Federal inspection record · CMS data as of October 1, 2026
Victoria Care Center
5445 Everglades Street, Ventura, CA · (805) 642-1736
- CMS high-performer trophy
- Certified beds
- 188
- Residents per day
- 177
- Ownership
- For-Profit
- Chain
- The Ensign Group
- Medicare / Medicaid
- Medicare + Medicaid
- Certified since
- September 18, 1991
1
How this home got 5 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.
-
Quality measures
★★★★★+1 star
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
★★★★★5 of 5
Matches the rating CMS publishes on Care Compare.
2
Where it sits among California homes
Victoria Care Center carries 53 inspection points. That is fewer than 76% 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
29 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.
No citation on record at the harm or immediate-jeopardy level.
Everything else, by area of care
Resident Assessment and Care Planning12E
- D
Ensure services provided by the nursing facility meet professional standards of quality.
- 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
Ensure services provided by the nursing facility meet professional standards of quality.
- D
Ensure services provided by the nursing facility meet professional standards of quality.
- E
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
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.
- 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
Ensure each resident receives an accurate assessment.
Resident Rights5D
- 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.
- D
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
- D
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
- D
Allow resident to participate in the development and implementation of his or her person-centered plan of care.
Pharmacy Service3D
- D
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
- 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.
Environmental3D
- D
Keep all essential equipment working safely.
- D
Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public.
- D
Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public.
Infection Control2D
- D
Provide and implement an infection prevention and control program.
- D
Provide and implement an infection prevention and control program.
Nutrition and Dietary1F
- F
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Nursing and Physician Services1D
- D
Provide or arrange emergency care by a doctor 24 hours a day.
Freedom from Abuse, Neglect, and Exploitation1D
- D
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
Quality of Life and Care1D
- D
Provide care and assistance to perform activities of daily living for any resident who is unable.
Inspection history
2026-06-25
8 health deficiencies · 12 fire-safety deficiencies
Top issue: Environmental (2 deficiencies)
2025-02-27
15 health deficiencies · 6 fire-safety deficiencies
Top issue: Resident Assessment and Care Planning (8 deficiencies)
2023-10-19
6 health deficiencies · 9 fire-safety deficiencies
Top issue: Resident Assessment and Care Planning (2 deficiencies)
4
Nursing time per resident, per day
Each resident here gets about 4 h 31 min of nursing staff time a day, 27 min of it from a registered nurse.
This home
4 h 31 min
California average
4 h 33 min
U.S. average
3 h 54 min
- Registered nurse
- Licensed practical nurse
- Nurse aide
Turnover: 30% of nursing staff and 31% of registered nurses left in the past year.
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 days0.7 pts better | 1.5 | 2.2 | 1.8 |
| Number of outpatient emergency department visits per 1000 long-stay resident days0.5 pts worse | 2.0 | 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 vaccine1.4 pts better | 99.3% | 97.9% | 95.3% |
| Percentage of long-stay residents experiencing one or more falls with major injury0.5 pts better | 1.1% | 1.6% | 3.2% |
| Percentage of long-stay residents who have depressive symptoms5.7 pts better | 1.9% | 7.6% | 13.5% |
| Percentage of long-stay residents who lose too much weight0.3 pts better | 3.8% | 4.1% | 5.1% |
| Percentage of long-stay residents who received an antianxiety or hypnotic medication2.4 pts better | 11.3% | 13.7% | 19.5% |
| Percentage of long-stay residents who received an antipsychotic medication5.1 pts better | 7.2% | 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 worsened1.3 pts better | 7.6% | 8.9% | 12.7% |
| Percentage of long-stay residents whose need for help with daily activities has increased3.9 pts better | 6.3% | 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 worse | 1.9% | 1.2% | 1.5% |
| Percentage of long-stay residents with new or worsened bowel or bladder incontinence3.5 pts worse | 13.3% | 9.8% | 18.3% |
| Percentage of long-stay residents with pressure ulcers0.7 pts better | 3.6% | 4.3% | 4.5% |
| Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine5.1 pts better | 99.7% | 94.6% | 82.3% |
