Federal inspection record · CMS data as of October 1, 2026
Kit Carson Nursing & Rehabilitation Center
811 Court Street, Jackson, CA · (209) 223-2231
- Special Focus Facility
- Certified beds
- 199
- Residents per day
- 59
- Ownership
- For-Profit
- Chain
- Eva Care Group
- Medicare / Medicaid
- Medicare + Medicaid
- Certified since
- May 4, 1970
1
How this home got 1 star
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.
-
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.
-
Quality measures
★★★★★no change
Same rule: 5 stars adds one, 1 star takes one away. These measures are mostly reported by the home itself.
-
Overall
★★★★★1 of 5
Matches the rating CMS publishes on Care Compare.
2
Where it sits among California homes
Kit Carson Nursing & Rehabilitation Center carries 315 inspection points. That is fewer than 2% 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
85 health citations on record since 2023. 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.
Harm and immediate-jeopardy citations (5)
-
G
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
-
G
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
-
G
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
-
G
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
-
G
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
Everything else, by area of care
Pharmacy Service16E
- D
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
- D
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
- D
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
- 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.
- E
Ensure each resident’s drug regimen must be free from unnecessary drugs.
- E
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.
- E
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
- E
Ensure each resident’s drug regimen must be free from unnecessary drugs.
- E
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.
- E
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
Ensure medication error rates are not 5 percent or greater.
- E
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
- E
Ensure medication error rates are not 5 percent or greater.
- E
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.
Quality of Life and Care15E
- D
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
- D
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
- D
Ensure each resident must receive and the facility must provide necessary behavioral health care and services.
- D
Provide enough food/fluids to maintain a resident's health.
- D
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
- D
Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.
- E
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
- D
Provide enough food/fluids to maintain a resident's health.
- E
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
- D
Provide care and assistance to perform activities of daily living for any resident who is unable.
- D
Assist a resident in gaining access to vision and hearing services.
- D
Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.
- D
Provide safe and appropriate respiratory care for a resident when needed.
- D
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
- D
Provide care and assistance to perform activities of daily living for any resident who is unable.
Nutrition and Dietary11F
- E
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
- F
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
- E
Ensure menus must meet the nutritional needs of residents, be prepared in advance, be followed, be updated, be reviewed by dietician, and meet the needs of the resident.
- D
Ensure each resident receives and the facility provides food that accommodates resident allergies, intolerances, and preferences, as well as appealing options.
- D
Provide special eating equipment and utensils for residents who need them and appropriate assistance.
- F
Employ sufficient staff with the appropriate competencies and skills sets to carry out the functions of the food and nutrition service, including a qualified dietician.
- F
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
- F
Dispose of garbage and refuse properly.
- E
Provide sufficient support personnel to safely and effectively carry out the functions of the food and nutrition service.
- E
Ensure menus must meet the nutritional needs of residents, be prepared in advance, be followed, be updated, be reviewed by dietician, and meet the needs of the resident.
- E
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Resident Rights11F
- E
Honor the resident's right to choose his or her attending physician.
- D
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
- D
Reasonably accommodate the needs and preferences of each resident.
- D
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
- F
Allow residents to easily view the nursing home's survey results and communicate with advocate agencies.
- D
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
- 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.
- E
Allow resident to participate in the development and implementation of his or her person-centered plan of care.
- E
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.
- 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.
- E
Keep residents' personal and medical records private and confidential.
Resident Assessment and Care Planning10E
- D
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
- D
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
- D
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
- D
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
- D
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
- D
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
- D
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
- D
Ensure services provided by the nursing facility meet professional standards of quality.
- E
Ensure services provided by the nursing facility meet professional standards of quality.
- D
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Infection Control7F
- D
Provide and implement an infection prevention and control program.
- D
Provide and implement an infection prevention and control program.
- F
Provide and implement an infection prevention and control program.
- E
Educate residents and staff on COVID-19 vaccination, offer the COVID-19 vaccine to eligible residents and staff after education, and properly document each resident and staff member's vaccination status.
- D
Develop and implement policies and procedures for flu and pneumonia vaccinations.
- E
Provide and implement an infection prevention and control program.
