★★★★★Overall Medicare rating
★★★★★Health inspections
★★★★★Staffing
★★★★★Quality measures
Medicare rates every nursing home from 1 to 5 stars. 5 is much above average, 1 is much below.
Findings, latest cycle16
Findings with harm or immediate jeopardy, 3 cycles0
Fines, 3 years$0
Beds78
Inspection findings
Inspectors recorded 55 findings in the last three inspection cycles.
Each entry below is a requirement that inspectors found the home did not meet on that date, in the regulator's own English wording.
| Inspection date | Area | Requirement the home did not meet (official wording, in English) | Severity | Corrected |
|---|---|---|---|---|
| Mar 10, 2026 | Quality of life and care | Provide safe, appropriate pain management for a resident who requires such services. (F0697) | No harm, but a risk of harm isolated · from a complaint | Corrected: Mar 10, 2026 |
| Dec 11, 2025 | Quality of life and care | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. (F0689) | No harm, but a risk of harm isolated · from a complaint | Corrected: Dec 19, 2025 |
| Feb 13, 2025 | Building and environment | Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public. (F0921) | No harm, but a risk of harm isolated | Corrected: Mar 5, 2025 |
| Feb 13, 2025 | Building and environment | Keep all essential equipment working safely. (F0908) | No harm, but a risk of harm pattern | Corrected: Feb 15, 2025 |
| Feb 13, 2025 | Infection control | Provide and implement an infection prevention and control program. (F0880) | No harm, but a risk of harm isolated | Corrected: Mar 3, 2025 |
| Feb 13, 2025 | Food and nutrition | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. (F0812) | No harm, but a risk of harm pattern | Corrected: Feb 15, 2025 |
| Feb 13, 2025 | Food and nutrition | Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature. (F0804) | No harm, but a risk of harm pattern | Corrected: Feb 15, 2025 |
| Feb 13, 2025 | Pharmacy and medications | 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. (F0761) | No harm, but a risk of harm isolated | Corrected: Mar 7, 2025 |
| Feb 13, 2025 | Pharmacy and medications | Ensure medication error rates are not 5 percent or greater. (F0759) | No harm, but a risk of harm isolated | Corrected: Mar 7, 2025 |
| Feb 13, 2025 | Pharmacy and medications | 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. (F0758) | No harm, but a risk of harm isolated | Corrected: Mar 3, 2025 |
| Feb 13, 2025 | Pharmacy and medications | Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. (F0755) | No harm, but a risk of harm isolated | Corrected: Mar 3, 2025 |
| Feb 13, 2025 | Nursing and physician services | 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. (F0727) | No harm, but a risk of harm isolated | Corrected: Feb 15, 2025 |
| Feb 13, 2025 | Quality of life and care | Provide safe, appropriate dialysis care/services for a resident who requires such services. (F0698) | No harm, but a risk of harm isolated | Corrected: Mar 3, 2025 |
| Feb 13, 2025 | Quality of life and care | Provide safe and appropriate respiratory care for a resident when needed. (F0695) | No harm, but a risk of harm isolated | Corrected: Mar 3, 2025 |
| Feb 13, 2025 | Quality of life and care | Provide appropriate colostomy, urostomy, or ileostomy care/services for a resident who requires such services. (F0691) | No harm, but a risk of harm isolated | Corrected: Mar 3, 2025 |
| Feb 13, 2025 | Resident rights | Keep residents' personal and medical records private and confidential. (F0583) | No harm, but a risk of harm isolated | Corrected: Mar 3, 2025 |
Earlier inspections (39)
| Inspection date | Area | Requirement the home did not meet (official wording, in English) | Severity | Corrected |
|---|---|---|---|---|
| Oct 9, 2024 | Food and nutrition | Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature. (F0804) | No harm, but a risk of harm isolated · from a complaint | Corrected: Oct 11, 2024 |
| Sep 30, 2024 | Pharmacy and medications | Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. (F0755) | No harm, but a risk of harm isolated · from a complaint | Corrected: Oct 9, 2024 |
