01 / INSPECTION LEDGER
Survey cycles in this release
| Cycle | Health date | Health deficiencies | Fire date | Fire deficiencies |
|---|---|---|---|---|
| Cycle 1 | 2025-08-28 | 7 | 2025-08-28 | 8 |
| Cycle 2 | 2023-09-01 | 5 | 2023-09-01 | 5 |
| Cycle 3 | 2019-11-08 | 3 | 2019-11-08 | 5 |
CMS CCN 5557932026-08-01 PROCESSING DATE
NURSING HOME PUBLIC RECORD
Vi At La Jolla Village
4171 Las Palmas Square · San Diego, CA 92122 · San Diego County
Certified beds60CMS provider file
Recent citation rows33current 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
33 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.
2025-08-28 · FIREE0006Severity C · widespread; potential for minimal harm
Emergency Preparedness Deficiencies
Conduct risk assessment and an All-Hazards approach.
Correction field: Deficient, Provider has date of correction · 2025-09-102025-08-28 · FIREE0041Severity F · widespread; potential for more than minimal harm
Emergency Preparedness Deficiencies
Implement emergency and standby power systems.
Correction field: Deficient, Provider has date of correction · 2025-09-062025-08-28 · HEALTHF0552Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Ensure that residents are fully informed and understand their health status, care and treatments.
Correction field: Deficient, Provider has date of correction · 2025-09-102025-08-28 · 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 · 2025-09-102025-08-28 · HEALTHF0679Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide activities to meet all resident's needs.
Correction field: Deficient, Provider has date of correction · 2025-09-102025-08-28 · 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 · 2025-09-102025-08-28 · HEALTHF0757Severity D · isolated; potential for more than minimal harm
Pharmacy Service Deficiencies
Ensure each resident’s drug regimen must be free from unnecessary drugs.
Correction field: Deficient, Provider has date of correction · 2025-09-102025-08-28 · 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 · 2025-09-102025-08-28 · 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 · 2025-09-032025-08-28 · FIREK0355Severity D · isolated; 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 · 2025-09-042025-08-28 · FIREK0363Severity D · isolated; potential for more than minimal harm
Smoke Deficiencies
Install corridor and hallway doors that block smoke.
Correction field: Deficient, Provider has date of correction · 2025-09-032025-08-28 · FIREK0521Severity D · isolated; 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 · 2025-09-032025-08-28 · FIREK0711Severity E · pattern; potential for more than minimal harm
Miscellaneous Deficiencies
Provide a written emergency evacuation plan.
Correction field: Deficient, Provider has date of correction · 2025-09-032025-08-28 · FIREK0914Severity F · widespread; potential for more than minimal harm
Gas, Vacuum, and Electrical Systems Deficiencies
Ensure receptacles at patient bed locations and where general anesthesia is administered, are tested after initial installation, replacement or servicing.
Correction field: Deficient, Provider has date of correction · 2025-09-082025-08-12 · HEALTHF0583Severity E · pattern; potential for more than minimal harm
Resident Rights Deficiencies
Keep residents' personal and medical records private and confidential.
Correction field: Deficient, Provider has date of correction · 2025-08-27 · complaint2025-05-07 · HEALTHF0760Severity D · isolated; potential for more than minimal harm
Pharmacy Service Deficiencies
Ensure that residents are free from significant medication errors.
Correction field: Deficient, Provider has date of correction · 2025-05-25 · complaint2023-10-19 · HEALTHF0609Severity D · isolated; potential for more than minimal harm
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
Correction field: Deficient, Provider has date of correction · 2023-10-20 · complaint2023-09-22 · HEALTHF0656Severity E · pattern; 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 · 2023-10-06 · complaint2023-09-01 · 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 · 2023-09-292023-09-01 · 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 · 2023-09-292023-09-01 · 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 · 2023-09-292023-09-01 · 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 · 2023-09-292023-09-01 · FIREK0161Severity F · widespread; potential for more than minimal harm
Construction Deficiencies
Use approved construction type or materials.
Correction field: Deficient, Provider has date of correction · 2023-08-092023-09-01 · FIREK0347Severity E · pattern; 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 · 2023-08-0903 / 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
- CC LA JOLLA LLCOrganization · 5% OR GREATER DIRECT OWNERSHIP INTEREST100% · since 04/03/1998
- CC DEVELOPMENT GROUP II LLCOrganization · 5% OR GREATER INDIRECT OWNERSHIP INTERESTNO PERCENTAGE PROVIDED · since 05/01/2026
- CC LIVING HOLDING COMPANY LLCOrganization · 5% OR GREATER INDIRECT OWNERSHIP INTERESTNO PERCENTAGE PROVIDED · since 05/01/2026
- COPE, TARAIndividual · CORPORATE OFFICERNOT APPLICABLE · since 05/01/2026
- CLASSIC RESIDENCE MANAGEMENT LIMITED PARTNERSHIPOrganization · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 10/26/2005
- BLYS, ELLENIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 10/26/2015
- BOUDREAU, STEPHANIEIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 03/15/2011
- EVRAETS, MELISSAIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 08/31/2020
- KOSZYLKO, TOMEKIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 10/15/2018
- MASLOW, CARYIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 08/01/2019
- MUSZYNSKI, THOMASIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 06/01/2022
- PATTERSON, AMYIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 02/13/2023
- RAWI, TAIBIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 02/01/2019
- SMITH, GARYIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 06/01/2022
- WHITE, KELLYIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 04/21/2024
- WILLIAMS, BRIDGETIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 12/01/2022
- CLASSIC RESIDENCE MANAGEMENT LIMITED PARTNERSHIPOrganization · ADP OF THE SNFNOT APPLICABLE · since 09/25/2025
- BLYS, ELLENIndividual · ADP OF THE SNFNOT APPLICABLE · since 10/26/2015
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 hours5.24per resident day
RN hours1.08per resident day
Weekend nurse hours4.81per resident day
Staff turnover25.6%CMS reported field
06 / LOCAL RECORDS
Open the San Diego ledger →Other published facilities nearby
Arroyo Vista Nursing Center53 beds · CMS overall 5/540 citation rowsBalboa Nursing & Rehabilitation Center194 beds · CMS overall 4/572 citation rowsBayshire Torrey Pines Post-Acute45 beds · CMS overall 5/577 citation rowsBrighton Place San Diego99 beds · CMS overall 1/574 citation rowsCarmel Mountain Rehabilitation & Healthcare Center120 beds · CMS overall 3/570 citation rowsCasa De Las Campanas99 beds · CMS overall 2/568 citation rowsGolden Hill Post Acute99 beds · CMS overall 3/568 citation rowsHelen Bernardy Center D/P Snf43 beds · CMS overall 5/525 citation rows