- D
Provide and implement an infection prevention and control program.
Freedom from Abuse, Neglect, and Exploitation6E
- D
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
- D
Respond appropriately to all alleged violations.
- D
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
- D
Respond appropriately to all alleged violations.
- E
Prevent the use of unnecessary psychotropic medications or use medications that may restrain a resident's ability to function.
- D
Ensure that each resident is free from the use of physical restraints, unless needed for medical treatment.
Nursing and Physician Services2F
- F
Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.
- D
Obtain a doctor's order to admit a resident and ensure the resident is under a doctor's care.
Environmental1F
- F
Make sure that a working call system is available in each resident's bathroom and bathing area.
Administration1D
- D
Have the Quality Assessment and Assurance group have the required members and meet at least quarterly
Inspection history
2025-08-14
52 health deficiencies · 15 fire-safety deficiencies
Top issue: Quality of Life and Care (9 deficiencies)
2024-09-12
25 health deficiencies · 16 fire-safety deficiencies
Top issue: Quality of Life and Care (7 deficiencies)
2023-03-09
8 health deficiencies · 12 fire-safety deficiencies
Top issue: Pharmacy Service (3 deficiencies)
4
Nursing time per resident, per day
Each resident here gets about 5 h 51 min of nursing staff time a day, 51 min of it from a registered nurse.
This home
5 h 51 min
California average
4 h 33 min
U.S. average
3 h 54 min
- Registered nurse
- Licensed practical nurse
- Nurse aide
Turnover: 58% of nursing staff and 69% 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
Fines and payment denials
$28,327 in federal fines on record over the past three years.
| Date | Penalty | Amount |
|---|---|---|
| 2026-02-19 | Fine | $9,347 |
| 2026-02-19 | Fine | $9,870 |
| 2026-02-19 | Payment Denial · 17 day denial | $0 |
| 2025-03-28 | Fine | $9,110 |
6
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 days0.4 pts better | 1.8 | 2.2 | 1.8 |
| Number of outpatient emergency department visits per 1000 long-stay resident days0.4 pts worse | 1.9 | 1.5 | 1.7 |
| Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine1.3 pts better | 100.0% | 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 injury0.7 pts better | 0.9% | 1.6% | 3.2% |
| Percentage of long-stay residents who have depressive symptoms7.6 pts better | 0.0% | 7.6% | 13.5% |
| Percentage of long-stay residents who lose too much weight0.5 pts worse | 4.6% | 4.1% | 5.1% |
| Percentage of long-stay residents who received an antianxiety or hypnotic medication10.3 pts worse | 24.0% | 13.7% | 19.5% |
| Percentage of long-stay residents who received an antipsychotic medication7.3 pts worse | 19.6% | 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 worsened9.5 pts worse | 18.4% | 8.9% | 12.7% |
| Percentage of long-stay residents whose need for help with daily activities has increased4.6 pts worse | 14.8% | 10.2% | 13.5% |
| Percentage of long-stay residents with a catheter inserted and left in their bladder0.4 pts better | 0.3% | 0.7% | 0.7% |
| Percentage of long-stay residents with a urinary tract infection0.7 pts better | 0.5% | 1.2% | 1.5% |
| Percentage of long-stay residents with new or worsened bowel or bladder incontinence4.8 pts better | 5.0% | 9.8% | 18.3% |
| Percentage of long-stay residents with pressure ulcers1.7 pts worse | 6.0% | 4.3% | 4.5% |
| Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine5.4 pts better | 100.0% | 94.6% | 82.3% |
| Percentage of short-stay residents who had an outpatient emergency department visit2.6 pts worse | 13.7% | 11.1% | 11.8% |
| Percentage of short-stay residents who newly received an antipsychotic medication0.9 pts better | 0.4% | 1.3% | 1.5% |
| Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine5 pts better | 98.1% | 93.1% | 80.1% |
| Percentage of short-stay residents who were rehospitalized after a nursing home admission4.2 pts better | 18.4% | 22.6% | 23.4% |
·
Who owns and runs it
8 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 |
|---|---|---|---|
| Chen, Jenq | 5% Or Greater Direct Ownership Interest · Individual | 100% | 9 facilities |
| Chen, Jenq | Corporate Director · Individual | 0% | 9 facilities |
| Chen, Tze-Yun | Corporate Director · Individual | 0% | 9 facilities |
| Hawkins, Douglas | Operational/Managerial Control · Individual | 0% | 1 facilities |
| Hawkins, Douglas | Adp Of The SNF · Individual | 0% | 1 facilities |
| Padama, John | Managing Control - Governing Body · Individual | 0% | 9 facilities |
| Smith, Gregory | Operational/Managerial Control · Individual | 0% | 7 facilities |
| Smith, Gregory | Adp Of The SNF · Individual | 0% | 7 facilities |
·
Fire safety
43 life-safety citations (sprinklers, exits, alarms). These don't count toward the star rating.