| Sep 30, 2024 | Quality of life and care | Provide appropriate treatment and care according to orders, resident’s preferences and goals. (F0684) | No harm, but a risk of harm isolated · from a complaint | Corrected: Oct 9, 2024 |
| Sep 23, 2024 | Quality of life and care | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. (F0689) | No harm, but a risk of harm isolated · from a complaint | Corrected: Sep 27, 2024 |
| Aug 14, 2024 | Quality of life and care | Provide appropriate treatment and care according to orders, resident’s preferences and goals. (F0684) | No harm, but a risk of harm isolated · from a complaint | Corrected: Aug 23, 2024 |
| May 29, 2024 | Abuse, neglect and exploitation | Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. (F0609) | No harm, but a risk of harm isolated · from a complaint | Corrected: Jun 28, 2024 |
| May 3, 2024 | Quality of life and care | Provide medically-related social services to help each resident achieve the highest possible quality of life. (F0745) | No harm, but a risk of harm isolated · from a complaint | Corrected: May 16, 2024 |
| Jun 30, 2023 | Building and environment | Make sure there is a pest control program to prevent/deal with mice, insects, or other pests. (F0925) | No harm, but a risk of harm isolated | Corrected: Jul 27, 2023 |
| Jun 30, 2023 | Building and environment | Keep all essential equipment working safely. (F0908) | No harm, but a risk of harm widespread | Corrected: Jul 27, 2023 |
| Jun 30, 2023 | Food and nutrition | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. (F0812) | No harm, but a risk of harm widespread | Corrected: Jul 27, 2023 |
| Jun 30, 2023 | Pharmacy and medications | 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. (F0761) | No harm, but a risk of harm isolated | Corrected: Jul 27, 2023 |
| Jun 30, 2023 | Pharmacy and medications | Ensure that residents are free from significant medication errors. (F0760) | No harm, but a risk of harm pattern | Corrected: Jul 27, 2023 |
| Jun 30, 2023 | Pharmacy and medications | Ensure medication error rates are not 5 percent or greater. (F0759) | No harm, but a risk of harm isolated | Corrected: Jul 27, 2023 |
| Jun 30, 2023 | Pharmacy and medications | 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. (F0758) | No harm, but a risk of harm pattern | Corrected: Jul 27, 2023 |
| Jun 30, 2023 | Pharmacy and medications | Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures. (F0756) | No harm, but a risk of harm isolated | Corrected: Jul 27, 2023 |
| Jun 30, 2023 | Pharmacy and medications | Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. (F0755) | No harm, but a risk of harm pattern | Corrected: Jul 27, 2023 |
| Jun 30, 2023 | Quality of life and care | Ensure each resident must receive and the facility must provide necessary behavioral health care and services. (F0740) | No harm, but a risk of harm isolated | Corrected: Jul 27, 2023 |
| Jun 30, 2023 | Quality of life and care | Try different approaches before using a bed rail. If a bed rail is needed, the facility must (1) assess a resident for safety risk; (2) review these risks and benefits with the resident/representative; (3) get informed consent; and (4) Correctly install and maintain the bed rail. (F0700) | No harm, but a risk of harm isolated | Corrected: Jul 27, 2023 |
| Jun 30, 2023 | Quality of life and care | Provide safe and appropriate respiratory care for a resident when needed. (F0695) | No harm, but a risk of harm isolated | Corrected: Jul 27, 2023 |
| Jun 30, 2023 | Quality of life and care | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. (F0689) | No harm, but a risk of harm isolated | Corrected: Jul 27, 2023 |
| Jun 30, 2023 | Quality of life and care | Provide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM and/or mobility, unless a decline is for a medical reason. (F0688) | No harm, but a risk of harm isolated | Corrected: Jul 27, 2023 |
| Jun 30, 2023 | Quality of life and care | Provide appropriate pressure ulcer care and prevent new ulcers from developing. (F0686) | No harm, but a risk of harm isolated | Corrected: Jul 27, 2023 |
| Jun 30, 2023 | Quality of life and care | Assist a resident in gaining access to vision and hearing services. (F0685) | No harm, but a risk of harm isolated | Corrected: Jul 27, 2023 |
