Not rated by CMS — ratings are suppressed for new or low-volume facilities.
The next survey window likely opens around October 2026
Estimate from public CMS data, current as of June 2026. Survey timing is at the state agency's discretion.
Citation history
Health deficiencies cited at Granada Hills Convalescent during CMS and state inspections, most recent first.
The facility failed to ensure residents were free from physical restraints by not obtaining physician orders, performing assessments, or obtaining informed consent for bed placement against the wall, affecting six residents with various medical conditions.
A facility failed to rotate insulin injection sites for four residents, leading to potential skin trauma. Despite policies and guidelines emphasizing site rotation, insulin was repeatedly administered in the same areas, confirmed by the DON. This oversight affected residents with type 2 diabetes and other conditions, risking skin discoloration and swelling.
The facility failed to ensure a safe environment by improperly using fall mats and not securing equipment. Several residents' fall mats were obstructed by heavy items, reducing their effectiveness and increasing injury risk. Additionally, a portable AC unit's panel was not secured, posing a hazard in a resident's room.
The facility failed to ensure proper rotation of insulin injection sites for several residents, leading to significant medication errors. The DON confirmed that licensed nurses did not adhere to the facility's policy and manufacturer's guidelines, resulting in repeated injections in the same areas, which could cause skin trauma.
The facility failed to maintain an effective infection prevention and control program, resulting in several deficiencies. A resident's nasal cannula oxygen tubing was not labeled with the date it was last changed, and another resident's oxygen tubing was found on the floor. Enteral feeding kits were improperly stored, and a glucometer was not cleaned after use. Additionally, water temperatures were below recommended levels to prevent Legionella growth.
A resident with dementia and impaired cognition had their call light inaccessible, caught between the mattress and siderail, contrary to the care plan and facility policy. The DON confirmed the call light should have been within reach to ensure timely assistance.
A resident receiving enteral feeding was at risk of contamination due to the facility's failure to cap the Y adapter tubing when not in use. The resident, with conditions including GERD and dysphagia, was unable to make decisions or communicate effectively. The facility's policy required capping the tubing to prevent infection, which was not followed, as confirmed by the LVN and DON.
A facility failed to provide appropriate respiratory care for a resident by not obtaining a physician's order for the use of a BIPAP machine and allowing the BIPAP mask and tubing to be on the floor, risking respiratory infection. The resident had acute respiratory conditions requiring careful management, but the care plan did not include BIPAP use, contrary to facility policy.
A resident with dementia and gastrostomy status was at risk due to a failure in medication administration via G-tube. The facility's policy required flushing the tube with water between medications to prevent drug interactions. However, an LVN was observed not following this procedure, which was confirmed by the DON. This oversight could lead to health complications for the resident.
A resident's drug regimen was not adequately monitored for adverse effects of the anticoagulant Apixaban. Despite a care plan intervention to monitor for symptoms like discolored urine and black tarry stools, this was not done as it was not included in the MAR. The DON confirmed the absence of monitoring orders, contrary to the facility's anticoagulation policy.
The facility failed to discard nine boxes of expired BinaxNOW COVID-19 Antigen Self-Test kits, increasing the risk of misdiagnosis and delayed care. An LVN and the DON acknowledged the oversight, and the IP confirmed the kits were past the expiration extension set by the CDC. The facility's policy requires regular checks and proper disposal of expired products.
A resident with severe cognitive impairment and total dependence on staff did not receive prescribed restorative nursing assistance due to an inaccurate entry in the electronic health record. The charge nurse failed to correctly enter the order for splint application, resulting in the order not appearing in the restorative record flowsheet. This led to a delay in care as the assigned RNA was unaware of the new order.
The facility failed to meet the federal requirement of 80 square feet per resident in 19 rooms, although residents and staff reported no issues with space. A waiver was submitted, asserting adequate space for care and mobility. A portable HVAC unit was noted to crowd one resident's room, but staff reported no difficulties in performing duties.
Failure to Obtain Proper Authorization for Bed Placement as Restraint
Penalty
Summary
The facility failed to ensure that residents were free from the use of physical restraints unless needed for medical treatment. This deficiency was identified for six out of nine sampled residents during a review of the physical restraints care area. The facility did not obtain a physician's order, perform an assessment, develop a care plan, or obtain informed consent for the placement of beds against the wall, which restricted the residents' freedom of movement and violated their rights. For Resident 10, the facility admitted the resident with diagnoses including dementia, low back pain, and psychosis. The resident had severely impaired cognition and required assistance with activities of daily living. Observations revealed that the resident's bed was placed against the wall, restricting movement. The facility did not have a care plan addressing this placement, nor was there a physician's order or informed consent obtained. Similar deficiencies were noted for Residents 31, 6, 15, 32, and 25, who had various medical conditions and required different levels of assistance. In each case, the bed placement against the wall was considered a restraint, and the necessary assessments and consents were not completed. The facility's policy on the use of restraints, last reviewed in April 2024, defines physical restraints and outlines the requirements for their use, including a physician's order and informed consent. However, the facility did not adhere to these policies, as evidenced by the lack of documentation and assessments for the residents involved. Interviews with staff, including the Director of Nursing, confirmed that the bed placement against the wall was considered a restraint and that the appropriate procedures were not followed.
