Villa Mesa Care Center
867 E. 11th St, Upland, CA 91786 · San Bernardino County · 99 certified beds · avg 104 residents/day · certified since Jun 1, 1972 · Medicare and Medicaid certified
Certified for both programmes. Certification means the facility can bill Medicaid — it does not mean a Medicaid-funded bed is free right now, so ask directly. Who pays for nursing home care →
What health inspectors found (on-site government inspections — the most independent evidence available)
Health inspection rating: ★★★★☆4/5 · CMS overall rating: 3/5
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.
Most serious findings (actual harm or immediate jeopardy)
▲ Actual harm, one-off · Jan 23, 2026 · F-0686
The facility did not provide proper care for pressure ulcers (bedsores) or did not do enough to prevent new ones from forming. Bedsores develop when residents stay in one position too long without help moving.
Why it matters: Bedsores are painful, can become deeply infected, and in serious cases can be life-threatening.
Severity (G): One or a few residents were actually harmed — physically or emotionally — though not put in immediate danger of serious injury or death.
Corrected: Feb 12, 2026 (Deficient, Provider has date of correction)
All citations in the current public record (20)
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 |
|---|---|---|
| Jan 23, 2026 | ▲ G · Actual harm, one-off | The facility did not provide proper care for pressure ulcers (bedsores) or did not do enough to prevent new ones from forming. Bedsores develop when residents stay in one position too long without help moving. |
| Jan 23, 2026 | D · Potential for harm, one-off | The facility did not treat residents with dignity and respect, or did not honor their rights to make their own decisions and communicate freely. This is one of the most fundamental resident rights. |
| Jan 23, 2026 | 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. |
| Jan 23, 2026 | 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. |
| Jan 23, 2026 | 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. |
| Jan 23, 2026 | D · Potential for harm, one-off | The facility did not safely and appropriately administer IV fluids (fluids given through a vein) for residents who needed them. |
| Jan 23, 2026 | 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. |
| Jan 23, 2026 | D · Potential for harm, one-off | 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. |
| Dec 13, 2024 | 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. · from a complaint |
| Oct 28, 2024 | 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 |
| Oct 3, 2024 | E · Potential for harm, repeated | The facility did not properly complete the required screening (called PASARR) that identifies whether a person entering a nursing home has a mental illness or intellectual disability and needs specialized services. |
| Oct 19, 2023 | D · Potential for harm, one-off | The facility did not immediately notify the resident, their doctor, and a family member when something significant happened — such as an injury, a decline in health, or a room change. Families and doctors are entitled to know right away. · from a complaint |
| Nov 19, 2021 | E · Potential for harm, repeated | The facility did not provide pharmacy services that meet each resident's needs, or did not employ or contract with a licensed pharmacist. |
| Nov 19, 2021 | 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. |
| Nov 19, 2021 | D · Potential for harm, one-off | The facility did not treat residents with respect and dignity, or did not let them keep and use their own personal belongings. |
| Nov 19, 2021 | 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. |
| Nov 19, 2021 | 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. |
| Nov 19, 2021 | D · Potential for harm, one-off | The facility did not make sure its nurses and nurse aides had the skills and training needed to properly care for every resident. |
| Nov 19, 2021 | 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. |
| Nov 19, 2021 | 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. |
Inspection trend by year
Citations from standard inspections increased between the last two inspection cycles (1 → 8).
| Year | Citations | Serious (G–L) | Worst severity that year |
|---|---|---|---|
| 2021 | 8 | 0 | E |
| 2023 | 1 | 0 | D |
| 2024 | 3 | 0 | E |
| 2026 | 8 | 1 | G ▲ |
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) | 3.24 | 4.31 | 3.95 | bottom 3% in California; bottom 24% in the U.S. |
| Registered Nurse hours | 0.30 | 0.61 | 0.69 | bottom 13% in California; bottom 10% in the U.S. |
| Weekend total nurse staffing | 3.02 | 3.90 | 3.50 | bottom 4% in California; bottom 32% in the U.S. |
| Weekend RN hours (not acuity-adjusted) | 0.23 | 0.51 | 0.48 | bottom 16% in California; bottom 17% in the U.S. |
| Total nursing staff turnover (%) | 53.4 | 36.7 | 45.8 | bottom 9% in California; bottom 28% in the U.S. |
| RN turnover (%) | 63.6 | 38.1 | 42.9 | bottom 12% in California; bottom 17% 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 3.61, RN 0.34, weekend 3.37. Staffing rating: 1/5.
