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PLUM TREE CARE CENTER Inspection Report, Violations & Safety Grade (SAN JOSE, California)

2580 SAMARITAN DRIVE, SAN JOSE, California 95124

Phone: 4083568181

CMS Overall:5/5

Overview & Bed Count

Certified Beds
76
Avg Residents/Day
65.4
Ownership
For profit - Limited Liability company
Provider Type
Medicare and Medicaid
County
Santa Clara
Sprinkler Systems
Yes
Special Focus
None
Abuse Icon
No

CMS Star Ratings

Overall5/5
Health4/5
Staffing3/5
Quality5/5

Nurse Staffing Check

MetricThis FacilityCalifornia AvgDifference
RN Hours per Resident per Day0.770.68+0.09
Total Nurse Hours per Resident per Day4.644.54+0.10
CMS Staffing Rating3/53.3/5-
Nursing Staff Turnover42.7%36.6%-

Health Citation History

34 health citations on record

DateCategoryDescriptionSeverity
2026-07-29Environmental DeficienciesMake sure that a working call system is available in each resident's bathroom and bathing area.D – Moderate Harm Potential
2026-06-11Resident Rights DeficienciesEnsure the transfer/discharge meets the resident's needs/preferences and that the resident is prepared for a safe transfer/discharge.D – Moderate Harm Potential
2025-08-07Resident Rights DeficienciesLet each resident or the resident's legal representative access or purchase copies of all the resident's records.D – Moderate Harm Potential
2025-07-16Resident Assessment and Care Planning DeficienciesEnsure services provided by the nursing facility meet professional standards of quality.D – Moderate Harm Potential
2025-07-16Administration DeficienciesProvide or obtain laboratory tests/services when ordered and promptly tell the ordering practitioner of the results.D – Moderate Harm Potential
2025-03-28Resident Assessment and Care Planning DeficienciesEnsure services provided by the nursing facility meet professional standards of quality.E – Moderate Harm Potential
2025-03-28Quality of Life and Care DeficienciesProvide safe and appropriate respiratory care for a resident when needed.E – Moderate Harm Potential
2025-03-28Pharmacy Service DeficienciesEnsure 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.E – Moderate Harm Potential
2025-03-28Infection Control DeficienciesProvide and implement an infection prevention and control program.E – Moderate Harm Potential
2025-03-28Resident Rights DeficienciesHonor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.D – Moderate Harm Potential
2025-03-28Freedom from Abuse, Neglect, and Exploitation DeficienciesEnsure that each resident is free from the use of physical restraints, unless needed for medical treatment.D – Moderate Harm Potential
2025-03-28Resident Assessment and Care Planning DeficienciesCoordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.D – Moderate Harm Potential
2025-03-28Nutrition and Dietary DeficienciesProcure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.D – Moderate Harm Potential
2024-09-24Quality of Life and Care DeficienciesEnsure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.G – Actual Harm
2024-05-31Resident Assessment and Care Planning DeficienciesEnsure services provided by the nursing facility meet professional standards of quality.D – Moderate Harm Potential
2024-05-31Infection Control DeficienciesProvide and implement an infection prevention and control program.D – Moderate Harm Potential
2023-12-01Quality of Life and Care DeficienciesProvide appropriate treatment and care according to orders, resident’s preferences and goals.E – Moderate Harm Potential
2023-12-01Pharmacy Service DeficienciesEnsure 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.E – Moderate Harm Potential
2023-12-01Nutrition and Dietary DeficienciesProcure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.E – Moderate Harm Potential
2023-12-01Infection Control DeficienciesProvide and implement an infection prevention and control program.E – Moderate Harm Potential
2023-12-01Resident Rights DeficienciesGive residents notice of Medicaid/Medicare coverage and potential liability for services not covered.D – Moderate Harm Potential
2023-12-01Resident Assessment and Care Planning DeficienciesEnsure services provided by the nursing facility meet professional standards of quality.D – Moderate Harm Potential
2023-12-01Pharmacy Service DeficienciesImplement 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 – Moderate Harm Potential
2023-12-01Pharmacy Service DeficienciesEnsure medication error rates are not 5 percent or greater.D – Moderate Harm Potential
2023-10-31Resident Rights DeficienciesPrepare residents for a safe transfer or discharge from the nursing home.D – Moderate Harm Potential
2022-02-11Resident Assessment and Care Planning DeficienciesDevelop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.E – Moderate Harm Potential
2022-02-11Pharmacy Service DeficienciesProvide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.E – Moderate Harm Potential
2022-02-11Pharmacy Service DeficienciesEnsure 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.E – Moderate Harm Potential
2022-02-11Nutrition and Dietary DeficienciesProcure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.E – Moderate Harm Potential
2022-02-11Resident Rights DeficienciesHonor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.D – Moderate Harm Potential
2022-02-11Quality of Life and Care DeficienciesProvide appropriate treatment and care according to orders, resident’s preferences and goals.D – Moderate Harm Potential
2022-02-11Quality of Life and Care DeficienciesEnsure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.D – Moderate Harm Potential
2022-02-11Quality of Life and Care DeficienciesProvide safe, appropriate dialysis care/services for a resident who requires such services.D – Moderate Harm Potential
2022-02-11Pharmacy Service DeficienciesImplement 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 – Moderate Harm Potential

