The Royal Home
12436 Royal Road · El Cajon, CA · 92021 · 6194433886
19 certified beds For profit - Individual
Why this verdict
- Staffing levels are well below research benchmarks for safe care.
- No federal fines or payment denials in CMS’s 3-year window.
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
RN staffing in the bottom 10% nationally
0.00 registered-nurse hours per resident per day, vs a 0.58 national median and 0.75 benchmark.
Total nurse staffing below 3.0 hours per resident-day
2.83 reported hours vs the 3.48 minimum CMS's own staffing study recommends.
75% of nursing staff left within a year
High turnover disrupts continuity of care; the national median is 45%.
Score breakdown
Quality-measure stars are deliberately excluded — they're largely self-reported by facilities. Full method.
CMS ratings & staffing
Overall: 3 of 5 Inspections: 3 of 5 Staffing: 1 of 5 Quality measures: 5 of 5
| Total nurse hours / resident-day | 2.83 | 3.48 min · 4.1 strong |
|---|---|---|
| RN hours / resident-day | 0.00 | 0.55–0.75 |
| Weekend hours / resident-day | 3.09 | ≈ weekday level |
| Nursing turnover / year | 75% | median 45% |
| Fines (3-yr window) | none |
Inspection citations (31 in the current record)
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Potential for harm · D December 3, 2025
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
Corrected December 6, 2025 · Resident Rights
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Potential for harm · E December 3, 2025
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.
Corrected December 6, 2025 · Resident Rights
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Potential for harm · F December 3, 2025
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.
Corrected December 6, 2025 · Nursing and Physician Services
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Potential for harm · F December 3, 2025
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.
Corrected December 6, 2025 · Nutrition and Dietary
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Potential for harm · D December 3, 2025
Ensure each resident receives and the facility provides food prepared in a form designed to meet individual needs.
Corrected December 6, 2025 · Nutrition and Dietary
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Potential for harm · F December 3, 2025
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Corrected December 6, 2025 · Nutrition and Dietary
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Potential for harm · F December 3, 2025
Provide and implement an infection prevention and control program.
Corrected December 6, 2025 · Infection Control
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No harm found · B December 3, 2025
Ensure resident rooms hold no more than 4 residents; for new construction after November 28, 2016, rooms hold no more than 2 residents.
Corrected December 6, 2025 · Environmental
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No harm found · B December 3, 2025
Provide rooms that are at least 80 square feet per resident in multiple rooms and 100 square feet for single resident rooms.
Corrected December 6, 2025 · Environmental
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Potential for harm · D December 15, 2023
Ensure that residents are fully informed and understand their health status, care and treatments.
Corrected January 17, 2024 · Resident Rights
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Potential for harm · D December 15, 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 January 17, 2024 · Resident Rights
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Potential for harm · D December 15, 2023
Ensure each resident receives an accurate assessment.
Corrected January 17, 2024 · Resident Assessment and Care Planning
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Potential for harm · D December 15, 2023
Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.
Corrected January 17, 2024 · Resident Assessment and Care Planning
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Potential for harm · D December 15, 2023
Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures.
Corrected January 17, 2024 · Pharmacy Service
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Potential for harm · E December 15, 2023
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.
Corrected January 17, 2024 · Pharmacy Service
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Potential for harm · F December 15, 2023
Provide sufficient support personnel to safely and effectively carry out the functions of the food and nutrition service.
Corrected January 17, 2024 · Nutrition and Dietary
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Potential for harm · F December 15, 2023
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Corrected January 17, 2024 · Nutrition and Dietary
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Potential for harm · F December 15, 2023
Set up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action.
Corrected January 17, 2024 · Administration
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Potential for harm · F December 15, 2023
Provide and implement an infection prevention and control program.
Corrected January 17, 2024 · Infection Control
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Potential for harm · D December 15, 2023
Develop and implement policies and procedures for flu and pneumonia vaccinations.
Corrected January 17, 2024 · Infection Control
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No harm found · B December 15, 2023
Ensure resident rooms hold no more than 4 residents; for new construction after November 28, 2016, rooms hold no more than 2 residents.
Corrected January 17, 2024 · Environmental
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No harm found · B December 15, 2023
Provide rooms that are at least 80 square feet per resident in multiple rooms and 100 square feet for single resident rooms.
Corrected January 17, 2024 · Environmental
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Potential for harm · D February 11, 2022
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
Corrected February 24, 2022 · Pharmacy Service
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Potential for harm · D February 11, 2022
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 February 24, 2022 · Pharmacy Service
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Potential for harm · D February 11, 2022
Provide or obtain dental services for each resident.
Corrected February 24, 2022 · Quality of Life and Care
Showing the 25 most recent. The Safety Report includes every citation with full findings.
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Source: CMS Care Compare (public domain), data as of June 1, 2026 · CCN 05A192 · certified since July 1, 1975. The score is a screen, not a verdict on any one resident's experience — read how it's computed, then visit in person.