PACIFIC COAST MANOR

1935 WHARF ROAD
CAPITOLA, CA, 95010
8314760770
CCN: 056048
5
Overall
5
Health
4
Staffing
5
Quality
ChainCOVENANT CARE
Special FocusAbuse IconOwnership Changed (12mo)Inspection OverdueOIG ExcludedUnder CIA
Ownership
NameRole%
COVENANT CARE CALIFORNIA, LLC5% OR GREATER DIRECT OWNERSHIP INTEREST100%
CENTRE CAPITAL INVESTORS V, LP5% OR GREATER INDIRECT OWNERSHIP INTERESTNO PERCENTAGE PROVIDED
CENTRE COVENANT PURCHASER (B), LLC5% OR GREATER INDIRECT OWNERSHIP INTERESTNO PERCENTAGE PROVIDED
CENTRE COVENANT PURCHASER (Q), LLC5% OR GREATER INDIRECT OWNERSHIP INTERESTNO PERCENTAGE PROVIDED
CENTRE COVENANT PURCHASER (S), LLC5% OR GREATER INDIRECT OWNERSHIP INTERESTNO PERCENTAGE PROVIDED
CENTRE V SECONDARY FUND, L.P.5% OR GREATER INDIRECT OWNERSHIP INTERESTNO PERCENTAGE PROVIDED
COVENANT CARE, LLC5% OR GREATER INDIRECT OWNERSHIP INTERESTNO PERCENTAGE PROVIDED
COVENANT HOLDCO, LLC5% OR GREATER INDIRECT OWNERSHIP INTERESTNO PERCENTAGE PROVIDED
COVENANT SUBCO, LLC5% OR GREATER INDIRECT OWNERSHIP INTERESTNO PERCENTAGE PROVIDED
STATE TREASURER OF MICH CUSTODIAN OF PUBLIC SCHOOL EMPL RTMNT SYSTEMS5% OR GREATER INDIRECT OWNERSHIP INTERESTNO PERCENTAGE PROVIDED
STOCKWELL FUND II LP5% OR GREATER INDIRECT OWNERSHIP INTERESTNO PERCENTAGE PROVIDED
EVANS, MARY5% OR GREATER INDIRECT OWNERSHIP INTERESTNO PERCENTAGE PROVIDED
LEVIN, ROBERT5% OR GREATER INDIRECT OWNERSHIP INTERESTNO PERCENTAGE PROVIDED
TOROK, ANDREW5% OR GREATER INDIRECT OWNERSHIP INTERESTNO PERCENTAGE PROVIDED
SIMS, CHRISTINE5% OR GREATER INDIRECT OWNERSHIP INTERESTNO PERCENTAGE PROVIDED
MIDCAP FUNDING IV TRUST5% OR GREATER SECURITY INTERESTNOT APPLICABLE
CARNEY, KEVINCORPORATE OFFICERNOT APPLICABLE
ASHLEY, DAVACORPORATE OFFICERNOT APPLICABLE
EVANS, MARYCORPORATE OFFICERNOT APPLICABLE
LEVIN, ROBERTCORPORATE OFFICERNOT APPLICABLE
SIMS, CHRISTINECORPORATE OFFICERNOT APPLICABLE
TOROK, ANDREWCORPORATE OFFICERNOT APPLICABLE
LEVIN, ROBERTOPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE
SIMS, CHRISTINEOPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE
SPARKS, CAROLOPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE
EVANS, MARYOPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE
ASHLEY, DAVAOPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE
Health Deficiencies (29)
2025-04-02 · Health
D
F684 · Quality of Life and Care Deficiencies
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
2025-02-20 · Health
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
F644 · Resident Assessment and Care Planning Deficiencies
Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.
2024-08-02 · Health
D
F623 · Resident Rights Deficiencies
Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.
2024-08-01 · Health
D
F699 · Quality of Life and Care Deficiencies
Provide care or services that was trauma informed and/or culturally competent.
2024-05-09 · Health
D
F600 · Freedom from Abuse, Neglect, and Exploitation Deficiencies
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
2023-12-13 · Health
D
F600 · Freedom from Abuse, Neglect, and Exploitation Deficiencies
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
2023-09-11 · Health
D
F745 · Quality of Life and Care Deficiencies
Provide medically-related social services to help each resident achieve the highest possible quality of life.
2023-06-16 · Health
D
F909 · Environmental Deficiencies
Regularly inspect all bed frames, mattresses, and bed rails (if any) for safety; and all bed rails and mattresses must attach safely to the bed frame.
E
F880 · Infection Control Deficiencies
Provide and implement an infection prevention and control program.
D
F813 · Nutrition and Dietary Deficiencies
Have a policy regarding use and storage of foods brought to residents by family and other visitors.
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
F758 · Pharmacy Service Deficiencies
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.
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.
E
F725 · Nursing and Physician Services Deficiencies
Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.
D
F700 · Quality of Life and Care Deficiencies
Try different approaches before using a bed rail. If a bed rail is needed, the facility must (1) assess a resident for safety risk; (2) review these risks and benefits with the resident/representative; (3) get informed consent; and (4) Correctly install and maintain the bed rail.
D
F689 · Quality of Life and Care Deficiencies
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
D
F658 · Resident Assessment and Care Planning Deficiencies
Ensure services provided by the nursing facility meet professional standards of quality.
D
F644 · Resident Assessment and Care Planning Deficiencies
Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.
D
F640 · Resident Assessment and Care Planning Deficiencies
Encode each resident’s assessment data and transmit these data to the State within 7 days of assessment.
D
F552 · Resident Rights Deficiencies
Ensure that residents are fully informed and understand their health status, care and treatments.
2023-05-31 · Health
D
F622 · Resident Rights Deficiencies
Not transfer or discharge a resident without an adequate reason; and must provide documentation and convey specific information when a resident is transferred or discharged.
2023-03-07 · Health
E
F880 · Infection Control Deficiencies
Provide and implement an infection prevention and control program.
2019-12-05 · Health
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.
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
F757 · Pharmacy Service Deficiencies
Ensure each resident’s drug regimen must be free from unnecessary drugs.
D
F686 · Quality of Life and Care Deficiencies
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
D
F658 · Resident Assessment and Care Planning Deficiencies
Ensure services provided by the nursing facility meet professional standards of quality.
D
F558 · Resident Rights Deficiencies
Reasonably accommodate the needs and preferences of each resident.
Staffing
MetricThis FacilityNational Avg
Total Nurse Hrs/Resident/Day
4.39
3.68
RN Hrs/Resident/Day
1.13
0.54
LPN Hrs/Resident/Day
0.78
0.81
CNA Hrs/Resident/Day
2.48
2.33
PT Hrs/Resident/Day
0.09
0.12
Data as of 2026-03-01