Safety Report: Golden Sonora Care Center
Official ratings
Medicare's star ratings compare nursing homes within the same state for health inspections. A 5-star facility performed better than most in its state; a 1-star facility performed worse than most.
Stars are calculated by CMS, not by us. We do not create our own safety score.
Serious documented violations
Citations by topic
Topics use CMS's own deficiency categories; “accidents & supervision” counts tag F689 (free of accident hazards / adequate supervision). Counts cover the last three inspection cycles, including complaint investigations.
Is it getting better or worse?
More citations in the most recent cycle (29) than in the cycle before (22).
An inspection cycle is roughly one year and includes the standard inspection plus complaint investigations. Counts depend partly on how many complaint investigations occurred, so treat small changes with caution. Red bars include at least one serious citation.
Staffing and rating trends will appear as we collect monthly CMS releases. We have one month so far, so a staffing trend cannot yet be determined.
Repeat findings
These requirements were cited on more than one inspection date in the last three cycles.
| Requirement | Times cited | Inspection dates |
|---|---|---|
| Provide appropriate treatment and care according to orders, resident’s preferences and goals. (F684) | 8 | July 9, 2026; April 2, 2026; February 19, 2025; October 2, 2024; July 18, 2024; April 11, 2024; October 17, 2023; June 22, 2023 |
| Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. (F689) | 5 | August 7, 2025; July 1, 2025; June 20, 2024; February 26, 2024; June 22, 2023 |
| Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. (F550) | 4 | March 12, 2026; August 7, 2025; June 20, 2024; June 22, 2023 |
| Provide and implement an infection prevention and control program. (F880) | 4 | August 7, 2025; June 20, 2024; March 27, 2024; June 22, 2023 |
| Ensure services provided by the nursing facility meet professional standards of quality. (F658) | 4 | August 7, 2025; December 6, 2023; October 20, 2023; June 22, 2023 |
| Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. (F656) | 4 | August 7, 2025; July 18, 2024; January 9, 2024; June 22, 2023 |
| Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. (F580) | 3 | September 2, 2025; August 7, 2025; March 5, 2024 |
| Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. (F812) | 3 | August 7, 2025; June 20, 2024; June 22, 2023 |
| 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. (F761) | 3 | August 7, 2025; June 20, 2024; June 22, 2023 |
| Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. (F755) | 3 | August 7, 2025; June 20, 2024; October 11, 2023 |
| Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections. (F690) | 2 | May 20, 2026; August 7, 2025 |
| Ensure each resident receives and the facility provides food that accommodates resident allergies, intolerances, and preferences, as well as appealing options. (F806) | 2 | August 7, 2025; June 22, 2023 |
| Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature. (F804) | 2 | August 7, 2025; June 22, 2023 |
| Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. (F842) | 2 | August 7, 2025; June 22, 2023 |
| Ensure medication error rates are not 5 percent or greater. (F759) | 2 | August 7, 2025; June 22, 2023 |
| 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. (F688) | 2 | August 7, 2025; June 22, 2023 |
| Provide appropriate foot care. (F687) | 2 | June 11, 2025; June 22, 2023 |
| Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted (F655) | 2 | February 19, 2025; June 22, 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. (F584) | 2 | January 29, 2025; June 22, 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. (F758) | 2 | June 20, 2024; January 9, 2024 |
| Provide safe and appropriate respiratory care for a resident when needed. (F695) | 2 | June 20, 2024; June 22, 2023 |
| Provide for the safe, appropriate administration of IV fluids for a resident when needed. (F694) | 2 | June 20, 2024; June 22, 2023 |
| Reasonably accommodate the needs and preferences of each resident. (F558) | 2 | June 20, 2024; June 22, 2023 |
Fines and enforcement
| Date | Type | Amount / length |
|---|---|---|
| February 26, 2024 | Payment Denial | Payment denial for 21 days, starting March 29, 2024 |
| February 26, 2024 | Fine | $56,843 |
Federal civil money penalties and Medicare/Medicaid payment denials. State-level penalties may not be included.
Complete inspection history
July 9, 2026 — 1 citation · complaint investigation
May 20, 2026 — 1 citation · complaint investigation
April 2, 2026 — 2 citations · complaint investigation
March 12, 2026 — 1 citation · complaint investigation
December 9, 2025 — 1 citation · complaint investigation
September 2, 2025 — 1 citation · complaint investigation
August 7, 2025 — 23 citations
July 1, 2025 — 1 citation · complaint investigation
June 11, 2025 — 1 citation · complaint investigation
February 19, 2025 — 2 citations · complaint investigation
January 29, 2025 — 1 citation · complaint investigation
October 2, 2024 — 1 citation · complaint investigation
July 23, 2024 — 1 citation · complaint investigation
July 18, 2024 — 2 citations · complaint investigation
June 20, 2024 — 15 citations
May 17, 2024 — 1 citation · complaint investigation
April 11, 2024 — 1 citation · complaint investigation
March 27, 2024 — 1 citation · complaint investigation
March 5, 2024 — 1 citation · complaint investigation
February 26, 2024 — 1 citation (includes serious) · complaint investigation
January 9, 2024 — 2 citations · complaint investigation
December 6, 2023 — 1 citation · complaint investigation
October 20, 2023 — 1 citation · complaint investigation
October 17, 2023 — 1 citation · complaint investigation
October 11, 2023 — 1 citation · complaint investigation
June 22, 2023 — 25 citations (includes serious)
Source: CMS Health Deficiencies dataset (data as of October 1, 2026); full inspection narratives on Medicare Care Compare