Nursing Care Index

The Royal Home

El Cajon, San Diego County, California · CCN 05A192 · For-profit (Individual) · not part of a chain

CMS rates The Royal Home 4 of 5 overall as of August 2026. 19 certified beds, 14 residents a day on average. 31 citations on record from the current inspection cycles; no fines on record.

CMS’s ratings

The Five-Star Quality Rating System, as CMS publishes it. Where CMS gives no rating, the reason CMS gives is printed instead.

Overall★★★★☆ 4 of 5
Health inspections★★★☆☆ 3 of 5
Staffing★★★★☆ 4 of 5
Quality measures★★★★★ 5 of 5
Quality: long-stay / short-stay5 / — of 5

Staffing

Total nurse staffing4.17601 hours per resident per day
Registered nurses0.56953 hours per resident per day
Weekend total3.78919 hours per resident per day
Nursing staff turnover73.9%

Citations from health inspections

Each is a finding by a state surveyor on the date shown, in CMS’s words. The severity is CMS’s scope-and-severity grid, spelled out: harm on the left, how widespread on the right.

SurveyFindingSeverityStatus
2025-12-03 Have a registered nurse on duty 8 hours a day; and select a registered nurse to be the director of nurses on a full time basis.
Nursing and Physician Services Deficiencies · tag F0727
F No actual harm, with potential for more than minimal harm; widespread Deficient, Provider has date of correction
2025-12-06
2025-12-03 Employ sufficient staff with the appropriate competencies and skills sets to carry out the functions of the food and nutrition service, including a qualified dietician.
Nutrition and Dietary Deficiencies · tag F0801
F No actual harm, with potential for more than minimal harm; widespread Deficient, Provider has date of correction
2025-12-06
2025-12-03 Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Nutrition and Dietary Deficiencies · tag F0812
F No actual harm, with potential for more than minimal harm; widespread Deficient, Provider has date of correction
2025-12-06
2025-12-03 Provide and implement an infection prevention and control program.
Infection Control Deficiencies · tag F0880
F No actual harm, with potential for more than minimal harm; widespread Deficient, Provider has date of correction
2025-12-06
2025-12-03 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.
Resident Rights Deficiencies · tag F0578
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2025-12-06
2025-12-03 Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
Resident Rights Deficiencies · tag F0550
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2025-12-06
2025-12-03 Ensure each resident receives and the facility provides food prepared in a form designed to meet individual needs.
Nutrition and Dietary Deficiencies · tag F0805
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2025-12-06
2025-12-03 Ensure resident rooms hold no more than 4 residents; for new construction after November 28, 2016, rooms hold no more than 2 residents.
Environmental Deficiencies · tag F0911
B No actual harm, with potential for minimal harm; pattern Deficient, Provider has date of correction
2025-12-06
2025-12-03 Provide rooms that are at least 80 square feet per resident in multiple rooms and 100 square feet for single resident rooms.
Environmental Deficiencies · tag F0912
B No actual harm, with potential for minimal harm; pattern Deficient, Provider has date of correction
2025-12-06
2023-12-15 Provide sufficient support personnel to safely and effectively carry out the functions of the food and nutrition service.
Nutrition and Dietary Deficiencies · tag F0802
F No actual harm, with potential for more than minimal harm; widespread Deficient, Provider has date of correction
2024-01-17
2023-12-15 Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Nutrition and Dietary Deficiencies · tag F0812
F No actual harm, with potential for more than minimal harm; widespread Deficient, Provider has date of correction
2024-01-17
2023-12-15 Set up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action.
Administration Deficiencies · tag F0867
F No actual harm, with potential for more than minimal harm; widespread Deficient, Provider has date of correction
2024-01-17
2023-12-15 Provide and implement an infection prevention and control program.
Infection Control Deficiencies · tag F0880
F No actual harm, with potential for more than minimal harm; widespread Deficient, Provider has date of correction
2024-01-17
2023-12-15 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.
Pharmacy Service Deficiencies · tag F0758
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2024-01-17
2023-12-15 Ensure that residents are fully informed and understand their health status, care and treatments.
Resident Rights Deficiencies · tag F0552
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2024-01-17
2023-12-15 Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.
Resident Rights Deficiencies · tag F0584
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2024-01-17
2023-12-15 Ensure each resident receives an accurate assessment.
Resident Assessment and Care Planning Deficiencies · tag F0641
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2024-01-17
2023-12-15 Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.
Resident Assessment and Care Planning Deficiencies · tag F0644
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2024-01-17
2023-12-15 Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures.
Pharmacy Service Deficiencies · tag F0756
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2024-01-17
2023-12-15 Develop and implement policies and procedures for flu and pneumonia vaccinations.
Infection Control Deficiencies · tag F0883
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2024-01-17
2023-12-15 Ensure resident rooms hold no more than 4 residents; for new construction after November 28, 2016, rooms hold no more than 2 residents.
Environmental Deficiencies · tag F0911
B No actual harm, with potential for minimal harm; pattern Deficient, Provider has plan of correction
2024-01-17
2023-12-15 Provide rooms that are at least 80 square feet per resident in multiple rooms and 100 square feet for single resident rooms.
Environmental Deficiencies · tag F0912
B No actual harm, with potential for minimal harm; pattern Deficient, Provider has plan of correction
2024-01-17
2022-02-11 Provide and implement an infection prevention and control program.
Infection Control Deficiencies · tag F0880
F No actual harm, with potential for more than minimal harm; widespread Deficient, Provider has date of correction
2022-02-24
2022-02-11 Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
Pharmacy Service Deficiencies · tag F0755
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2022-02-24
2022-02-11 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.
Pharmacy Service Deficiencies · tag F0761
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2022-02-24
2022-02-11 Provide or obtain dental services for each resident.
Quality of Life and Care Deficiencies · tag F0791
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2022-02-24
2022-02-11 Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
Resident Assessment and Care Planning Deficiencies · tag F0842
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2022-02-24
2022-02-11 Set up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action.
Administration Deficiencies · tag F0867
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2022-02-24
2022-02-11 Develop and implement policies and procedures for flu and pneumonia vaccinations.
Infection Control Deficiencies · tag F0883
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2022-02-24
2022-02-11 Ensure resident rooms hold no more than 4 residents; for new construction after November 28, 2016, rooms hold no more than 2 residents.
Environmental Deficiencies · tag F0911
B No actual harm, with potential for minimal harm; pattern Deficient, Provider has date of correction
2022-02-24
2022-02-11 Provide rooms that are at least 80 square feet per resident in multiple rooms and 100 square feet for single resident rooms.
Environmental Deficiencies · tag F0912
B No actual harm, with potential for minimal harm; pattern Deficient, Provider has date of correction
2022-02-24

Fines and payment denials

No fines or payment denials on record since 2023.

Who owns and runs it

Every owner, officer and manager CMS lists, as filed. These are the names in CMS’s ownership record; anyone named in the ownership record can ask about it on the about page.

CMS lists no ownership for this facility.

What changed

Nothing has changed in this record since it was first loaded. The next CMS refresh is the next chance.

Tell me when this record changes

One email when the monthly CMS refresh brings a new citation, a fine or payment denial, a rating change, a flag, or a change of ownership for The Royal Home.

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Source: Centers for Medicare & Medicaid Services, Provider Data Catalog (public domain), files dated 2026-08-01. Ratings are CMS’s; citations are state surveyors’ findings; nothing here is estimated or a recommendation. Every nursing home in San Diego County.