Federal inspection record · CMS data as of October 1, 2026
Arrowhead Springs Healthcare
1335 N. Waterman Ave., San Bernardino, CA · (909) 885-0268
- Certified beds
- 119
- Residents per day
- 107
- Ownership
- For-Profit
- Chain
- The Ensign Group
- Medicare / Medicaid
- Medicare + Medicaid
- Certified since
- January 1, 1971
1
How this home got 4 stars
The overall rating isn't an average. CMS starts from the inspection rating and nudges it at most two steps. Here is the arithmetic for this home, using CMS's own rules.
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Health inspections
★★★★★starting point
Everything starts from what state inspectors found on site. This is a ranking against other homes in California.
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Staffing
★★★★★no change
Only a 5-star staffing rating adds a star, and only a 1-star rating removes one. Ratings of 2 to 4 change nothing.
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Quality measures
★★★★★no change
Same rule: 5 stars adds one, 1 star takes one away. These measures are mostly reported by the home itself.
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Overall
★★★★★4 of 5
Matches the rating CMS publishes on Care Compare.
2
Where it sits among California homes
Arrowhead Springs Healthcare carries 49 inspection points. That is fewer than 79% of California's 1,154 rated homes.
Inspectors' citations earn points by how serious and how widespread they were (the grid below). CMS then ranks every home in California: the 10% with the fewest points get 5 stars, the 20% with the most get 1 star, and the middle 70% split evenly into 2, 3 and 4.
- 5★ 0–33 pts
- 4★ 33–66 pts
- 3★ 66–96 pts
- 2★ 96–146 pts
- 1★ over 146 pts
Bars show every rated home in California by its weighted inspection score. CMS recalibrates the cut points monthly but holds a home's rating until its own score changes, so a home can sit just outside today's band.
3
What inspectors found
28 health citations on record since 2022. Each one gets a letter: the row says how badly residents were affected, the column how many.
Immediate jeopardyResidents at risk of serious injury or death
Actual harmA resident was hurt
Potential for harmNo one was hurt, but could have been
Minimal harmPaperwork-level problems
Read the rows, not the total. Most citations nationwide are a D: one problem, nobody hurt. Rows G–I mean a resident was harmed; J–L mean inspectors found residents in immediate danger of serious injury or death.
Small numbers in each cell are the inspection points CMS assigns per citation. Those points are what the state curve above ranks.
No citation on record at the harm or immediate-jeopardy level.
Everything else, by area of care
Quality of Life and Care9E
- E
Ensure that feeding tubes are not used unless there is a medical reason and the resident agrees; and provide appropriate care for a resident with a feeding tube.
- D
Provide care and assistance to perform activities of daily living for any resident who is unable.
- D
Try different approaches before using a bed rail. If a bed rail is needed, the facility must (1) assess a resident for safety risk; (2) review these risks and benefits with the resident/representative; (3) get informed consent; and (4) Correctly install and maintain the bed rail.
- D
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
- D
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
- D
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
- D
Provide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM and/or mobility, unless a decline is for a medical reason.
- D
Provide enough food/fluids to maintain a resident's health.
- D
Ensure that feeding tubes are not used unless there is a medical reason and the resident agrees; and provide appropriate care for a resident with a feeding tube.
Resident Assessment and Care Planning5E
- E
Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.
- D
Assess the resident completely in a timely manner when first admitted, and then periodically, at least every 12 months.
- D
PASARR screening for Mental disorders or Intellectual Disabilities
- D
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
- D
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
Resident Rights4E
- E
Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.
- D
Allow residents to self-administer drugs if determined clinically appropriate.
- D
Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.
- D
Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive.
Pharmacy Service4D
- D
Ensure medication error rates are not 5 percent or greater.
- D
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.
- D
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
- D
Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures.
Infection Control4D
- D
Provide and implement an infection prevention and control program.
- D
Provide and implement an infection prevention and control program.
- D
Provide and implement an infection prevention and control program.
- D
Provide and implement an infection prevention and control program.
Nutrition and Dietary1F
- F
Dispose of garbage and refuse properly.
Environmental1F
- F
Keep all essential equipment working safely.
Inspection history
2026-06-04
9 health deficiencies · 3 fire-safety deficiencies
Top issue: Resident Assessment and Care Planning (3 deficiencies)
2025-04-24
9 health deficiencies · 1 fire-safety deficiencies
Top issue: Quality of Life and Care (5 deficiencies)
2022-05-26
10 health deficiencies · 10 fire-safety deficiencies
Top issue: Quality of Life and Care (3 deficiencies)
4
Nursing time per resident, per day
Each resident here gets about 4 h 37 min of nursing staff time a day, 20 min of it from a registered nurse.
This home
4 h 37 min
California average
4 h 33 min
U.S. average
3 h 54 min
- Registered nurse
- Licensed practical nurse
- Nurse aide
Turnover: 28% of nursing staff and 22% of registered nurses left in the past year, along with 1 administrator.
Reported hours from payroll data the home submits to CMS, divided by its daily resident count. Not adjusted for how sick residents are.