Fire Safety Citation History

23 fire safety citations on record

DateCategoryDescriptionSeverity
2025-03-28Smoke DeficienciesInstall corridor and hallway doors that block smoke.F – Moderate Harm Potential
2025-03-28Miscellaneous DeficienciesHave simulated fire drills held at unexpected times.F – Moderate Harm Potential
2025-03-28Gas, Vacuum, and Electrical Systems DeficienciesMeet requirements for the use of electrical equipment.E – Moderate Harm Potential
2025-03-28Gas, Vacuum, and Electrical Systems DeficienciesEnsure proper usage of power strips and extension cords.E – Moderate Harm Potential
2025-03-28Egress DeficienciesHave properly located and lighted "Exit" signs.D – Moderate Harm Potential
2025-03-28Smoke DeficienciesInspect, test, and maintain automatic sprinkler systems.D – Moderate Harm Potential
2023-12-01Construction DeficienciesUse approved construction type or materials.D – Moderate Harm Potential
2023-12-01Egress DeficienciesMeet other general requirements that are deficient.D – Moderate Harm Potential
2023-12-01Smoke DeficienciesProvide properly protected cooking facilities.D – Moderate Harm Potential
2023-12-01Smoke DeficienciesInspect, test, and maintain automatic sprinkler systems.D – Moderate Harm Potential
2023-12-01Miscellaneous DeficienciesHave simulated fire drills held at unexpected times.D – Moderate Harm Potential
2023-12-01Gas, Vacuum, and Electrical Systems DeficienciesHave generator or other power source capable of supplying service within 10 seconds.D – Moderate Harm Potential
2022-02-11Egress DeficienciesKeep aisles, corridors, and exits free of obstruction in case of emergency.E – Moderate Harm Potential
2022-02-11Smoke DeficienciesEnsure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.E – Moderate Harm Potential
2022-02-11Smoke DeficienciesInstall corridor and hallway doors that block smoke.E – Moderate Harm Potential
2022-02-11Smoke DeficienciesInstall smoke barrier doors that can resist smoke for at least 20 minutes.E – Moderate Harm Potential
2022-02-11Gas, Vacuum, and Electrical Systems DeficienciesHave generator or other power source capable of supplying service within 10 seconds.E – Moderate Harm Potential
2022-02-11Gas, Vacuum, and Electrical Systems DeficienciesMeet requirements for the use of electrical equipment.E – Moderate Harm Potential
2022-02-11Emergency Preparedness DeficienciesEstablish roles under a Waiver declared by secretary.D – Moderate Harm Potential
2022-02-11Egress DeficienciesHave properly located and lighted "Exit" signs.D – Moderate Harm Potential
2022-02-11Miscellaneous DeficienciesProvide a written emergency evacuation plan.D – Moderate Harm Potential
2022-02-11Gas, Vacuum, and Electrical Systems DeficienciesEnsure proper usage of power strips and extension cords.D – Moderate Harm Potential
2022-02-11Gas, Vacuum, and Electrical Systems DeficienciesHave proper medical gas storage and administration areas.D – Moderate Harm Potential

Total Penalties & Fines

$8,018
Total Fine Amount (CMS)
1
Number of Fines
1
Total Penalties
DateTypeFine AmountPayment Denial
2024-09-24Fine$8,018-

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