Avondale Villa Post-Acute

Name: Avondale Villa Post-Acute
Address: 788 HOLMES STREET, Livermore, CA, 94550, US
Telephone: 9254472280

788 Holmes Street, Livermore, CA 94550 · Alameda County · 37 certified beds · avg 34 residents/day · certified since Jul 26, 1989

Part of chain: LINKS HEALTHCARE GROUP (32 facilities, chain avg rating 2.9★)

3/5

Health inspection rating (on-site)

Serious findings on record

Fines, last 3 years

4.03

Nurse hours/resident/day (adjusted)

What health inspectors found (on-site government inspections — the most independent evidence available)

Health inspection rating: ★★★☆☆3/5 · CMS overall rating: 4/5

The health inspection star above is graded on a curve within each state — a set share of each state's facilities gets each star level — so a facility can have few citations and still rate 2–3 stars if others in its state did even better. The overall rating combines that inspection score with staffing and self-reported quality measures.

All citations in the current public record (36)

CMS publishes roughly the last three inspection cycles plus recent complaint investigations. Older surveys drop out of the record as new ones are completed.

Date	Severity	What the facility was cited for
Mar 10, 2026	D · Potential for harm, one-off	The facility did not report suspected abuse, neglect, or theft to the proper authorities quickly enough, or did not report the results of its investigation. · from a complaint
May 16, 2025	E · Potential for harm, repeated	The facility did not have or follow an effective program to prevent and control infections — such as proper hand washing, cleaning, and isolation practices. This is the most commonly cited deficiency nationwide.
May 16, 2025	D · Potential for harm, one-off	The facility provided care that did not meet professional standards of quality — the accepted standards that nurses and other clinicians are expected to follow.
May 16, 2025	D · Potential for harm, one-off	The facility did not provide pharmacy services that meet each resident's needs, or did not employ or contract with a licensed pharmacist.
May 16, 2025	D · Potential for harm, one-off	The facility did not keep residents' medications free from unnecessary drugs. Residents should only take medicines they truly need, at the right dose, for a clear reason.
May 16, 2025	D · Potential for harm, one-off	The facility's medication error rate was 5 percent or higher — meaning too many doses were given incorrectly, such as the wrong drug, dose, or time.
May 16, 2025	D · Potential for harm, one-off	The facility did not label drugs according to professional standards or did not store them in locked compartments, with controlled drugs (medications with a high risk of misuse) kept under a separate lock.
May 16, 2025	D · Potential for harm, one-off	The facility did not have a policy covering how food brought in by family and visitors is used and stored safely.
May 16, 2025	B · Minimal risk, repeated	The facility had resident rooms smaller than required — at least 80 square feet per person in shared rooms and 100 square feet in single rooms.
Mar 1, 2024	F · Potential for harm, facility-wide	The facility did not employ enough qualified food and nutrition staff, including a qualified dietician, to properly run its food service.
Mar 1, 2024	F · Potential for harm, facility-wide	The facility did not have enough support staff to safely and effectively run its food and nutrition service.
Mar 1, 2024	F · Potential for harm, facility-wide	The facility's menus did not meet residents' nutritional needs, or were not prepared in advance, followed as written, kept up to date, or reviewed by a dietician.
Mar 1, 2024	F · Potential for harm, facility-wide	The facility did not serve food and drinks that were appetizing, attractive, and at a safe and pleasant temperature.
Mar 1, 2024	F · Potential for harm, facility-wide	The facility did not get its food from approved, safe sources, or did not store, prepare, and serve food according to professional food safety standards.
Mar 1, 2024	E · Potential for harm, repeated	The facility did not keep the environment free of accident hazards, or did not provide enough supervision to prevent accidents like falls.
Mar 1, 2024	E · Potential for harm, repeated	The facility did not prepare and serve food in a form that meets each resident's individual needs — for example, chopped, pureed, or softened food for residents with chewing or swallowing problems.
Mar 1, 2024	E · Potential for harm, repeated	The facility did not provide food that accounts for each resident's allergies, intolerances, and personal preferences, or did not offer appealing alternatives.
Mar 1, 2024	E · Potential for harm, repeated	The facility did not make sure special medical diets — like low-sodium or diabetic diets — were properly ordered by the resident's doctor or managed by a qualified dietitian as state law allows.
Mar 1, 2024	E · Potential for harm, repeated	The facility did not protect residents' personal information or did not keep complete, accurate medical records that meet professional standards.
Mar 1, 2024	E · Potential for harm, repeated	The facility did not keep all essential equipment working safely — things like heating and cooling systems, kitchen equipment, and medical devices.
Mar 1, 2024	D · Potential for harm, one-off	The facility did not create and follow a basic care plan covering a new resident's most immediate needs within 48 hours of admission. The first days are when a new resident is most vulnerable.
Mar 1, 2024	D · Potential for harm, one-off	The facility did not develop or follow a complete care plan for each resident — the written roadmap covering all of a resident's needs, with measurable goals and timelines.
Mar 1, 2024	D · Potential for harm, one-off	The facility did not provide enough food and fluids to keep residents healthy, such as preventing unplanned weight loss or dehydration.
Mar 1, 2024	D · Potential for harm, one-off	The facility did not try to gradually reduce doses of mood- and mind-altering medications or use non-drug approaches first, as required, or used 'as needed' psychiatric drugs without proper limits.
Mar 1, 2024	D · Potential for harm, one-off	The facility did not provide special eating equipment and utensils — like adaptive cups or easy-grip silverware — for residents who need them, along with appropriate help at meals.
Mar 1, 2024	B · Minimal risk, repeated	The facility had resident rooms smaller than required — at least 80 square feet per person in shared rooms and 100 square feet in single rooms.
Dec 21, 2023	D · Potential for harm, one-off	The facility did not keep the environment free of accident hazards, or did not provide enough supervision to prevent accidents like falls. · from a complaint
Dec 21, 2023	D · Potential for harm, one-off	The facility did not protect residents' personal information or did not keep complete, accurate medical records that meet professional standards. · from a complaint
Aug 18, 2023	D · Potential for harm, one-off	The facility did not make reasonable adjustments to fit each resident's individual needs and preferences — things like call buttons within reach, preferred wake-up times, or accessible room setups. · from a complaint
Aug 18, 2023	D · Potential for harm, one-off	The facility did not accurately assess a resident's health and needs. Assessments are the foundation for all the care a resident receives. · from a complaint
Aug 18, 2023	D · Potential for harm, one-off	The facility did not provide treatment and care that follows the doctor's orders and matches the resident's own preferences and goals. · from a complaint
Mar 25, 2022	E · Potential for harm, repeated	The facility did not have a licensed pharmacist review each resident's complete medication regimen and medical chart every month, or did not follow its own rules for reporting medication problems.
Mar 25, 2022	E · Potential for harm, repeated	The facility did not have or follow an effective program to prevent and control infections — such as proper hand washing, cleaning, and isolation practices. This is the most commonly cited deficiency nationwide.
Mar 25, 2022	D · Potential for harm, one-off	The facility did not provide pharmacy services that meet each resident's needs, or did not employ or contract with a licensed pharmacist.
Mar 25, 2022	D · Potential for harm, one-off	The facility did not get its food from approved, safe sources, or did not store, prepare, and serve food according to professional food safety standards.
Mar 25, 2022	B · Minimal risk, repeated	The facility had resident rooms smaller than required — at least 80 square feet per person in shared rooms and 100 square feet in single rooms.