Failure to Rotate Insulin Injection Sites
Penalty
Summary
The facility failed to adhere to professional standards of care by not rotating insulin injection sites for four residents, leading to potential adverse effects. Resident 11, admitted with type 2 diabetes mellitus and other conditions, received insulin injections repeatedly in the same areas of the abdomen over several weeks. This practice was against the facility's policy and the manufacturer's guidelines, which both emphasized the importance of rotating injection sites to prevent skin trauma and other complications. Similarly, Resident 144, who also had type 2 diabetes and chronic kidney disease, received insulin injections in the same area of the abdomen on consecutive days. The Director of Nursing (DON) confirmed that the licensed nurses failed to rotate the injection sites, which could lead to skin discoloration, swelling, and trauma. The facility's policy and the manufacturer's guidelines both required site rotation to minimize skin injury. Residents 33 and 28 experienced the same issue, with insulin injections administered repeatedly in the same areas. Resident 33, with type 2 diabetes and heart failure, and Resident 28, with type 2 diabetes and impaired cognition, both had their insulin administered without proper site rotation. The DON acknowledged the oversight and reiterated the necessity of rotating injection sites to prevent skin damage, as outlined in the facility's policy and the manufacturer's instructions.
Improper Use of Fall Mats and Unsecured Equipment in Resident Rooms
Penalty
Summary
The facility failed to maintain a safe environment free from accident hazards for several residents by improperly using fall mats. For multiple residents, including those with high fall risk and cognitive impairments, fall mats were obstructed by heavy medical equipment and furniture, such as side tables and oxygen concentrators. This improper placement compromised the mats' effectiveness, as the weight of the items caused permanent indentations, reducing the mats' ability to cushion falls and increasing the risk of injury if residents were to fall onto the equipment or furniture. In one instance, a resident with a history of falls and cognitive impairments was found with a wheelchair and overbed table placed on top of their fall mat. The Director of Nursing confirmed that such placement could damage the mat and diminish its protective function. Similarly, another resident's fall mat was obstructed by a side table and an oxygen concentrator, which was acknowledged by both a Certified Nursing Assistant and the Director of Nursing as a practice that could lead to increased injury risk during a fall. Additionally, the facility failed to secure a portable air conditioning unit's exhaust panel in a resident's room, posing a potential hazard. The panel, which was part of the installation kit, was not properly secured and fell onto the resident's bed. This oversight was recognized by the Maintenance Supervisor and the Director of Nursing, who both stated that the panel should have been secured to prevent it from falling and causing injury.
Failure to Rotate Insulin Injection Sites
Penalty
Summary
The facility failed to ensure that residents were free from significant medication errors, specifically in the administration of insulin. The deficiency was identified during a review of insulin care for four residents, where it was found that licensed nurses did not rotate subcutaneous insulin administration sites as required. This practice is contrary to the facility's policy and procedure, which mandates the rotation of injection sites to prevent skin trauma and other adverse effects. The Director of Nursing (DON) confirmed that the failure to rotate injection sites constitutes a medication error. Resident 11, admitted with type 2 diabetes mellitus and other conditions, received insulin injections repeatedly in the same areas of the abdomen over several months. The DON acknowledged multiple instances where the licensed nurses failed to rotate the injection sites, which is against the facility's guidelines and the manufacturer's instructions. Similar issues were found with Resident 144, who also received insulin injections in the same area without proper site rotation, as confirmed by the DON. Residents 33 and 28 also experienced similar deficiencies in insulin administration. Resident 33's records showed repeated insulin injections in the same abdominal areas, while Resident 28's records indicated repeated injections in the upper arm and abdomen without proper rotation. The DON verified these findings and reiterated that the licensed nurses should have rotated the injection sites to prevent skin trauma, as per the facility's policy and the manufacturer's guidelines.
