Heartwood Avenue Healthcare
1044 Heartwood Ave. · Vallejo, CA · 94591 · 7076432267
60 certified beds For profit - Limited Liability company Chain: Bvhc, LLC
Why this verdict
- 4 citations involved actual harm to residents.
- Inspection results have improved across recent cycles.
The complete Safety Report — $19
Everything on this page plus the full citation-by-citation history with inspector findings, the complete penalty record, staffing vs benchmarks, side-by-side nearby comparisons, and the printable tour checklist. One PDF, emailed in minutes, yours to keep and share with family.
Red flags
Cited under the freedom-from-abuse rule
Cited 1 time under F600 (freedom from abuse/neglect) below the actual-harm level — worth asking about on a tour.
Score breakdown
Quality-measure stars are deliberately excluded — they're largely self-reported by facilities. Full method.
CMS ratings & staffing
Overall: 4 of 5 Inspections: 3 of 5 Staffing: 3 of 5 Quality measures: 5 of 5
| Total nurse hours / resident-day | 3.98 | 3.48 min · 4.1 strong |
|---|---|---|
| RN hours / resident-day | 0.48 | 0.55–0.75 |
| Weekend hours / resident-day | 3.70 | ≈ weekday level |
| Nursing turnover / year | 50% | median 45% |
| Fines (3-yr window) | 2 · $16,988 |
Inspection citations (42 in the current record)
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Actual harm · G April 14, 2026 · found via complaint
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Corrected April 23, 2026 · Quality of Life and Care
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Potential for harm · D February 25, 2026 · found via complaint
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Corrected March 6, 2026 · Quality of Life and Care
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Potential for harm · D October 29, 2025 · found via complaint
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
Corrected November 6, 2025 · Freedom from Abuse, Neglect, and Exploitation
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Potential for harm · D August 8, 2025 · found via complaint
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
Corrected September 2, 2025 · Freedom from Abuse, Neglect, and Exploitation
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Potential for harm · E February 27, 2025
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
Corrected March 11, 2025 · Resident Rights
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Potential for harm · D February 27, 2025
Reasonably accommodate the needs and preferences of each resident.
Corrected March 11, 2025 · Resident Rights
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Potential for harm · D February 27, 2025
Ensure services provided by the nursing facility meet professional standards of quality.
Corrected March 11, 2025 · Resident Assessment and Care Planning
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Potential for harm · E February 27, 2025
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.
Corrected March 11, 2025 · Pharmacy Service
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Potential for harm · E February 27, 2025 · found via complaint
Provide and implement an infection prevention and control program.
Corrected March 11, 2025 · Infection Control
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Potential for harm · D February 10, 2025 · found via complaint
Provide and implement an infection prevention and control program.
Corrected February 20, 2025 · Infection Control
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Potential for harm · E June 4, 2024 · found via complaint
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.
Corrected July 2, 2024 · Resident Rights
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Actual harm · G May 3, 2024 · found via complaint
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Corrected May 15, 2024 · Quality of Life and Care
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Potential for harm · D March 6, 2024 · found via complaint
Provide and implement an infection prevention and control program.
Corrected April 16, 2024 · Infection Control
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Actual harm · G January 9, 2024 · found via complaint
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
Corrected January 22, 2024 · Quality of Life and Care
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Actual harm · G January 9, 2024 · found via complaint
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Corrected January 22, 2024 · Quality of Life and Care
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Potential for harm · E January 9, 2024 · found via complaint
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Corrected January 22, 2024 · Quality of Life and Care
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Potential for harm · E January 9, 2024 · found via complaint
Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.
Corrected January 22, 2024 · Nursing and Physician Services
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Potential for harm · E January 9, 2024 · found via complaint
Provide and implement an infection prevention and control program.
Corrected January 22, 2024 · Infection Control
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Potential for harm · E February 9, 2023
Keep residents' personal and medical records private and confidential.
Corrected March 13, 2023 · Resident Rights
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Potential for harm · D February 9, 2023
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.
Corrected March 13, 2023 · Resident Rights
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Potential for harm · D February 9, 2023
Ensure each resident receives an accurate assessment.
Corrected March 13, 2023 · Resident Assessment and Care Planning
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Potential for harm · D February 9, 2023
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Corrected March 13, 2023 · Resident Assessment and Care Planning
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Potential for harm · D February 9, 2023
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
Corrected March 13, 2023 · Resident Assessment and Care Planning
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Potential for harm · D February 9, 2023
Provide activities to meet all resident's needs.
Corrected March 13, 2023 · Quality of Life and Care
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Potential for harm · D February 9, 2023
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Corrected March 13, 2023 · Quality of Life and Care
Showing the 25 most recent. The Safety Report includes every citation with full findings.
Federal penalties
| Date | Type | Amount / length |
|---|---|---|
| May 3, 2024 | Fine | $8,970 |
| January 9, 2024 | Fine | $8,018 |
Family & resident reviews — a separate signal, never mixed into the score
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Source: CMS Care Compare (public domain), data as of June 1, 2026 · CCN 555184 · certified since January 1, 1985. The score is a screen, not a verdict on any one resident's experience — read how it's computed, then visit in person.