Inspection trend by year

Citations from standard inspections decreased between the last two inspection cycles (17 → 8).

Year	Citations	Worst severity that year
2022	5	E
2023	5	D
2024	17	F
2025	8	E
2026	1	D

Counts reflect the current CMS public record (~3 inspection cycles plus complaint investigations); years with no surveys show no row. Inspection frequency varies, so compare severity as well as counts.

Fines and enforcement (last 3 years)

No fines or payment denials in the published 3-year window.

Nurse staffing (from payroll records, adjusted for how much care residents need)

Measure	This facility	California avg	U.S. avg	Where it stands
Total nurse staffing (hours per resident per day)	4.03	4.31	3.95	bottom 44% in California; top 38% in the U.S.
Registered Nurse hours	0.33	0.61	0.69	bottom 16% in California; bottom 13% in the U.S.
Weekend total nurse staffing	3.62	3.90	3.50	bottom 40% in California; top 37% in the U.S.
Weekend RN hours (not acuity-adjusted)	0.34	0.51	0.48	bottom 43% in California; bottom 40% in the U.S.
Total nursing staff turnover (%)	36.4	36.7	45.8	top 50% in California; top 27% in the U.S.
RN turnover (%)	60.0	38.1	42.9	bottom 16% in California; bottom 22% in the U.S.

Hours are per resident per day, case-mix adjusted by CMS so facilities caring for sicker residents can be compared fairly (same basis as the CMS staffing star). "Top X%" means better than most facilities: more staffing hours, or lower turnover. Raw (unadjusted) reported hours: total 4.32, RN 0.35, weekend 3.88. Staffing rating: 3/5.

Self-reported quality measures

Note: these ratings are based on data the facility reports about itself to CMS. They are not independently verified by inspectors, and can look better than inspection findings. Give more weight to the inspection results above.

Quality measures rating: 5/5 · long-stay residents: 5/5 · short-stay residents: 5/5