Infection Control Deficiencies in LTC Facility
Penalty
Summary
The facility failed to maintain an effective infection prevention and control program, as evidenced by several deficiencies observed during the survey. One deficiency involved Resident 15, whose nasal cannula oxygen tubing was not labeled with the date it was last changed. This oversight was confirmed by a Certified Nursing Assistant (CNA) who acknowledged that the tubing should be changed daily. The Director of Nursing (DON) also confirmed that the staff should date the oxygen tubing to ensure timely replacement for infection control purposes. Another deficiency was observed with Resident 32, whose nasal cannula oxygen tubing was found on the floor, and the nebulizer tubing was not labeled with the date it was last changed. The Infection Preventionist (IP) and the DON both stated that the oxygen tubing should be kept off the floor and replaced if it touches the floor to prevent infection. Additionally, the nebulizer tubing should be dated to track when it needs to be changed. Further deficiencies included the improper storage of enteral feeding kits, as two opened kits were mixed with unopened ones in the medication room, which should have been discarded to prevent infection. A Licensed Vocational Nurse (LVN) failed to clean a glucometer with an antiseptic wipe after use, which is necessary to prevent the spread of bloodborne diseases. Lastly, the facility's water temperature logs indicated temperatures below the recommended level to prevent Legionella growth, with consistent readings of 109 degrees Fahrenheit, which predisposes the facility's water system to developing Legionella.
Call Light Accessibility Deficiency
Penalty
Summary
The facility failed to ensure that a pad call light was within reach for one resident, which could potentially delay care and services. The resident, who was admitted with diagnoses including dementia, depression, and mild protein-calorie nutrition, had severely impaired cognition and required substantial assistance with activities of daily living. The resident's care plan included an intervention to place the call light within reach due to the risk of falls related to balance problems and mental status. During an observation, the call light was found caught between the mattress and the siderail, not within the resident's reach. The Director of Nursing acknowledged that the call light should have been accessible to the resident. The facility's policy stated that the call system should be functional and within reach at all times, with calls for assistance answered promptly. However, this policy was not adhered to in this instance, leading to the deficiency.
Failure to Cap Feeding Tube Y Adapter
Penalty
Summary
The facility failed to ensure appropriate care for a resident receiving enteral feeding, leading to a potential contamination risk. The deficiency was identified during an observation where a resident's feeding tube was found disconnected and the Y adapter tubing was not capped. This was contrary to the facility's policy, which requires that tubing be capped when not in use to prevent infection. The Licensed Vocational Nurse (LVN) acknowledged that the tubing should have been capped or placed in a clean plastic bag for infection control. The resident involved had been admitted with diagnoses including gastro-esophageal reflux disease and dysphagia, and was receiving continuous gastrostomy tube feeding. The resident's medical records indicated they lacked the capacity to make decisions and rarely had the ability to communicate effectively. The Director of Nursing confirmed that the Y adapter should be capped when not in use to prevent gastrointestinal infection, aligning with the facility's policy on enteral feeding safety precautions.
Failure to Ensure Proper Respiratory Care for a Resident
Penalty
Summary
The facility failed to provide appropriate respiratory care for a resident, identified as Resident 32, who required the use of a bilevel positive airway pressure (BIPAP) machine. The deficiency was identified during a survey where it was observed that there was no physician's order for the use of the BIPAP machine for Resident 32. This lack of a physician's order is critical as it ensures the machine is set correctly to provide the necessary therapy. Additionally, the BIPAP mask and tubing were found on the floor, which poses a risk of respiratory infection. Resident 32 was admitted with diagnoses including acute respiratory failure with hypercapnia, pleural effusion, and dependence on supplemental oxygen. The resident's care plan included interventions for respiratory risk related to chronic obstructive pulmonary disease (COPD) and acute hypoxemic hypercapnia respiratory failure, but did not include the use of a BIPAP machine. The facility's policies require a physician or qualified healthcare provider to evaluate and confirm the need for BIPAP therapy, which was not adhered to in this case.
Failure to Flush G-tube Between Medications
Penalty
Summary
The facility failed to accurately and safely provide pharmaceutical services to a resident during medication administration via a gastrostomy tube (G-tube). The resident, who was admitted with diagnoses including dementia, gastrostomy status, and chronic pain syndrome, was dependent on staff for all activities of daily living and received feeding through a G-tube. The facility's policy required medications to be administered separately with a flush of 10 ml of water between each medication to prevent drug interactions and ensure full absorption. However, during an observation, a Licensed Vocational Nurse (LVN) was seen administering medications without flushing the G-tube between them, contrary to the facility's policy. The resident's care plan and physician orders specified the need for flushing the G-tube with water before and after medication administration. Despite these instructions, the LVN failed to flush the tube between medications, which was acknowledged during an interview with the Director of Nursing. This oversight had the potential to place the resident at risk of health complications due to drug interactions and delays in care provision. The facility's policy on administering medications through an enteral tube was not followed, leading to this deficiency.
