HEALTH CARE CTR AT THE FORUM AT RANCHO SAN ANTONIO
23600 VIA ESPLENDOR
CUPERTINO, CA, 95014
6509440200
CCN: 555524
5
Overall4
Health5
Staffing5
QualitySpecial FocusAbuse IconOwnership Changed (12mo)Inspection OverdueOIG ExcludedUnder CIA
Ownership
| Name | Role | % |
|---|---|---|
| RANCHO SAN ANTONIO RETIREMENT HOUSING CORPORATION | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 100% |
| JOHNSON, EIKO | CORPORATE DIRECTOR | NOT APPLICABLE |
| EXLINE, RICK | CORPORATE DIRECTOR | NOT APPLICABLE |
| BROWN, KATHY | CORPORATE OFFICER | NOT APPLICABLE |
| BUSH, ELLYN | CORPORATE OFFICER | NOT APPLICABLE |
| FISHBEIN, MARGERY | CORPORATE OFFICER | NOT APPLICABLE |
| BRAUMAN, SHARON | CORPORATE OFFICER | NOT APPLICABLE |
| KAO, NANCY | OPERATIONAL/MANAGERIAL CONTROL | NOT APPLICABLE |
| LIFE CARE SERVICES LLC | OPERATIONAL/MANAGERIAL CONTROL | NOT APPLICABLE |
| JO, DANIEL | OPERATIONAL/MANAGERIAL CONTROL | NOT APPLICABLE |
| NELSON, MARK | OPERATIONAL/MANAGERIAL CONTROL | NOT APPLICABLE |
Health Deficiencies (22)
2024-09-06 · Health
D
F684 · Quality of Life and Care Deficiencies
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
2024-07-19 · Health
E
F880 · Infection Control Deficiencies
Provide and implement an infection prevention and control program.
E
F812 · Nutrition and Dietary Deficiencies
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
E
F761 · 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.
D
F758 · Pharmacy Service Deficiencies
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.
D
F732 · Nursing and Physician Services Deficiencies
Post nurse staffing information every day.
D
F700 · Quality of Life and Care Deficiencies
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.
D
F695 · Quality of Life and Care Deficiencies
Provide safe and appropriate respiratory care for a resident when needed.
D
F658 · Resident Assessment and Care Planning Deficiencies
Ensure services provided by the nursing facility meet professional standards of quality.
D
F656 · Resident Assessment and Care Planning Deficiencies
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
D
F641 · Resident Assessment and Care Planning Deficiencies
Ensure each resident receives an accurate assessment.
D
F582 · Resident Rights Deficiencies
Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.
E
F578 · 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.
D
F550 · Resident Rights Deficiencies
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
2023-06-09 · Health
E
F880 · Infection Control Deficiencies
Provide and implement an infection prevention and control program.
E
F812 · Nutrition and Dietary Deficiencies
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
E
F761 · 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.
D
F758 · Pharmacy Service Deficiencies
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.
D
F658 · Resident Assessment and Care Planning Deficiencies
Ensure services provided by the nursing facility meet professional standards of quality.
2019-05-03 · Health
D
F880 · Infection Control Deficiencies
Provide and implement an infection prevention and control program.
E
F812 · Nutrition and Dietary Deficiencies
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
D
F658 · Resident Assessment and Care Planning Deficiencies
Ensure services provided by the nursing facility meet professional standards of quality.
Staffing
MetricThis FacilityNational Avg
Total Nurse Hrs/Resident/Day3.68
5.25
RN Hrs/Resident/Day0.54
1.23
LPN Hrs/Resident/Day0.81
0.96
CNA Hrs/Resident/Day2.33
3.06
PT Hrs/Resident/Day0.12
0.35
Data as of 2026-03-01