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: 3/5 · long-stay residents: 5/5 · short-stay residents: 1/5
Who owns this facility
For profit - Limited Liability company
| Owner / manager | Type | Role | Stake | Since |
|---|---|---|---|---|
| Mahan, Marylynn | Individual | 5% or Greater Direct Ownership Interest | 30% | 08/17/2023 |
| Weinberger, Philip | Individual | 5% or Greater Direct Ownership Interest | 30% | 04/01/2002 |
| Weiss, Hadassah | Individual | 5% or Greater Direct Ownership Interest | 20% | 08/17/2023 |
| Gateways Rehabilitation Center II LLC | Organization | ADP of the SNF | NOT APPLICABLE | 08/17/2023 |
| Gharibian, Patric | Individual | Corporate Officer | NOT APPLICABLE | 11/25/2024 |
| Gharibian, Patric | Individual | Operational/Managerial Control | NOT APPLICABLE | 11/25/2024 |
| Gharibian, Patric | Individual | ADP of the SNF | NOT APPLICABLE | 11/25/2024 |
| Grant, Daniel | Individual | Operational/Managerial Control | NOT APPLICABLE | 02/07/2025 |
| Grant, Daniel | Individual | ADP of the SNF | NOT APPLICABLE | 02/07/2025 |
| Lopez, Kimberly | Individual | Individual Is an Owner, Partner or Trustee of Any ADP of the SNF | NOT APPLICABLE | 09/10/2025 |
| Mahan, Marylynn | Individual | Corporate Director | NOT APPLICABLE | 08/17/2023 |
| Mahan, Marylynn | Individual | Corporate Officer | NOT APPLICABLE | 08/17/2023 |
| Power & Design Development LLC | Organization | ADP of the SNF | NOT APPLICABLE | 09/10/2025 |
| Powers, Greg | Individual | Individual Is an Owner, Partner or Trustee of Any ADP of the SNF | NOT APPLICABLE | 09/10/2025 |
| Powers, Katherine | Individual | Individual Is an Owner, Partner or Trustee of Any ADP of the SNF | NOT APPLICABLE | 09/10/2025 |
| Powers, Michael | Individual | Individual Is an Owner, Partner or Trustee of Any ADP of the SNF | NOT APPLICABLE | 09/10/2025 |
| Powers, Scott | Individual | Individual Is an Owner, Partner or Trustee of Any ADP of the SNF | NOT APPLICABLE | 09/10/2025 |
| Renew Health Consulting Services LLC | Organization | Operational/Managerial Control | NOT APPLICABLE | 08/17/2023 |
| Renew Health Consulting Services LLC | Organization | ADP of the SNF | NOT APPLICABLE | 08/17/2023 |
| Rizvi, Abid | Individual | Operational/Managerial Control | NOT APPLICABLE | 02/01/2025 |
Questions to ask on your visit
Generated from this facility's actual citation record — bring them to a tour and ask the administrator directly.
- "How do you prevent bedsores for residents who can't move themselves, and how often are at-risk residents repositioned?"
- "Can you give me examples of how your staff protect residents' dignity in everyday care, like bathing and dressing?"
- "Who completes resident assessments here, and how do you check them for accuracy?"
- "Can you show me an example care plan, and how are families included when it's created and updated?"
- "How do you monitor residents' weight and eating, and what happens when someone starts losing weight?"
- "Who on your staff manages IV therapy, and what training and monitoring is in place?"
- "How does your pharmacist review residents' medications, and how quickly can you fill new or urgent prescriptions?"
- "Who leads your infection prevention program, and how do you make sure staff follow practices like hand hygiene every day?"
- "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 | Flags |
|---|---|---|---|---|---|
| Upland Rehabilitation and Care Center | 0.3 mi | Upland, CA | ★★★★★ | 4/5 | |
| Heritage Park Nursing Center | 0.7 mi | Upland, CA | ★★★★★ | 5/5 | |
| Ontario Grove Healthcare & Wellness Centre, LP | 1.2 mi | Ontario, CA | ★★★☆☆ | 4/5 | |
| Las Colinas Post Acute | 1.5 mi | Ontario, CA | ★★☆☆☆ | 2/5 | |
| Rancho Mesa Care Center | 2.7 mi | Alta Loma, CA | ★★★★☆ | 4/5 | |
| Community Extended Care Hospital of Montclair | 3.3 mi | Montclair, CA | ★★★★★ | 5/5 | |
| Montclair Manor Care Center | 3.9 mi | Montclair, CA | ★★★★★ | 4/5 | |
| Ontario Healthcare Center | 4.2 mi | Ontario, CA | ★★★★★ | 5/5 | |
| Claremont Heights Post Acute | 4.7 mi | Claremont, CA | ★★☆☆☆ | 2/5 | |
| Inland Christian Home | 4.8 mi | Ontario, CA | ★★★★☆ | 4/5 | |
| Pilgrim Place Health Services Center | 5.2 mi | Claremont, CA | ★★★☆☆ | 2/5 | |
| Claremont Manor Care Center | 5.2 mi | Claremont, CA | ★★★☆☆ | 3/5 |
Compare this facility with the 3 closest →
Facility data as of CMS processing date 2026-08-01. CCN 056136.