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Facility Information

Facility ID: 060000020

Register Complaint

Country Villa Plaza Convalescent Center

1209 Hemlock Way
Santa Ana, Ca   92707

County:Orange

Phone:(714) 546-1966

Fax:(323) 596-2240

Managing District Office

Please contact the following Licensing and Certification office for any questions and/or concerns:

Orange County District Office
681 S Parker St, Ste 200
Orange, CA. 92868
Phone Number: (714) 567-2906

License Information

Licensee: Country Villa Plaza Lp
5120 W. Goldleaf Circle, Suite 400
Los Angeles, Ca 90056

Licensee Type: Partnership

License Number: 060000168

License Status: Active

License Category: Skilled Nursing Facility

License Effective Date: 11/6/2013

Expiration Date: 11/5/2014

Total License Capacity: 145

Bed Classification/Services:

Certification Information
Title 18 = Medicare
Title 19 = Medi-Cal (Medicaid)

Provider Category:SNF/NF

Last Certification Inspection Status:In Compliance

Certification Status:Eligible to Participate

Approval Date:4/15/2014

Nursing Home Compare Five Star Quality Ratings are provided by the Medicare.gov - Nursing Home Compare website.

Complaints/Facility Self-Reported Incidents/Inspection Results Summary

View Statement of Deficiencies With Plan of Correction

Year: 2014

0ComplaintsComplaints

2Facility Self-Reported IncidentsFacility Self-Reported Incidents

0State Enforcement ActionsEnforcement Actions

25Survey DeficienciesSurvey Deficiencies

Year: 2013

8ComplaintsComplaints

5Facility Self-Reported IncidentsFacility Self-Reported Incidents

0State Enforcement ActionsEnforcement Actions

38Survey DeficienciesSurvey Deficiencies

Year: 2012

3ComplaintsComplaints

2Facility Self-Reported IncidentsFacility Self-Reported Incidents

0State Enforcement ActionsEnforcement Actions

26Survey DeficienciesSurvey Deficiencies

Year: 2011

9ComplaintsComplaints

5Facility Self-Reported IncidentsFacility Self-Reported Incidents

1State Enforcement ActionsEnforcement Actions

4Survey DeficienciesSurvey Deficiencies

Year: 2010

7ComplaintsComplaints

9Facility Self-Reported IncidentsFacility Self-Reported Incidents

1State Enforcement ActionsEnforcement Actions

37Survey DeficienciesSurvey Deficiencies

Year: 2009

7ComplaintsComplaints

8Facility Self-Reported IncidentsFacility Self-Reported Incidents

1State Enforcement ActionsEnforcement Actions

71Survey DeficienciesSurvey Deficiencies

Year: 2008

0ComplaintsComplaints

0Facility Self-Reported IncidentsFacility Self-Reported Incidents

1State Enforcement ActionsEnforcement Actions

49Survey DeficienciesSurvey Deficiencies

Year: 2007

0ComplaintsComplaints

0Facility Self-Reported IncidentsFacility Self-Reported Incidents

0State Enforcement ActionsEnforcement Actions

34Survey DeficienciesSurvey Deficiencies

Year: 2006

0ComplaintsComplaints

0Facility Self-Reported IncidentsFacility Self-Reported Incidents

0State Enforcement ActionsEnforcement Actions

25Survey DeficienciesSurvey Deficiencies

Year: 2005

0ComplaintsComplaints

0Facility Self-Reported IncidentsFacility Self-Reported Incidents

0State Enforcement ActionsEnforcement Actions

29Survey DeficienciesSurvey Deficiencies

Year: 2004

0ComplaintsComplaints

0Facility Self-Reported IncidentsFacility Self-Reported Incidents

0State Enforcement ActionsEnforcement Actions

21Survey DeficienciesSurvey Deficiencies

Administration Information

6/10/2013
to Present

Plaza Healthcare Center, Llc
Relationship to Facility: Licensee

8/6/1985
to Present

Country Villa Plaza Lp
Relationship to Facility: Licensee

8/1/2013
to Present

Birla, Rashmi
Relationship to Facility: Administrator

12/5/2013
to Present

Silva, Leticia
Relationship to Facility: Director Of Nursing

1/1/2000
to Present

Cambridge Healthcare Services, Llc
Relationship to Facility: Management Company

Ownership Information

To request additional ownership information about this facility, please click the ownership name below.

8/6/1985
to Present

Reissman Family Trust
Relationship to Facility: Property Owner
Percentage of Ownership: 0

Operating Entities

None found