BROOKDALE SAN RAMON

Official classification

Type B

Official code

87303(a)

Regulation authority

CCR

What the official deficiency says

(a) The facility shall be clean, safe, sanitary and in good repair at all times. Maintenance shall include provision of maintenance services and procedures for the safety and well-being of residents, employees and visit This requirement is not met as evidenced by: Based on LPAs interview licensee did not comply with the section above by not cleaning a residents microwave which allowed maggots to form which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

The facility agrees to review the regulation and submit a letter of self certification along with the updated housekeeping check list to CCLD by POC date.

Deadline recorded: Jun 18, 2026. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87309(a)

Regulation authority

CCR

What the official deficiency says

(a) Except as specified in subsection (b), the licensee shall ensure that disinfectants, cleaning solutions, poisonous substances, knives, matches, tools, sharp objects, and other similar items which could pose a danger to residents are in locked storage and are not left unattended if outside the locked storage. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, the licensee did not comply with the section cited above in having 2 pairs of unlocked scissors in a common area unattended and stainless steel cleaner in residents available laundry rooms which poses an immediate safety risk to persons in care.

Official plan of correction

POC Due Date: 01/26/2026 Plan of Correction Items removed POC clear

Official classification

Type B

Official code

87411(c)(1)

Regulation authority

CCR

What the official deficiency says

(1) Staff providing care shall receive appropriate training in first aid from persons qualified by such agencies as the American Red Cross. This requirement is not met as evidenced by: Deficient Practice Statement Based on record review, the licensee did not comply with the section cited above in 4 out of 5 staff records review not having valid first aid which poses a potential safety and personal rights risk to persons in care.

Official plan of correction

POC Due Date: 02/10/2026 Plan of Correction By POC facility agrees to have all required staff complete first aid training and update their files and notify CCLD

Official classification

Type B

Official code

87555(a)

Regulation authority

CCR

What the official deficiency says

(a) The total daily diet shall be of the quality and in the quantity necessary to meet the needs of the residents an shall meet the Recommended Dietary Allowances of the Food and Nutrition Board of the National Research Council. All food shall be selected, stored, prepared and served in a safe and healthful manner. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, the licensee did not comply with the section cited above in having food improperly stored throughout the kitchen which poses a potential health and personal rights risk to persons in care.

Official plan of correction

POC Due Date: 02/10/2026 Plan of Correction By POC Facility agrees to have all kitchen staff retake state approved food handlers/ expectation training, develop an after meal kichen checklist, and notify CCLD

Official classification

Type B

Official code

87625(b)(3)

Regulation authority

CCR

What the official deficiency says

(b)In addition .. the licensee shall be responsible for the following: (3) Ensuring that incontinent residents are kept clean and dry... from incontinence. This requirement was not met as evidence by: Based on interview with staff (S1-S10), the licensee did not comply with the section cited above in residents not being kept clean and dry from incontinence which poses a potential personal rights risk to persons in care.

Official plan of correction

By POC date Health and Wellness Director agrees to submit a memo reminding staff of incontinent practices and provide a copy to CCLD

Deadline recorded: Oct 14, 2025. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87555(a)

Regulation authority

CCR

What the official deficiency says

(a)The total daily diet shall ...be selected, stored, prepared and served in a safe and healthful manner. This requirement was not met as evidence by: Based on observation, the licensee did not comply with the section cited above in having improperly stored and expired food in the kitchen which poses a potential personal rights risk to persons in care.

Official plan of correction

By POC date Executive Director agrees to conduct a training regarding food storage and cleanliness procedures and notify CCLD

Deadline recorded: Oct 14, 2025. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87303(a)

Regulation authority

CCR

What the official deficiency says

(a) The facility shall be ...in good repair at all times...for the safety and well-being of residents... This requirement is not met as evidence by: Based on interviews the facility did not comply with the section cited above by the southside elevator going in and out of service over the last few years which poses a potential safety and personal rights risk to residents in care.

Official plan of correction

By POC facility agrees to submit documents for the work being done and notify CCLD of the completed repairs. LPA may conduct a case management once repairs are complete.

Deadline recorded: Jul 11, 2025. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87411(a)

Regulation authority

CCR

What the official deficiency says

(a) Facility personnel shall at all times be sufficient in numbers, and competent to provide the services necessary...of adequate services. This requirement is not met as evidence by: Based on interviews the facility did not comply with the regulation above by not providing adequete services to residents requesting assistance which posed a potential personal rights violation to residents in care.

Official plan of correction

ED states that the facility now has low response times for clients and understands the importance of timely responses. POC cleared.

Deadline recorded: Feb 7, 2025. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87211(a)(1)(D)

Regulation authority

CCR

What the official deficiency says

87211(a)(1)(D) Reporting Requirements (a) Each licensee shall furnish to the licensing agency such reports as the Department may require, including, but not limited to, the following: (1) A written report shall be submitted to the licensing agency and to the person responsible for the resident within seven days of the occurrence … (D) Any incident which threatens the welfare, safety or health of any resident, such as psychological abuse of a resident by staff or other residents, or unexplained absence of any resident. This requirement is not met as evidenced by: Based on interviews and record review conducted, facility failed to report R1’s concerns regarding S8 inappropriate behavior to CCL within 7 days of occurrence which poses a potential risk to the health and safety of the clients under care. The incident was reported to S9 on 7/12/23. SOC 341 was created on 7/28/23.

Official plan of correction

By POC date, the Administrator will review cited section and submit certificate of understanding to CCL.

Deadline recorded: Apr 30, 2024. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87506(b)

Regulation authority

CCR

What the official deficiency says

(b) Each resident's record shall contain at least the following information: This requirement is not met as evidenced by: Deficient Practice Statement Based on record review, the licensee did not comply with the section cited above in resident files being incomplete which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 03/01/2024 Plan of Correction By POC date Executive Director agrees to review all files and ensure that they are complete and self certify to CCLD

Official classification

Type B

Official code

87211(g)

Regulation authority

CCR

What the official deficiency says

87211 Reporting Requirements (g) The licensee shall notify the Department, in writing, within thirty (30) days of the hiring of a new administrator. The notification shall include the following: (1) Name and residence and mailing addresses of the new administrator. (2) Date he/she assumed his/her position. (3) Description of his/her background and qualifications, including documentation of required education and administrator certification. (A) A photocopy of the documentation is acceptable. Based on record review conducted, Executive Director has been working at the facility since 1/15/2022 but failed to notify CCL which poses a potential risk to health and safety of clients under care.

Official plan of correction

By POC, Executive Director will send to CCL all required documents per Sec 87211(g).

Deadline recorded: Aug 3, 2023. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87468.1(a)(2)

Regulation authority

CCR

What the official deficiency says

PERSONAL RIGHTS OF RESIDENTS.. (a) Residents in all residential care facilities for the elderly shall have all of the following personal rights: (2) To be accorded safe, healthful and comfortable accommodations, furnishings and equipment. This requirement was not met as evidenced by: Based on LPAs interviews, Licensee did not comply with the regulation cited above. S6 confirmed S6 did not intervene during verbal altercation between two residents which poses a potential health and safety concern to residents in care.

Official plan of correction

By POC date, Administrator agrees to implement protocol and conduct training with staff, and submit a copy to CCL.

Deadline recorded: Oct 22, 2021. A deadline is not proof that correction was completed.