Smoke15F
- E
Install corridor and hallway doors that block smoke.
- D
Inspect, test, and maintain automatic sprinkler systems.
- C
Have approved installation, maintenance and testing program for fire alarm systems.
- C
Properly select, install, inspect, or maintain portable fire extinguishes.
- F
Inspect, test, and maintain automatic sprinkler systems.
- F
Install corridor and hallway doors that block smoke.
- D
Provide properly protected cooking facilities.
- D
Install a fire alarm system that can be heard throughout the facility.
- D
Have a complete alarm system manually initiated and initiated by fire sprinkler system connection.
- D
Install smoke barrier doors that can resist smoke for at least 20 minutes.
- F
Properly provide smoke detection systems in areas open to corridors.
- F
Properly select, install, inspect, or maintain portable fire extinguishes.
- E
Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.
- E
Inspect, test, and maintain automatic sprinkler systems.
- D
Install corridor and hallway doors that block smoke.
Gas, Vacuum, and Electrical Systems12F
- F
Ensure that testing and maintenance of electrical equipment is performed.
- D
Meet requirements for the use of electrical equipment.
- D
Ensure proper usage of power strips and extension cords.
- C
Have generator or other power source capable of supplying service within 10 seconds.
- F
Have generator or other power source capable of supplying service within 10 seconds.
- E
Ensure proper usage of power strips and extension cords.
- D
Meet requirements for the use of electrical equipment.
- C
Ensure that testing and maintenance of electrical equipment is performed.
- F
Ensure receptacles at patient bed locations and where general anesthesia is administered, are tested after initial installation, replacement or servicing.
- F
Have generator or other power source capable of supplying service within 10 seconds.
- D
Meet requirements for the use of electrical equipment.
- D
Ensure proper usage of power strips and extension cords.
Emergency Preparedness6C
- C
Develop Emergency Preparedness policies and procedures.
- C
Develop a communication plan.
- C
List the names and contact information of those in the facility.
- C
Establish emergency prep training and testing.
- C
Conduct testing and exercise requirements.
- C
Develop and maintain an Emergency Preparedness Program (EP).
Egress4F
- F
Have properly located and lighted "Exit" signs.
- D
Keep aisles, corridors, and exits free of obstruction in case of emergency.
- D
Install emergency lighting that can last at least 1 1/2 hours.
- D
Keep aisles, corridors, and exits free of obstruction in case of emergency.
Construction3D
- D
Use approved construction type or materials.
- D
Use approved construction type or materials.
- D
Use approved construction type or materials.
Miscellaneous3D
- D
Have restrictions on the use of portable space heaters.
- C
To conduct inspection, testing and maintenance of fire doors by qualified individuals.
- D
Have posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed.
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Other homes nearby
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Golden San Andreas Care Center
San Andreas, CA · Golden SNF Operations
★★★★★- Worst citation, 3 yrs
- J
- Nursing / resident / day
- 4 h 7 min
- Fines
- $66,534
-
Gold Country Health Center
Placerville, CA · Cypress Healthcare Group
★★★★★- Worst citation, 3 yrs
- F
- Nursing / resident / day
- 5 h 2 min
- Fines
- $0
-
Western Slope Health Center
Placerville, CA · Pacs Group
★★★★★- Worst citation, 3 yrs
- F
- Nursing / resident / day
- 3 h 50 min
- Fines
- $0