LAKE BALBOA CARE CENTER

16955 VANOWEN STREET
VAN NUYS, CA, 91406
8183430700
CCN: 056180
5
Overall
5
Health
3
Staffing
5
Quality
ChainTHE ENSIGN GROUP
Special FocusAbuse IconOwnership Changed (12mo)Inspection OverdueOIG ExcludedUnder CIA
OIG Federal Exclusion Matches (3)
This facility's name matches one or more entities on the OIG List of Excluded Individuals/Entities (LEIE). Excluded parties are prohibited from participation in Medicare and Medicaid programs.
BODY CARE CENTER, CLINIC
1128b4
Excluded 2003-08-20
CENTURION HEALTHCARE, INC
1128a1
Excluded 2013-04-18
INDEPENDENCE HOME HEALTHCARE,
1128b7
Excluded 2024-01-08
Ownership
NameRole%
FLAGSTONE HEALTHCARE SOUTH LLC5% OR GREATER DIRECT OWNERSHIP INTEREST100%
THE ENSIGN GROUP INC5% OR GREATER INDIRECT OWNERSHIP INTEREST100%
WILLITS, ADAMCORPORATE DIRECTORNOT APPLICABLE
BURNAM, SOONCORPORATE OFFICERNOT APPLICABLE
GAMERO, ALICIACORPORATE OFFICERNOT APPLICABLE
KEETCH, CHADCORPORATE OFFICERNOT APPLICABLE
SATO, AMICORPORATE OFFICERNOT APPLICABLE
SHIRAZI, KEYVANOPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE
BARRON, CRAIGOPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE
Health Deficiencies (23)
2026-01-26 · Health
D
F583 · Resident Rights Deficiencies
Keep residents' personal and medical records private and confidential.
2025-12-05 · Health
D
F880 · Infection Control Deficiencies
Provide and implement an infection prevention and control program.
2025-03-30 · Health
B
F912 · Environmental Deficiencies
Provide rooms that are at least 80 square feet per resident in multiple rooms and 100 square feet for single resident rooms.
D
F880 · Infection Control Deficiencies
Provide and implement an infection prevention and control program.
D
F697 · Quality of Life and Care Deficiencies
Provide safe, appropriate pain management for a resident who requires such services.
D
F583 · Resident Rights Deficiencies
Keep residents' personal and medical records private and confidential.
D
F550 · Resident Rights Deficiencies
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
2024-12-18 · Health
D
F684 · Quality of Life and Care Deficiencies
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
2024-12-13 · Health
D
F880 · Infection Control Deficiencies
Provide and implement an infection prevention and control program.
2024-03-21 · Health
B
F912 · Environmental Deficiencies
Provide rooms that are at least 80 square feet per resident in multiple rooms and 100 square feet for single resident rooms.
D
F812 · Nutrition and Dietary Deficiencies
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
E
F755 · Pharmacy Service Deficiencies
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
D
F578 · Resident Rights Deficiencies
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
F558 · Resident Rights Deficiencies
Reasonably accommodate the needs and preferences of each resident.
D
F550 · Resident Rights Deficiencies
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
2023-05-25 · Health
D
F550 · Resident Rights Deficiencies
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
2021-11-21 · Health
B
F912 · Environmental Deficiencies
Provide rooms that are at least 80 square feet per resident in multiple rooms and 100 square feet for single resident rooms.
E
F880 · Infection Control Deficiencies
Provide and implement an infection prevention and control program.
D
F761 · Pharmacy Service Deficiencies
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
F755 · Pharmacy Service Deficiencies
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
D
F656 · Resident Assessment and Care Planning Deficiencies
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
E
F565 · Resident Rights Deficiencies
Honor the resident's right to organize and participate in resident/family groups in the facility.
D
F558 · Resident Rights Deficiencies
Reasonably accommodate the needs and preferences of each resident.
Staffing
MetricThis FacilityNational Avg
Total Nurse Hrs/Resident/Day
4.65
3.68
RN Hrs/Resident/Day
0.78
0.54
LPN Hrs/Resident/Day
1.37
0.81
CNA Hrs/Resident/Day
2.49
2.33
PT Hrs/Resident/Day
0.28
0.12
Data as of 2026-03-01