | 8 | 2023-03-09 | 12 |
CMS CCN 0561982026-08-01 PROCESSING DATE
NURSING HOME PUBLIC RECORD
Kit Carson Nursing & Rehabilitation Center
811 Court Street · Jackson, CA 95642 · Amador County
Certified beds199CMS provider file
Recent citation rows115current CMS citation release
Penalty rows4current 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
115 rows in the current release
5 rows carry G–L scope/severity codes; 0 carry J–L. 25 tag codes appear on more than one survey date. These counts describe citation rows, not residents or incidents.
2026-05-08 · HEALTHF0656Severity D · isolated; potential for more than minimal harm
Resident 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.
Correction field: Deficient, Provider has date of correction · 2026-05-24 · complaint2026-04-22 · HEALTHF0550Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
Correction field: Deficient, Provider has date of correction · 2026-04-28 · complaint2026-04-22 · HEALTHF0558Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Reasonably accommodate the needs and preferences of each resident.
Correction field: Deficient, Provider has date of correction · 2026-04-28 · complaint2026-04-15 · HEALTHF0755Severity D · isolated; potential for more than minimal harm
Pharmacy Service Deficiencies
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
Correction field: Deficient, Provider has date of correction · 2026-04-25 · complaint2026-03-30 · HEALTHF0684Severity G · isolated actual 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 · 2026-04-27 · complaint2026-03-30 · HEALTHF0692Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide enough food/fluids to maintain a resident's health.
Correction field: Deficient, Provider has date of correction · 2026-04-27 · complaint2026-03-30 · HEALTHF0725Severity F · widespread; potential for more than minimal harm
Nursing and Physician Services Deficiencies
Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.
Correction field: Deficient, Provider has date of correction · 2026-04-27 · complaint2026-03-30 · HEALTHF0755Severity D · isolated; potential for more than minimal harm
Pharmacy Service Deficiencies
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
Correction field: Deficient, Provider has date of correction · 2026-04-27 · complaint2026-03-30 · 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 · 2026-04-27 · complaint2026-03-17 · HEALTHF0656Severity D · isolated; potential for more than minimal harm
Resident 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.
Correction field: Deficient, Provider has date of correction · 2026-04-10 · complaint2026-03-17 · HEALTHF0880Severity D · isolated; 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 · 2026-04-10 · complaint2026-03-10 · HEALTHF0684Severity G · isolated actual 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 · 2026-04-10 · complaint2026-03-10 · HEALTHF0710Severity D · isolated; potential for more than minimal harm
Nursing and Physician Services Deficiencies
Obtain a doctor's order to admit a resident and ensure the resident is under a doctor's care.
Correction field: Deficient, Provider has date of correction · 2026-04-10 · complaint2026-02-19 · HEALTHF0580Severity G · isolated actual harm
Resident Rights Deficiencies
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
Correction field: Deficient, Provider has date of correction · 2026-03-19 · complaint2026-02-19 · HEALTHF0657Severity D · isolated; potential for more than minimal harm
Resident 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.
Correction field: Deficient, Provider has date of correction · 2026-04-10 · complaint2026-02-19 · 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 · 2026-03-19 · complaint2026-02-19 · 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 · 2026-04-10 · complaint2026-01-06 · HEALTHF0656Severity D · isolated; potential for more than minimal harm
Resident 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.
Correction field: Deficient, Provider has date of correction · 2026-02-05 · complaint2025-12-03 · HEALTHF0550Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
Correction field: Deficient, Provider has date of correction · 2026-01-03 · complaint2025-08-20 · HEALTHF0690Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.
Correction field: Deficient, Provider has date of correction · 2025-09-19 · complaint2025-08-14 · FIREE0004Severity C · widespread; potential for minimal harm
Emergency Preparedness Deficiencies
Develop and maintain an Emergency Preparedness Program (EP).
Correction field: Deficient, Provider has date of correction · 2025-08-202025-08-14 · FIREE0013Severity C · widespread; potential for minimal harm
Emergency Preparedness Deficiencies
Develop Emergency Preparedness policies and procedures.
Correction field: Deficient, Provider has date of correction · 2025-08-202025-08-14 · FIREE0029Severity C · widespread; potential for minimal harm
Emergency Preparedness Deficiencies
Develop a communication plan.
Correction field: Deficient, Provider has date of correction · 2025-08-202025-08-14 · FIREE0030Severity C · widespread; potential for minimal harm
Emergency Preparedness Deficiencies
List the names and contact information of those in the facility.
Correction field: Deficient, Provider has date of correction · 2025-08-2003 / 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 |
|---|---|---|---|
| 2026-02-19 | Fine | $9,347 | 0 |
| 2026-02-19 | Fine | $9,870 | 0 |
| 2026-02-19 | Payment Denial | $0 | 17 |
| 2025-03-28 | Fine | $9,110 | 0 |
04 / OWNERSHIP DISCLOSURES
Who appears in the CMS file
- CHEN, JENQIndividual · 5% OR GREATER DIRECT OWNERSHIP INTEREST100% · since 08/04/2004
- PADAMA, JOHNIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 10/02/2017
- CHEN, JENQIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 11/23/2017
- CHEN, TZE-YUNIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 05/23/2017
- HAWKINS, DOUGLASIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 04/11/2025
- SMITH, GREGORYIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 02/03/2017
- HAWKINS, DOUGLASIndividual · ADP OF THE SNFNOT APPLICABLE · since 04/17/2025
- SMITH, GREGORYIndividual · ADP OF THE SNFNOT APPLICABLE · since 02/03/2017
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 hours4.64per resident day
RN hours0.83per resident day
Weekend nurse hours3.83per resident day
Staff turnover54.6%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.