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Nursing HomeMedicaid Investigative

California Terrace

Below-average Medicare ratings — review the inspection history and ask the administrator about recent corrections before visiting.

2829 South California Blvd, South Lawndale · Chicago, IL 60608297 bedsLicensed & Active
1/5
Medicare
Inspection
Quality
Staffing
Google rating
2.0/5

based on 64 Google reviews

5
4
3
2
1
California Terrace Nursing Home in Chicago, IL — Street View
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6/ 10
high Risk

Quality Concerns Identified

Medicare inspection and quality data reveal areas that families should carefully evaluate before choosing this facility.

  • Abuse citation on record
  • Low overall rating (1/5 stars)
  • Low staffing rating (2/5 stars)
  • Above-median deficiencies (23 vs median 11.0)

Bottom 25% in IL · Below recommended RN staffing · Significantly below average staffing · Worst in SABA HEALTHCARE chain · $392,635 in fines · Abuse citation

Source: Medicare data

What this means for your family

This facility has a long history of severe complaints regarding sanitation and staff engagement. Before considering this location, we strongly recommend conducting an unannounced visit to observe the environment firsthand and speaking directly with current residents' families about their daily experiences.

Google Reviews

Google Reviews

64 reviews on Google
California Terrace is a nursing facility that faces severe and recurring criticism regarding cleanliness, staff attentiveness, and basic patient care. Multiple reviewers report pervasive odors, missing personal belongings, and staff who are frequently disengaged or on their phones. While a small minority of recent reviews offer praise, the overwhelming majority of feedback describes a neglectful environment that families find deeply distressing.

Quality Themes

Tap a score for details
Food1.0Staff1.0Clean1.0Activities0.0Meds1.0MemoryN/AComms1.0ValueN/A

Strengths

  • Occasional friendly staff interactions
  • Some reports of clean rooms in specific instances

Concerns

  • Pervasive, overwhelming smell of urine and feces (mentioned by 7 reviewers)
  • Staff disengaged, on phones, or ignoring residents (mentioned by 9 reviewers)
  • Theft or loss of resident clothing and personal belongings (mentioned by 4 reviewers)
  • Difficulty reaching staff via phone or getting information (mentioned by 4 reviewers)
  • Poor hygiene and lack of basic care (soiled linens, feeding issues) (mentioned by 6 reviewers)

Rating Trends

Tap a year to see what changed

234'14(1)'17(2)'19(6)'22(4)'24(6)'26(4)

Distribution · 50 analyzed

5
8
4
2
3
1
2
5
1
34

How They Respond to Reviews

0%response rate

Questions for Your Tour

  • 1How does the facility manage daily cleaning schedules to ensure all resident rooms and common areas stay fresh and odor-free?
  • 2What specific steps are in place to ensure that residents' personal belongings and clothing are securely tracked and protected from loss?
  • 3Could you describe your process for communicating important health updates or changes in condition to family members, especially if we are unable to reach the floor staff by phone?
  • 4How does the nursing team ensure that medication management and feeding assistance are handled consistently and accurately during every shift?
  • 5What kind of daily activities or social events are currently available to help residents stay engaged and connected with one another?
  • 6In the event of a medical emergency after hours, what is the immediate protocol for contacting physicians and notifying the family?

Personalized based on this facility's data


Key Review Excerpts

My relative frequently lays / sits around in soiled depends & flimsy growns. They claims the clothing are always in the laundry room or somewhere.

Long-term resident's family · 2024☆☆☆☆

I had to spend three agonizing weeks there to 'help my mental health more'. They don't have group therapy meetings, I saw a nurse practitioner to the psychiatrist once, they gave me the wrong meds or didn't give me meds at all, food was barely edible.

Rehab patient · 2023☆☆☆☆

Most of staff are at nurses station on their phone and have no regard to helping get answers for the care for their loved ones.