| Percentage of short-stay residents who had an outpatient emergency department visit0.3 pts worse | 11.4% | 11.1% | 11.8% |
| Percentage of short-stay residents who newly received an antipsychotic medication0.5 pts worse | 1.8% | 1.3% | 1.5% |
| Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine5.7 pts better | 98.8% | 93.1% | 80.1% |
| Percentage of short-stay residents who were rehospitalized after a nursing home admission2.5 pts better | 20.1% | 22.6% | 23.4% |
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Who owns and runs it
19 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 |
|---|---|---|---|
| Flagstone Healthcare Central LLC | 5% Or Greater Indirect Ownership Interest · Organization | 100% | 2 facilities |
| Burnam, Soon | Corporate Officer · Individual | 0% | 353 facilities |
| Caretrust Gp LLC | Adp Of The SNF · Organization | 0% | 95 facilities |
| Caretrust Reit Inc | Adp Of The SNF · Organization | 0% | 102 facilities |
| Ctr Partnership LP | Adp Of The SNF · Organization | 0% | 104 facilities |
| Cullifer, Jared | Corporate Officer · Individual | 0% | 6 facilities |
| Ensign Services Inc | Adp Of The SNF · Organization | 0% | 299 facilities |
| Everglades Health Holdings LLC | Adp Of The SNF · Organization | 0% | 1 facilities |
| Gardner, John | Managing Control - Governing Body · Individual | 0% | 1 facilities |
| Gardner, John | Operational/Managerial Control · Individual | 0% | 1 facilities |
| Gardner, John | Adp Of The SNF · Individual | 0% | 1 facilities |
| Keetch, Chad | Corporate Officer · Individual | 0% | 301 facilities |
| Port, Barry | Individual Is An Owner, Partner Or Trustee Of Any Adp Of The SNF · Individual | 0% | 203 facilities |
| Sato, Ami | Corporate Officer · Individual | 0% | 151 facilities |
| The Ensign Group Inc | Indirect Ownership Interest · Organization | 0% | 135 facilities |
| Valiveti, Vinod | Managing Control - Governing Body · Individual | 0% | 5 facilities |
| Valiveti, Vinod | Operational/Managerial Control · Individual | 0% | 5 facilities |
| Valiveti, Vinod | Adp Of The SNF · Individual | 0% | 5 facilities |
| Willits, Adam | Corporate Officer · Individual | 0% | 77 facilities |
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Fire safety
27 life-safety citations (sprinklers, exits, alarms). These don't count toward the star rating.
Smoke11F
- F
Have approved installation, maintenance and testing program for fire alarm systems.
- F
Inspect, test, and maintain automatic sprinkler systems.
- E
Install smoke barrier doors that can resist smoke for at least 20 minutes.
- D
Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.
- D
Install corridor and hallway doors that block smoke.
- F
Inspect, test, and maintain automatic sprinkler systems.
- D
Properly provide smoke detection systems in areas open to corridors.
- D
Install corridor and hallway doors that block smoke.
- F
Properly provide smoke detection systems in areas open to corridors.
- E
Inspect, test, and maintain automatic sprinkler systems.
- D
Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.
Gas, Vacuum, and Electrical Systems9F
- E
Ensure receptacles at patient bed locations and where general anesthesia is administered, are tested after initial installation, replacement or servicing.
- D
Ensure proper usage of power strips and extension cords.
- D
Have proper medical gas storage and administration areas.
- C
Have a battery powered remote alarm panel in a location accessible by operating personnel.
- D
Have power receptacles that are properly grounded.
- D
Ensure proper usage of power strips and extension cords.
- F
Have generator or other power source capable of supplying service within 10 seconds.
- E
Have proper medical gas storage and administration areas.
- D
Ensure proper usage of power strips and extension cords.
Egress3D
- D
Keep aisles, corridors, and exits free of obstruction in case of emergency.
- D
Keep aisles, corridors, and exits free of obstruction in case of emergency.
- D
Provide exit doors that are held open by devices that will automatically close on the activation of a fire alarm or smoke detector.
Services2D
- D
Have elevators that firefighters can control in the event of a fire.
- D
Meet other general requirements that are deficient.
Miscellaneous1F
- F
Have simulated fire drills held at unexpected times.
Emergency Preparedness1D
- D
Conduct testing and exercise requirements.
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Other homes nearby
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Coastal View Healthcare Center
Ventura, CA · The Mandelbaum Family
★★★★★- Worst citation, 3 yrs
- G
- Nursing / resident / day
- 5 h 23 min
- Fines
- $8,278
-
Ventura Post Acute
Ventura, CA · The Mandelbaum Family
★★★★★- Worst citation, 3 yrs
- F
- Nursing / resident / day
- 4 h 47 min
- Fines
- $0
-
Oxnard Manor Healthcare Center
Oxnard, CA · Corporate Interface Services
★★★★★- Worst citation, 3 yrs
- E
- Nursing / resident / day
- 3 h 58 min
- Fines
- $0