Who owns this facility

For profit - Limited Liability company

Owner / manager	Type	Role	Stake	Since
Anderson, Chad	Individual	Operational/Managerial Control	NOT APPLICABLE	03/01/2020
Anderson, Chad	Individual	ADP of the SNF	NOT APPLICABLE	03/01/2020
Beardsley, Mary	Individual	Operational/Managerial Control	NOT APPLICABLE	03/01/2020
Beardsley, Mary	Individual	ADP of the SNF	NOT APPLICABLE	03/01/2020
Bernholz, Victoria	Individual	Operational/Managerial Control	NOT APPLICABLE	03/01/2020
Bernholz, Victoria	Individual	ADP of the SNF	NOT APPLICABLE	03/01/2020
Carter, Melissa	Individual	Operational/Managerial Control	NOT APPLICABLE	03/01/2020
Carter, Melissa	Individual	ADP of the SNF	NOT APPLICABLE	03/01/2020
Deguzman, Myrna	Individual	Operational/Managerial Control	NOT APPLICABLE	03/01/2020
Deguzman, Myrna	Individual	ADP of the SNF	NOT APPLICABLE	03/01/2020
Eide Bailly LLP	Organization	ADP of the SNF	NOT APPLICABLE	03/01/2020
Forbright Bank	Organization	5% or Greater Security Interest	NOT APPLICABLE	03/01/2020
Freanel & Sons Som LLC	Organization	5% or Greater Security Interest	NOT APPLICABLE	03/01/2020
Freanel & Sons Som LLC	Organization	ADP of the SNF	NOT APPLICABLE	03/01/2020
Frojelin, Antonette	Individual	Operational/Managerial Control	NOT APPLICABLE	03/01/2020
Frojelin, Antonette	Individual	ADP of the SNF	NOT APPLICABLE	03/01/2020
Kaur, Karamjit	Individual	Operational/Managerial Control	NOT APPLICABLE	03/01/2020
Kaur, Karamjit	Individual	ADP of the SNF	NOT APPLICABLE	03/01/2020
Links Healthcare Group LLC	Organization	Operational/Managerial Control	NOT APPLICABLE	03/01/2020
Links Healthcare Group LLC	Organization	ADP of the SNF	NOT APPLICABLE	07/11/2025

Questions to ask on your visit

Generated from this facility's actual citation record — bring them to a tour and ask the administrator directly.

"When abuse or theft is suspected, who do you notify, how fast, and how do you inform the family?"
"Who leads your infection prevention program, and how do you make sure staff follow practices like hand hygiene every day?"
"Can you tell me what this citation involved and what steps you took to bring care back up to standard?"
"How does your pharmacist review residents' medications, and how quickly can you fill new or urgent prescriptions?"
"How often is each resident's medication list reviewed, and who decides when a drug can be reduced or stopped?"
"What is your current medication error rate, and what have you changed to bring errors down?"
"Can you show me how medications are stored and secured on the units, including controlled drugs?"
"What are your rules for bringing in my family member's favorite foods, and how are they stored?"
"What is your current ratio of nursing staff to residents on day, evening, and weekend shifts?"
"Can I see the results and plan of correction from your most recent state inspection?"

Nearby facilities (within 20 miles)

Facility	Distance	City	Overall	Inspection
Stratford Villa Post-Acute	0.0 mi	Livermore, CA	★★★★☆	3/5
The Vineyards Healthcare Center	0.2 mi	Livermore, CA	★★★★★	5/5
Creekview Skilled Nursing	4.1 mi	Pleasanton, CA	★★★★★	5/5
Pleasanton Nursing and Rehabilitation Center	5.0 mi	Pleasanton, CA	★★★★★	5/5
The Reutlinger Community	10.9 mi	Danville, CA	★★★★☆	4/5
Niles Canyon Post Acute	12.6 mi	Fremont, CA	★★★★★	5/5
Mission Valley Post Acute	13.5 mi	Fremont, CA	★★★★☆	3/5
We Care Skilled Nursing - Fremont	13.5 mi	Fremont, CA	★★★☆☆	3/5
Country Drive Post Acute	13.5 mi	Fremont, CA	★★★☆☆	3/5
Masonic Home	13.5 mi	Union City, CA	★★★★☆	4/5

Compare this facility with the 3 closest →

All facilities in Livermore →

Facility data as of CMS processing date 2026-08-01. CCN 555399.

The Care File

Visit checklist — Avondale Villa Post-Acute

788 Holmes Street, Livermore, CA 94550 · 9254472280

Health inspection rating 3/5 · CMS overall 4/5· Fines (3y): $0

Questions for the administrator:

☐ "When abuse or theft is suspected, who do you notify, how fast, and how do you inform the family?"
☐ "Who leads your infection prevention program, and how do you make sure staff follow practices like hand hygiene every day?"
☐ "Can you tell me what this citation involved and what steps you took to bring care back up to standard?"
☐ "How does your pharmacist review residents' medications, and how quickly can you fill new or urgent prescriptions?"
☐ "How often is each resident's medication list reviewed, and who decides when a drug can be reduced or stopped?"
☐ "What is your current medication error rate, and what have you changed to bring errors down?"
☐ "Can you show me how medications are stored and secured on the units, including controlled drugs?"
☐ "What are your rules for bringing in my family member's favorite foods, and how are they stored?"
☐ "What is your current ratio of nursing staff to residents on day, evening, and weekend shifts?"
☐ "Can I see the results and plan of correction from your most recent state inspection?"

While you're there, notice:

☐ Smell and cleanliness in hallways, not just the lobby
☐ How staff speak to residents; call lights answered promptly
☐ Residents up, dressed, and engaged (visit mealtimes and a weekend if you can)

Data: CMS Provider Data Catalog, version 2026-08-01 · CCN 555399 · Verify at medicare.gov/care-compare · Printed from The Care File (thecarefile.com)