Long-term resident's family · 2024☆☆☆☆
Source: 64 Google reviews

Staffing

Staffing Hours

per resident/day · Medicare 2026
RN Hours
0.40hrs
53%
Registered nurses for medical care
Total Nursing
2.29hrs
56%
All nurses + aides combined
Staff Turnover
41%
Lower is better (< 30% = good)
RN Turnover
19%
Lower is better (< 30% = good)

Both RN and total nursing hours are below national benchmarks. This can mean less clinical attention per resident, so ask about their staffing plan.

Quality Measures

Quality Measures

Resident outcomes compared with national, state, and local averages · 17 measures

Medicare Rating
3/ 5
Better Than Avg

10

measures

Worse Than Avg

5

measures

Mixed Results

2

measures

Long-Stay Residents
😔

Residents with depression symptoms

↓ Lower is better
This Facility100.0%
Worse than Avg
Here
100.0%
US
12.1%
IL
52.5%
Cook
73.5%

Highly dependent on how each facility screens and codes depressive symptoms, so it varies widely between facilities.

💊

Residents on antipsychotic medication

↓ Lower is better
This Facility32.4%
Worse than Avg
Here
32.4%
US
15.5%
IL
21.8%
Cook
24.6%
💉

Residents vaccinated for pneumonia

↑ Higher is better
This Facility80.9%
Worse than Avg
Here
80.9%
US
93.4%
IL
90.0%
Cook
84.5%
🛏️

Residents needing more daily help over time

↓ Lower is better
This Facility2.1%
Better than Avg
Here
2.1%
US
14.4%
IL
14.2%
Cook
8.7%
💊

Residents on anti-anxiety or sleep medication

↓ Lower is better
This Facility9.8%
Better than Avg
Here
9.8%
US
19.5%
IL
18.3%
Cook
10.5%
🚶

Residents whose walking got worse

↓ Lower is better
This Facility6.9%
Better than Avg
Here
6.9%
US
15.3%
IL
15.9%
Cook
9.1%
Short-Stay Residents (Rehab / Post-Acute)
💉

Short-stay residents vaccinated for pneumonia

↑ Higher is better
This Facility50.3%
Worse than Avg
Here
50.3%
US
81.8%
IL
69.0%
Cook
54.4%
💉

Short-stay residents vaccinated for the flu

↑ Higher is better
This Facility54.2%
Mixed vs Avgs
Here
54.2%
US
79.8%
IL
63.1%
Cook
53.6%
💊

Short-stay residents newly given antipsychotics

↓ Lower is better
This Facility2.6%
Worse than Avg
Here
2.6%
US
1.6%
IL
2.4%
Cook
2.7%
Source: Medicare quality measures

US average from Medicare published data

Inspection History

Medicare Inspection History

3-year lookback · Medicare 2026

28deficiencies
5penalties
Well above state avg (12.0)
53 complaint-triggered
$392,635 in fines

California Terrace shows a concerning pattern of repeated deficiencies from numerous family complaints, with 52 of 88 violations complaint-triggered. The most recurring issues involve accident prevention and supervision, protection from abuse and neglect, and maintaining clean living environments. While all violations show correction dates, the same problems persist across multiple surveys, including recent citations for accident hazards and abuse protection in late 2024, suggesting ongoing challenges in addressing fundamental safety and care concerns.

Mar 28, 2026Complaint
1
0925Potential for harm · WidespreadCorrected

Environmental Deficiencies

Make sure there is a pest control program to prevent/deal with mice, insects, or other pests.

Mar 20, 2026Complaint
3
0584Potential for harm · WidespreadCorrected

Resident Rights Deficiencies

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.

0550Potential for harm · IsolatedCorrected

Resident Rights Deficiencies

Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.

0600Potential for harm · IsolatedCorrected

Freedom from Abuse, Neglect, and Exploitation Deficiencies

Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.

Mar 1, 2026Complaint
1
0584Potential for harm · PatternCorrected

Resident Rights Deficiencies

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.

Dec 31, 2025Complaint
1
0925Potential for harm · WidespreadCorrected

Environmental Deficiencies

Make sure there is a pest control program to prevent/deal with mice, insects, or other pests.

