SMITH RANCH SKILLED NURSING & REHABILITATION CENTE Inspection Report, Violations & Safety Grade (SAN RAFAEL, California)

1550 SILVEIRA PARKWAY, SAN RAFAEL, California 94903

Phone: 4154991000

CMS Overall:3/5

Overview & Bed Count

Certified Beds

Avg Residents/Day

73.4

Ownership

For profit - Limited Liability company

Provider Type

Medicare and Medicaid

County

Marin

Sprinkler Systems

Yes

Special Focus

None

Abuse Icon

CMS Star Ratings

Overall3/5

Health2/5

Staffing2/5

Quality5/5

Nurse Staffing Check

Metric	This Facility	California Avg	Difference
RN Hours per Resident per Day	0.34	0.68	-0.34
Total Nurse Hours per Resident per Day	4.12	4.54	-0.42
CMS Staffing Rating	2/5	3.3/5	-
Nursing Staff Turnover	38.3%	36.6%	-

Health Citation History

45 health citations on record

Date	Category	Description	Severity
2026-06-09	Freedom from Abuse, Neglect, and Exploitation Deficiencies	Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.	D – Moderate Harm Potential
2026-06-09	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 – Moderate Harm Potential
2026-04-15	Resident Assessment and Care Planning Deficiencies	Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.	E – Moderate Harm Potential
2026-04-15	Resident Assessment and Care Planning Deficiencies	Ensure services provided by the nursing facility meet professional standards of quality.	E – Moderate Harm Potential
2026-04-15	Quality of Life and Care Deficiencies	Provide appropriate treatment and care according to orders, resident’s preferences and goals.	E – Moderate Harm Potential
2026-04-15	Resident Assessment and Care Planning Deficiencies	Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.	E – Moderate Harm Potential
2026-04-15	Pharmacy Service Deficiencies	Ensure that residents are free from significant medication errors.	D – Moderate Harm Potential
2026-02-12	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.	E – Moderate Harm Potential
2026-02-12	Resident Assessment and Care Planning Deficiencies	Ensure services provided by the nursing facility meet professional standards of quality.	E – Moderate Harm Potential
2026-02-12	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 – Moderate Harm Potential
2026-02-12	Environmental Deficiencies	Keep all essential equipment working safely.	E – Moderate Harm Potential
2026-02-12	Resident Assessment and Care Planning Deficiencies	PASARR screening for Mental disorders or Intellectual Disabilities	D – Moderate Harm Potential
2026-02-12	Quality of Life and Care Deficiencies	Provide appropriate treatment and care according to orders, resident’s preferences and goals.	D – Moderate Harm Potential
2026-02-12	Pharmacy Service Deficiencies	Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.	D – Moderate Harm Potential
2026-02-12	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 – Moderate Harm Potential
2026-02-12	Infection Control Deficiencies	Provide and implement an infection prevention and control program.	D – Moderate Harm Potential
2025-05-16	Resident Rights Deficiencies	Post a list of names, addresses, and telephone numbers of all pertinent State agencies and advocacy groups and a statement that the resident may file a complaint with the State Survey Agency.	F – Moderate Harm Potential
2025-05-16	Nutrition and Dietary Deficiencies	Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.	F – Moderate Harm Potential
2025-05-16	Administration Deficiencies	Have a plan that describes the process for conducting QAPI and QAA activities.	F – Moderate Harm Potential
2025-05-16	Resident Assessment and Care Planning Deficiencies	Ensure services provided by the nursing facility meet professional standards of quality.	E – Moderate Harm Potential
2025-05-16	Quality of Life and Care Deficiencies	Provide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM and/or mobility, unless a decline is for a medical reason.	E – Moderate Harm Potential
2025-05-16	Resident Rights Deficiencies	Ensure that residents are fully informed and understand their health status, care and treatments.	D – Moderate Harm Potential
2025-05-16	Resident Rights Deficiencies	Reasonably accommodate the needs and preferences of each resident.	D – Moderate Harm Potential
2025-05-16	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.	D – Moderate Harm Potential
2025-05-16	Resident Assessment and Care Planning Deficiencies	Ensure each resident receives an accurate assessment.	D – Moderate Harm Potential
2025-05-16	Quality of Life and Care Deficiencies	Provide appropriate pressure ulcer care and prevent new ulcers from developing.	D – Moderate Harm Potential
2025-05-16	Quality of Life and Care Deficiencies	Provide enough food/fluids to maintain a resident's health.	D – Moderate Harm Potential
2025-05-16	Quality of Life and Care Deficiencies	Ensure that feeding tubes are not used unless there is a medical reason and the resident agrees; and provide appropriate care for a resident with a feeding tube.	D – Moderate Harm Potential
2025-05-16	Pharmacy Service Deficiencies	Ensure medication error rates are not 5 percent or greater.	D – Moderate Harm Potential
2025-05-16	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 – Moderate Harm Potential
2025-04-22	Freedom from Abuse, Neglect, and Exploitation Deficiencies	Protect each resident from the wrongful use of the resident's belongings or money.	D – Moderate Harm Potential
2023-08-22	Nutrition and Dietary Deficiencies	Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.	F – Moderate Harm Potential
2023-08-22	Resident Rights Deficiencies	Allow residents to easily view the nursing home's survey results and communicate with advocate agencies.	E – Moderate Harm Potential
2023-08-22	Resident Rights Deficiencies	Notify the resident or the resident’s representative in writing how long the nursing home will hold the resident’s bed in cases of transfer to a hospital or therapeutic leave.	E – Moderate Harm Potential
2023-08-22	Resident Assessment and Care Planning Deficiencies	Ensure each resident receives an accurate assessment.	E – Moderate Harm Potential
2023-08-22	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.	E – Moderate Harm Potential
2023-08-22	Quality of Life and Care Deficiencies	Provide care and assistance to perform activities of daily living for any resident who is unable.	E – Moderate Harm Potential
2023-08-22	Quality of Life and Care Deficiencies	Provide activities to meet all resident's needs.	E – Moderate Harm Potential
2023-08-22	Pharmacy Service Deficiencies	Ensure medication error rates are not 5 percent or greater.	E – Moderate Harm Potential
2023-08-22	Infection Control Deficiencies	Provide and implement an infection prevention and control program.	E – Moderate Harm Potential
2023-08-22	Resident Assessment and Care Planning Deficiencies	Ensure services provided by the nursing facility meet professional standards of quality.	D – Moderate Harm Potential
2023-08-22	Quality of Life and Care Deficiencies	Ensure residents do not lose the ability to perform activities of daily living unless there is a medical reason.	D – Moderate Harm Potential
2023-08-22	Quality of Life and Care Deficiencies	Provide appropriate pressure ulcer care and prevent new ulcers from developing.	D – Moderate Harm Potential
2023-08-22	Quality of Life and Care Deficiencies	Provide safe and appropriate respiratory care for a resident when needed.	D – Moderate Harm Potential
2023-08-22	Pharmacy Service Deficiencies	Ensure that residents are free from significant medication errors.	D – Moderate Harm Potential