Failure to Monitor Anticoagulant Use
Penalty
Summary
The facility failed to ensure that a resident's drug regimen was free from unnecessary drugs by not adequately monitoring the use of the anticoagulant Apixaban. This deficiency was identified for a resident who was admitted with diagnoses including atrial fibrillation and long-term use of anticoagulants. The resident's care plan included an intervention to monitor for adverse effects of anticoagulant use, such as discolored urine, black tarry stools, and other symptoms, but this monitoring was not conducted as it was not included in the Medication Administration Record (MAR). During a review, the Director of Nursing (DON) confirmed that there was no order for monitoring the adverse effects of Apixaban, and no monitoring had been done since the medication was ordered. The facility's policy on anticoagulation required assessment for signs or symptoms of adverse drug reactions, but this was not followed. The lack of monitoring had the potential to predispose the resident to adverse effects of anticoagulant use, such as bleeding.
Expired COVID-19 Test Kits Not Discarded
Penalty
Summary
The facility failed to properly manage expired COVID-19 test kits, specifically nine boxes of BinaxNOW COVID-19 Antigen Self-Test kits with an expiration date of 1/18/2024, which were stored in the Medication Room. During an observation and interview, a Licensed Vocational Nurse (LVN) acknowledged the presence of these expired test kits and stated that expired medications and test kits should be disposed of to prevent adverse effects and false diagnoses. The Director of Nursing (DON) also observed the expired test kits and mentioned that there was an extension on their use, but they should have been discarded to avoid false test results. The Infection Preventionist (IP) confirmed that the test kits should have been discarded as they were past the expiration extension set by the CDC. The facility's policy and procedure on expired products, last reviewed on 4/12/2024, requires staff to regularly check for expiration dates during inventory audits and before use, and to segregate and mark expired products for proper disposal. The failure to adhere to this policy increased the risk of misdiagnosis and delayed care for residents and staff.
Inaccurate EHR Entry Leads to Delay in Care
Penalty
Summary
The facility failed to accurately enter the order for a Restorative Nursing Assistance (RNA) program in the electronic health record (EHR) for a resident, leading to incomplete and inaccurate medical documentation. The resident, who was admitted with diagnoses including dementia, gastrostomy status, and chronic pain syndrome, had severely impaired cognition and was totally dependent on staff for all activities of daily living. The resident had physician orders for passive range of motion (PROM) exercises and the application of splints, which were not accurately reflected in the restorative record flowsheet. This discrepancy was observed during a review of the resident's records and confirmed by the Restorative Nursing Assistant (RNA 1) and the Director of Nursing (DON). The issue arose because the charge nurse did not correctly enter the new order for the application of splints in the EHR, resulting in the order not populating in the restorative record flowsheet. Consequently, the RNA assigned to the resident was unaware of the new order, leading to a delay in the provision of necessary care. The DON verified that the order entry error occurred, and the facility's policy on physician orders indicated that orders should be consistent with principles of safe and effective order writing.
Room Size Deficiency in Multiple Resident Rooms
Penalty
Summary
The facility failed to ensure that 19 out of 21 resident rooms met the federal square footage requirement of 80 square feet per resident in multiple resident rooms. During a recertification survey, it was observed that these rooms, although smaller than required, allowed residents to move freely and did not impede the use of mobility aids such as wheelchairs, walkers, or canes. The facility had submitted an application for a Room Variance Waiver, acknowledging that these rooms did not meet the required size but asserting that the space was adequate for resident care, dignity, and privacy. The waiver indicated that the room sizes would not adversely affect the residents' health and safety or their ability to attain their highest practicable well-being. During interviews, both residents and staff, including CNAs and an LVN, reported no issues with the space in the rooms. A specific observation noted a portable HVAC unit in one resident's room, which the resident stated was crowding the space and was not requested by him. Despite this, the staff reported no difficulties in performing their duties due to room size. The facility's policies and procedures were reviewed, indicating compliance with federal and state requirements for room sizes, with allowances for individual variations if they met residents' special needs without adverse effects.
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Resident with a documented fall history left unattended on the patio; found on the ground with a hip fracture.
Walk-in cooler logs missing for 12 days; expired supplements in the medication room fridge.
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Nursing homes near Granada Hills
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Casitas Care Center | 1.1 mi | — | 18 | 0 |
| Rinaldi Convalescent Hospital | 1.2 mi | — | 39 | 0 |
| The Rehabilitation Center Of North Hills | 1.4 mi | — | 8 | 0 |
| Providence Holy Cross Med Ctr D/p Snf | 1.6 mi | — | 17 | 2 |
| Ararat Nursing Facility | 1.6 mi | — | 14 | 1 |
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