Sep 19, 2025Complaint
3
0558Potential for harm · PatternCorrected

Resident Rights Deficiencies

Reasonably accommodate the needs and preferences of each resident.

0584Potential for harm · PatternCorrected

Resident Rights Deficiencies

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.

0689Potential for harm · PatternCorrected

Quality of Life and Care Deficiencies

Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.

Aug 14, 2025Routine
16
0812Potential for harm · WidespreadCorrected

Nutrition and Dietary Deficiencies

Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.

0814Potential for harm · WidespreadCorrected

Nutrition and Dietary Deficiencies

Dispose of garbage and refuse properly.

0881Potential for harm · WidespreadCorrected

Infection Control Deficiencies

Implement a program that monitors antibiotic use.

0925Potential for harm · WidespreadCorrected

Environmental Deficiencies

Make sure there is a pest control program to prevent/deal with mice, insects, or other pests.

0554Potential for harm · PatternCorrected

Resident Rights Deficiencies

Allow residents to self-administer drugs if determined clinically appropriate.

0689Potential for harm · PatternCorrected

Quality of Life and Care Deficiencies

Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.

0761Potential for harm · PatternCorrected

Pharmacy Service Deficiencies

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.

0880Potential for harm · PatternCorrected

Infection Control Deficiencies

Provide and implement an infection prevention and control program.

0578Potential for harm · IsolatedCorrected

Resident Rights Deficiencies

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.

0644Potential for harm · IsolatedCorrected

Resident Assessment and Care Planning Deficiencies

Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.

0677Potential for harm · IsolatedCorrected

Quality of Life and Care Deficiencies

Provide care and assistance to perform activities of daily living for any resident who is unable.

0686Potential for harm · IsolatedCorrected

Quality of Life and Care Deficiencies

Provide appropriate pressure ulcer care and prevent new ulcers from developing.

0695Potential for harm · IsolatedCorrected

Quality of Life and Care Deficiencies

Provide safe and appropriate respiratory care for a resident when needed.

0760Potential for harm · IsolatedCorrected

Pharmacy Service Deficiencies

Ensure that residents are free from significant medication errors.

0813Potential for harm · IsolatedCorrected

Nutrition and Dietary Deficiencies

Have a policy regarding use and storage of foods brought to residents by family and other visitors.

0914Potential for harm · IsolatedCorrected

Environmental Deficiencies

Provide bedrooms that don't allow residents to see each other when privacy is needed.

Federal Penalties

Fine

Oct 9, 2024

$139,231

Fine

Mar 6, 2024

$158,860

Fine

Jan 17, 2024

$37,700

Fine

Nov 17, 2023

$13,039

Fine

Sep 15, 2023

$14,745

Ownership & Operations

Who Operates This Facility

Owner / Operator

California Terrace

Organization Type

for profit

Chain Affiliation

Chain Name

Saba Healthcare

Chain Size

11 facilities nationwide

Chain avg rating: 1.4/5 · Rank 8 of 11 (Worst)

Ownership & Management

Owners

Mtj Holdings LLC

Owner · Organization

20%

Blonder, Moshe

Owner

28%

Singer, Aharon

Owner

28%

Cohen, Mayer

Owner (parent company)

10%

Singer, Tzvi

Owner (parent company)

10%

Key personnel

Tarjan, TerraW-2 Managing EmployeeSinger, AharonOfficer / Director
Source: Medicare provider data

Contact

Get in Touch

Contact this facility directly and verify the details that matter most to your family.

References & Resources

EveryPlace is a research directory. Facility information is compiled from public sources — Medicare.gov, state licensing portals, Google Places, and publicly available street-level imagery. Listings do not constitute endorsement, recommendation, or advertisement, and we do not accept payment for placement. Families should verify all details directly with the facility and the original sources linked above before making any care decisions. See our Research Policy for our editorial standards, correction process, and image-removal policy.

Safer Alternatives Nearby

Based on current clinical data, we identified 6 nearby facilities within 10 miles that may offer a stronger care environment. We encourage families to compare options carefully.

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