Fire Safety Citation History

20 fire safety citations on record

Date	Category	Description	Severity
2026-02-12	Smoke Deficiencies	Install corridor and hallway doors that block smoke.	D – Moderate Harm Potential
2026-02-12	Gas, Vacuum, and Electrical Systems Deficiencies	Ensure proper usage of power strips and extension cords.	D – Moderate Harm Potential
2026-02-12	Gas, Vacuum, and Electrical Systems Deficiencies	Have proper medical gas storage and administration areas.	D – Moderate Harm Potential
2025-05-16	Smoke Deficiencies	Inspect, test, and maintain automatic sprinkler systems.	D – Moderate Harm Potential
2025-05-16	Gas, Vacuum, and Electrical Systems Deficiencies	Meet requirements for the use of electrical equipment.	D – Moderate Harm Potential
2025-05-16	Gas, Vacuum, and Electrical Systems Deficiencies	Ensure proper usage of power strips and extension cords.	D – Moderate Harm Potential
2025-05-16	Emergency Preparedness Deficiencies	Provide emergency officials' contact information.	C – Minimal Harm Potential
2025-05-16	Emergency Preparedness Deficiencies	Provide primary/alternate means for communication.	C – Minimal Harm Potential
2023-08-22	Egress Deficiencies	Keep aisles, corridors, and exits free of obstruction in case of emergency.	E – Moderate Harm Potential
2023-08-22	Smoke Deficiencies	Have approved installation, maintenance and testing program for fire alarm systems.	E – Moderate Harm Potential
2023-08-22	Miscellaneous Deficiencies	Provide a written emergency evacuation plan.	E – Moderate Harm Potential
2023-08-22	Gas, Vacuum, and Electrical Systems Deficiencies	Meet requirements for the use of electrical equipment.	E – Moderate Harm Potential
2023-08-22	Construction Deficiencies	Use approved construction type or materials.	D – Moderate Harm Potential
2023-08-22	Egress Deficiencies	Have properly located and lighted "Exit" signs.	D – Moderate Harm Potential
2023-08-22	Smoke Deficiencies	Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.	D – Moderate Harm Potential
2023-08-22	Smoke Deficiencies	Install a fire alarm system that can be heard throughout the facility.	D – Moderate Harm Potential
2023-08-22	Smoke Deficiencies	Properly select, install, inspect, or maintain portable fire extinguishes.	D – Moderate Harm Potential
2023-08-22	Smoke Deficiencies	Install corridor and hallway doors that block smoke.	D – Moderate Harm Potential
2023-08-22	Smoke Deficiencies	Follow proper procedures when the fire alarm was out of service for more than 4 hours.	C – Minimal Harm Potential
2023-08-22	Smoke Deficiencies	Follow proper procedures when the automatic sprinkler systems was out of service for more than 10 hours.	C – Minimal Harm Potential

Total Penalties & Fines

Total Fine Amount (CMS)

Number of Fines

Total Penalties

No penalty records found.

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3-Year Complete Report ($19)

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