5
Resident outcomes
Quality measures compared with state and national averages. Most come from assessments the home itself reports.
| Measure | This home | State | U.S. |
|---|---|---|---|
| Number of hospitalizations per 1000 long-stay resident days1.1 pts worse | 3.3 | 2.2 | 1.8 |
| Number of outpatient emergency department visits per 1000 long-stay resident daysAbout the same | 1.5 | 1.5 | 1.7 |
| Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine0.6 pts better | 99.3% | 98.7% | 93.7% |
| Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine2.1 pts better | 100.0% | 97.9% | 95.3% |
| Percentage of long-stay residents experiencing one or more falls with major injury1.3 pts better | 0.3% | 1.6% | 3.2% |
| Percentage of long-stay residents who have depressive symptoms1 pts worse | 8.6% | 7.6% | 13.5% |
| Percentage of long-stay residents who lose too much weight2.2 pts better | 1.9% | 4.1% | 5.1% |
| Percentage of long-stay residents who received an antianxiety or hypnotic medication5.3 pts better | 8.4% | 13.7% | 19.5% |
| Percentage of long-stay residents who received an antipsychotic medication11.2 pts better | 1.1% | 12.3% | 15.4% |
| Percentage of long-stay residents who were physically restrained0.3 pts better | 0.0% | 0.3% | 0.1% |
| Percentage of long-stay residents whose ability to walk independently worsened0.9 pts better | 8.0% | 8.9% | 12.7% |
| Percentage of long-stay residents whose need for help with daily activities has increased1 pts better | 9.2% | 10.2% | 13.5% |
| Percentage of long-stay residents with a catheter inserted and left in their bladder0.2 pts better | 0.5% | 0.7% | 0.7% |
| Percentage of long-stay residents with a urinary tract infection0.5 pts better | 0.7% | 1.2% | 1.5% |
| Percentage of long-stay residents with new or worsened bowel or bladder incontinence2.2 pts better | 7.6% | 9.8% | 18.3% |
| Percentage of long-stay residents with pressure ulcers4.5 pts worse | 8.8% | 4.3% | 4.5% |
| Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine2.3 pts better | 96.9% | 94.6% | 82.3% |
| Percentage of short-stay residents who had an outpatient emergency department visit3.1 pts better | 8.0% | 11.1% | 11.8% |
| Percentage of short-stay residents who newly received an antipsychotic medication0.5 pts better | 0.8% | 1.3% | 1.5% |
| Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine4.5 pts better | 97.6% | 93.1% | 80.1% |
| Percentage of short-stay residents who were rehospitalized after a nursing home admission0.6 pts worse | 23.2% | 22.6% | 23.4% |
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Who owns and runs it
13 owners and managers reported to CMS. The last column counts how many nursing homes each one is tied to.
Show ownership list
| Name | Role | Share | Homes |
|---|---|---|---|
| Alvarado Health Holdings LLC | Adp Of The SNF · Organization | 0% | 1 facilities |
| Burnam, Soon | Managing Control - Governing Body · Individual | 0% | 353 facilities |
| Burnam, Soon | Corporate Officer · Individual | 0% | 353 facilities |
| Ensign Services Inc | Adp Of The SNF · Organization | 0% | 299 facilities |
| Keetch, Chad | Corporate Officer · Individual | 0% | 301 facilities |
| Mangoba, Luther | Operational/Managerial Control · Individual | 0% | 2 facilities |
| Mangoba, Luther | Adp Of The SNF · Individual | 0% | 2 facilities |
| Port, Barry | Corporate Officer · Individual | 0% | 203 facilities |
| Sanchez Gonzalez, Yamaliel | Operational/Managerial Control · Individual | 0% | 1 facilities |
| Sanchez Gonzalez, Yamaliel | Adp Of The SNF · Individual | 0% | 1 facilities |
| Standard Bearer Healthcare Op, LP | Adp Of The SNF · Organization | 0% | 78 facilities |
| The Ensign Group Inc | Adp Of The SNF · Organization | 0% | 135 facilities |
| Willits, Adam | Corporate Officer · Individual | 0% | 77 facilities |
·
Fire safety
14 life-safety citations (sprinklers, exits, alarms). These don't count toward the star rating.
Smoke6F
- F
Have approved installation, maintenance and testing program for fire alarm systems.
- D
Have properly installed hallway dispensers for alcohol-based hand rub.
- D
Inspect, test, and maintain automatic sprinkler systems.
- D
Have a fire alarm with audible and visual signals that transmits the alarm automatically to notify emergency forces in event of fire.
- D
Inspect, test, and maintain automatic sprinkler systems.
- D
Properly select, install, inspect, or maintain portable fire extinguishes.
Miscellaneous2D
- D
Provide a written emergency evacuation plan.
- D
Have simulated fire drills held at unexpected times.
Emergency Preparedness2D
- D
Provide emergency officials' contact information.
- D
Conduct testing and exercise requirements.
Gas, Vacuum, and Electrical Systems2D
- D
Have a battery powered remote alarm panel in a location accessible by operating personnel.
- D
Ensure proper usage of power strips and extension cords.
Construction1D
- D
Use approved construction type or materials.
Services1D
- D
Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.
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Other homes nearby
-
Medical Center Convalescent Hospital
San Bernardino, CA · Eva Care Group
★★★★★- Worst citation, 3 yrs
- F
- Nursing / resident / day
- 3 h 58 min
- Fines
- $0
-
Valley Healthcare Center
San Bernardino, CA · Progressive Health Care Centers
★★★★★- Worst citation, 3 yrs
- K
- Nursing / resident / day
- 3 h 57 min
- Fines
- $37,151
-
Waterman Canyon Post Acute
San Bernardino, CA · Pacs Group
★★★★★- Worst citation, 3 yrs
- D
- Nursing / resident / day
- 4 h 4 min
- Fines
- $0