BROOKDALE SAN RAMON

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

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.