01 / INSPECTION LEDGER
Survey cycles in this release
| Cycle | Health date | Health deficiencies | Fire date | Fire deficiencies |
|---|---|---|---|---|
| Cycle 1 | 2026-02-13 | 8 | 2026-02-13 | 2 |
| Cycle 2 | 2024-10-31 | 3 | 2024-10-31 | 4 |
| Cycle 3 | 2023-11-30 | 6 | 2023-11-30 | 6 |
CMS CCN 5559062026-08-01 PROCESSING DATE
NURSING HOME PUBLIC RECORD
Meadowbrook Village Christian Retirement Community
100 Holland Glen · Escondido, CA 92026 · San Diego County
Certified beds19CMS provider file
Recent citation rows29current CMS citation release
Penalty rows0current 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
29 rows in the current release
0 rows carry G–L scope/severity codes; 0 carry J–L. 5 tag codes appear on more than one survey date. These counts describe citation rows, not residents or incidents.
2026-02-13 · HEALTHF0605Severity D · isolated; potential for more than minimal harm
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Prevent the use of unnecessary psychotropic medications or use medications that may restrain a resident's ability to function.
Correction field: Deficient, Provider has date of correction · 2026-03-132026-02-13 · HEALTHF0655Severity E · pattern; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted
Correction field: Deficient, Provider has date of correction · 2026-03-132026-02-13 · HEALTHF0730Severity E · pattern; potential for more than minimal harm
Nursing and Physician Services Deficiencies
Observe each nurse aide's job performance and give regular training.
Correction field: Deficient, Provider has date of correction · 2026-03-132026-02-13 · HEALTHF0812Severity E · pattern; potential for more than minimal harm
Nutrition and Dietary Deficiencies
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Correction field: Deficient, Provider has date of correction · 2026-03-132026-02-13 · HEALTHF0825Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide or get specialized rehabilitative services as required for a resident.
Correction field: Deficient, Provider has date of correction · 2026-03-132026-02-13 · HEALTHF0865Severity D · isolated; potential for more than minimal harm
Administration Deficiencies
Have a plan that describes the process for conducting QAPI and QAA activities.
Correction field: Deficient, Provider has date of correction · 2026-03-132026-02-13 · HEALTHF0867Severity D · isolated; potential for more than minimal harm
Administration Deficiencies
Set up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action.
Correction field: Deficient, Provider has date of correction · 2026-03-132026-02-13 · 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 · 2026-03-132026-02-13 · 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 · 2026-03-062026-02-13 · 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 · 2026-03-112024-10-31 · 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 · 2024-11-152024-10-31 · FIREE0032Severity C · widespread; potential for minimal harm
Emergency Preparedness Deficiencies
Provide primary/alternate means for communication.
Correction field: Deficient, Provider has date of correction · 2024-11-152024-10-31 · HEALTHF0761Severity D · isolated; potential for more than minimal harm
Pharmacy Service Deficiencies
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.
Correction field: Deficient, Provider has date of correction · 2024-11-182024-10-31 · HEALTHF0812Severity E · pattern; potential for more than minimal harm
Nutrition and Dietary Deficiencies
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Correction field: Deficient, Provider has date of correction · 2024-11-182024-10-31 · HEALTHF0814Severity E · pattern; potential for more than minimal harm
Nutrition and Dietary Deficiencies
Dispose of garbage and refuse properly.
Correction field: Deficient, Provider has date of correction · 2024-11-182024-10-31 · 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 · 2024-11-272024-10-31 · 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 · 2024-11-272023-11-30 · HEALTHF0727Severity E · pattern; potential for more than minimal harm
Nursing and Physician Services Deficiencies
Have a registered nurse on duty 8 hours a day; and select a registered nurse to be the director of nurses on a full time basis.
Correction field: Deficient, Provider has date of correction · 2024-01-042023-11-30 · 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 · 2024-01-042023-11-30 · HEALTHF0758Severity B · pattern; potential for minimal harm
Pharmacy Service Deficiencies
Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited.
Correction field: Deficient, Provider has date of correction · 2024-01-042023-11-30 · HEALTHF0761Severity D · isolated; potential for more than minimal harm
Pharmacy Service Deficiencies
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.
Correction field: Deficient, Provider has date of correction · 2024-01-042023-11-30 · 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 · 2024-01-042023-11-30 · HEALTHF0880Severity F · widespread; 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 · 2024-01-042023-11-30 · FIREK0345Severity D · isolated; 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 · 2023-12-1503 / 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 |
|---|---|---|---|
| No penalty row appeared in the August 2026 penalties file. | |||
04 / OWNERSHIP DISCLOSURES
Who appears in the CMS file
- MEADOWBROOK VILLAGE CHRISTIAN RETIREMENT COMMUNITYOrganization · 5% OR GREATER DIRECT OWNERSHIP INTERESTNO PERCENTAGE PROVIDED · since 04/18/2017
- FRANCIS, LISAIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 09/21/2015
- MEMMELAAR, MARKIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 05/09/2008
- BROUWER, JACOBIndividual · CORPORATE OFFICERNOT APPLICABLE · since 08/02/2004
- COOPER, JOANNEIndividual · CORPORATE OFFICERNOT APPLICABLE · since 08/02/2004
- DENBOER, DERKINAIndividual · CORPORATE OFFICERNOT APPLICABLE · since 01/01/2013
- HOEKSEMA, LARRYIndividual · CORPORATE OFFICERNOT APPLICABLE · since 08/02/2004
- JANSMA, JAMESIndividual · CORPORATE OFFICERNOT APPLICABLE · since 01/01/2013
- PRINS, RONIndividual · CORPORATE OFFICERNOT APPLICABLE · since 08/02/2004
- VELDKAMP, ARNOLDIndividual · CORPORATE OFFICERNOT APPLICABLE · since 08/02/2004
- BROUWER, JACOBIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 04/18/2017
- COOPER, JOANNEIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 04/18/2017
- DENBOER, DERKINAIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 04/18/2017
- FRANCIS, LISAIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 04/18/2025
- HOEKSEMA, LARRYIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 04/18/2017
- JANSMA, JAMESIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 04/18/2017
- MEMMELAAR, MARKIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 04/18/2017
- PRINS, RONIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 04/18/2017
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 hours7.48per resident day
RN hours0.74per resident day
Weekend nurse hours6.93per resident day
Staff turnover30.0%CMS reported field
06 / LOCAL RECORDS
Open the Escondido ledger →Other published facilities nearby
Escondido Post Acute180 beds · CMS overall 5/565 citation rowsOcean View Post Acute120 beds · CMS overall 4/561 citation rowsPalomar Heights Post Acute98 beds · CMS overall 3/566 citation rowsPalomar Vista Healthcare Center74 beds · CMS overall 2/568 citation rowsRedwood Terrace Health Center59 beds · CMS overall 5/532 citation rowsValley Vista Post Acute59 beds · CMS overall 4/545 citation rows