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Facility Information

Facility ID: 080000031

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Country Manor La Mesa Healthcare Center

Other previous Names(s) known as:

  • Country Villa La Mesa Healthcare Center
  • Beverly Healthcare
  • Beverly Manor Convalescent Hospital

5696 Lake Murray Blvd
La Mesa, Ca   91942

County:San Diego

Phone:(619) 460-7871

Fax:(619) 460-4810

Managing District Office

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

San Diego North District Office
7575 Metropolitan Drive, Suite 104
San Diego, CA. 92108
Phone Number: (619) 278-3700

License Information

Licensee: Ag La Mesa, Llc
5696 Lake Murray Blvd
La Mesa, Ca 91942

Licensee Type: Limited Liability Company

License Number: 080000020

License Status: Active

License Category: Skilled Nursing Facility

License Effective Date: 11/1/2014

Expiration Date: 10/31/2015

Total License Capacity: 99

Bed Classification/Services:

  • 99 Skilled Nursing

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:9/22/2014

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

Year: 2014

10ComplaintsComplaints

8Facility Self-Reported IncidentsFacility Self-Reported Incidents

0State Enforcement ActionsEnforcement Actions

29Survey DeficienciesSurvey Deficiencies

Year: 2013

18ComplaintsComplaints

9Facility Self-Reported IncidentsFacility Self-Reported Incidents

0State Enforcement ActionsEnforcement Actions

9Survey DeficienciesSurvey Deficiencies

Year: 2012

10ComplaintsComplaints

31Facility Self-Reported IncidentsFacility Self-Reported Incidents

0State Enforcement ActionsEnforcement Actions

24Survey DeficienciesSurvey Deficiencies

Year: 2011

4ComplaintsComplaints

9Facility Self-Reported IncidentsFacility Self-Reported Incidents

0State Enforcement ActionsEnforcement Actions

9Survey DeficienciesSurvey Deficiencies

Year: 2010

3ComplaintsComplaints

10Facility Self-Reported IncidentsFacility Self-Reported Incidents

0State Enforcement ActionsEnforcement Actions

16Survey DeficienciesSurvey Deficiencies

Year: 2009

0ComplaintsComplaints

0Facility Self-Reported IncidentsFacility Self-Reported Incidents

0State Enforcement ActionsEnforcement Actions

17Survey DeficienciesSurvey Deficiencies

Year: 2008

0ComplaintsComplaints

0Facility Self-Reported IncidentsFacility Self-Reported Incidents

0State Enforcement ActionsEnforcement Actions

16Survey DeficienciesSurvey Deficiencies

Year: 2007

0ComplaintsComplaints

0Facility Self-Reported IncidentsFacility Self-Reported Incidents

0State Enforcement ActionsEnforcement Actions

32Survey DeficienciesSurvey Deficiencies

Year: 2006

0ComplaintsComplaints

0Facility Self-Reported IncidentsFacility Self-Reported Incidents

0State Enforcement ActionsEnforcement Actions

14Survey DeficienciesSurvey Deficiencies

Year: 2005

0ComplaintsComplaints

0Facility Self-Reported IncidentsFacility Self-Reported Incidents

1State Enforcement ActionsEnforcement Actions

22Survey DeficienciesSurvey Deficiencies

Year: 2004

0ComplaintsComplaints

0Facility Self-Reported IncidentsFacility Self-Reported Incidents

0State Enforcement ActionsEnforcement Actions

5Survey DeficienciesSurvey Deficiencies

Administration Information

10/1/2003
to Present

Ag La Mesa, Llc
Relationship to Facility: Licensee

10/10/2006
to Present

Ta May, Somrutai
Relationship to Facility: Administrator

6/1/2003
to Present

Hunte, Roger
Relationship to Facility: Administrator

4/6/2006
to Present

Jimenez, Lynn
Relationship to Facility: Director Of Nursing

Ownership Information

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

10/1/2003
to Present

Murray Med Partnership
Relationship to Facility: Property Owner
Percentage of Ownership: 0

Operating Entities

None found