| Jun 30, 2023 | Resident assessment and care planning | Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. (F0656) | No harm, but a risk of harm pattern | Corrected: Jul 27, 2023 |
| Jun 30, 2023 | Resident rights | Notify the resident or the resident’s representative in writing how long the nursing home will hold the resident’s bed in cases of transfer to a hospital or therapeutic leave. (F0625) | No harm, but a risk of harm isolated | Corrected: Jul 27, 2023 |
| Jun 30, 2023 | Resident rights | Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights. (F0623) | No harm, but a risk of harm isolated | Corrected: Jul 27, 2023 |
| Jun 30, 2023 | Resident rights | Reasonably accommodate the needs and preferences of each resident. (F0558) | No harm, but a risk of harm pattern | Corrected: Jul 27, 2023 |
| Jun 30, 2023 | Resident rights | Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. (F0550) | No harm, but a risk of harm isolated | Corrected: Jul 27, 2023 |
| May 3, 2019 | Administration | Arrange for the provision of hospice services or assist the resident in transferring to a facility that will arrange for the provision of hospice services. (F0849) | No harm, but a risk of harm isolated | Corrected: Jun 7, 2019 |
| May 3, 2019 | Food and nutrition | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. (F0812) | No harm, but a risk of harm pattern | Corrected: Jun 7, 2019 |
| May 3, 2019 | Pharmacy and medications | 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. (F0758) | No harm, but a risk of harm isolated | Corrected: Jun 7, 2019 |
| May 3, 2019 | Quality of life and care | Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections. (F0690) | No harm, but a risk of harm isolated | Corrected: Jun 7, 2019 |
| May 3, 2019 | Quality of life and care | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. (F0689) | No harm, but a risk of harm isolated | Corrected: Jun 7, 2019 |
| May 3, 2019 | Quality of life and care | Provide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM and/or mobility, unless a decline is for a medical reason. (F0688) | No harm, but a risk of harm isolated | Corrected: Jun 7, 2019 |
| May 3, 2019 | Quality of life and care | Provide appropriate treatment and care according to orders, resident’s preferences and goals. (F0684) | No harm, but a risk of harm isolated | Corrected: Jun 7, 2019 |
| May 3, 2019 | Quality of life and care | Provide care and assistance to perform activities of daily living for any resident who is unable. (F0677) | No harm, but a risk of harm isolated | Corrected: Jun 7, 2019 |
| May 3, 2019 | Resident assessment and care planning | Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. (F0656) | No harm, but a risk of harm isolated | Corrected: Jun 7, 2019 |
| May 3, 2019 | Resident assessment and care planning | Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed. (F0644) | No harm, but a risk of harm isolated | Corrected: Jun 7, 2019 |
| May 3, 2019 | Resident rights | Reasonably accommodate the needs and preferences of each resident. (F0558) | No harm, but a risk of harm isolated | Corrected: Jun 7, 2019 |
Fines and payment denials
No federal fines or payment denials in the last three years.
Staffing
| Nurse staff hours per resident per day | 3.82 | California median: 4.27 |
| Registered nurse hours per resident per day | 0.36 | California median: 0.52 |
| Nurse staff hours on weekends | 3.55 | California median: 3.85 |
| Nursing staff who left within a year | 49.4% | California median: 36.0% |
About this home
| Beds | 78 |
| Residents per day, average | 72.3 |
| Ownership | For-profit, limited liability company |
| Legal business name | Windsor Monterey Care Center LLC |
| Chain | Windsor (22 homes) |
| In Medicare/Medicaid since | Jun 1, 1969 |
Questions to ask when you call
- What was corrected after the last inspection?
- How many staff work at night and on weekends?
- Does anyone on staff speak my relative's language?
- May I visit at any time, without an appointment?
Source. Medicare Care Compare (CMS Provider Data), data dated Oct 1, 2026. Open this home on Medicare.gov
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