Above average — CMS composite of the measures below.
Past the typical resurvey interval — a standard survey could occur at any time
Estimate from public CMS data, current as of July 2026. Survey timing is at the state agency's discretion.
Citation history
Health deficiencies cited at Almaden Health And Rehabilitation Center during CMS and state inspections, most recent first.
A resident admitted with intracranial injury, subarachnoid hemorrhage, epilepsy, and cerebral edema did not receive ordered doses of levetiracetam, phenytoin, and trazodone on the admission day. Orders for these medications were sent to the pharmacy too late for a routine delivery, and only phenytoin was requested as a STAT medication. Pharmacy records showed levetiracetam and trazodone arrived after the scheduled administration times, while STAT phenytoin was delivered earlier and received by an LVN but was still not given at the scheduled time. The MAR lacked documentation for the missed doses, and the LVN later stated the medications were not administered and that she did not know how to enter notes in the updated medication administration system, despite facility policy requiring timely and accurate oral medication administration.
The facility failed to maintain a safe environment, with a resident's toilet clogged for weeks and a broken call light in their room. Additionally, three shower rooms had broken tiles. The MD was aware but did not document maintenance checks, compromising resident safety.
The facility failed to post required oxygen signage for four residents using oxygen concentrators, as observed during a survey. Nursing staff confirmed the absence of 'Oxygen in Use' signs on the doors of these residents, and one resident's nasal cannula lacked proper labeling. The facility's policy mandates such signage, which was not followed.
The facility failed to maintain safe food storage and sanitation practices. Kitchen staff did not wear proper hair restraints, and expired food items were found, including spices and canned goods. Additionally, cutting boards with deep cut marks were not replaced, and wrinkled produce was stored improperly. These issues could lead to food contamination and illness.
The facility failed to follow infection control practices, including improper cleaning of a glucometer by an LVN, incorrect handling of soiled laundry by housekeeping staff, and improper storage of a resident's breathing treatment mask. These actions were against the facility's policies and could lead to cross-contamination.
The facility failed to maintain an effective pest control program, resulting in the presence of cockroaches and spiders. Roach and spider carcasses were found in the kitchen and storage areas, and a resident reported seeing live roaches in her room. The facility's Pest Control/Sightings Log confirmed roach presence, but there were no written logs of deep cleaning actions. Staff interviews revealed inconsistencies in pest control measures and deep cleaning processes.
A resident with severe cognitive impairment was observed in a hallway with part of their lower back exposed while being wheeled in a shower chair by a CNA. Despite being covered with a blanket, the resident's buttocks were partially visible, compromising their dignity. The DON confirmed the exposure and acknowledged the need for complete coverage, as per the facility's policy on resident dignity and privacy.
A resident with moderate cognitive impairment and a history of falls was unable to reach their call light, which was found on a roommate's bed. This oversight was contrary to the care plan and facility policy, potentially affecting the resident's ability to request assistance.
A resident in an LTC facility received metformin late and not with a meal as prescribed. The LVN administered the medication at 10:12 a.m., despite the physician's order to give it with meals at 8:00 a.m. and 6:00 p.m. The resident had breakfast between 7:00 a.m. and 7:30 a.m., and no snacks were provided before the medication. The DON expects adherence to physician orders and facility policy.
The facility was found to have improper garbage disposal practices, with a dumpster lid not fully closed and waste scattered on the ground in the garbage storage area. This was confirmed by the DM and ADM, who acknowledged the need for proper waste management to prevent pest attraction, as outlined in the facility's Pest Control policy.
The facility did not maintain a safe environment as a window screen in the kitchen was broken, creating a gap that could allow pests to enter. The Director of Maintenance confirmed the issue, acknowledging that the screen should have been repaired to prevent potential health risks. The facility's Pest Control policy requires intact screens on windows that open.
The facility failed to adhere to infection control practices, including improper glove use by an LVN and a housekeeper, and inadequate PPE by a CNA in a COVID-19 isolation room. The LVN wore gloves in the hallway, the housekeeper used the same gloves in multiple rooms, and the CNA used a surgical mask instead of an N95 mask.
The facility's pest control program was ineffective, leading to a cockroach infestation in residents' rooms. Despite multiple treatments, a resident reported seeing cockroaches in his room, prompting him to use a trap that caught several dead cockroaches. The maintenance director confirmed the presence of live cockroaches, and another resident's room was also reported to have cockroaches.
A resident was transported from her room to the shower room with inadequate privacy, as her back and buttocks were exposed while sitting on a shower chair. The CNA responsible acknowledged the oversight, and the DON confirmed that staff should ensure residents are fully covered during transport, as per facility policy.
Failure to Administer and Document Ordered Seizure and Sleep Medications
Penalty
Summary
The facility failed to provide ordered pharmaceutical services when one resident did not receive multiple scheduled medications on the day of admission. The resident was admitted late in the evening with diagnoses including unspecified intracranial injury, nontraumatic subarachnoid hemorrhage, epilepsy, and cerebral edema. Physician orders dated 11/29/2025 included levetiracetam 1000 mg by mouth twice daily at 9:00 a.m. and 8:00 p.m. for seizures, phenytoin 50 mg chewable tablets, 2 tablets by mouth three times a day, and trazodone 75 mg, 0.5 tablet by mouth at bedtime (9:00 p.m.) for insomnia related to depression. Review of the Medication Administration Record for 11/29/2025 showed the resident did not receive levetiracetam 1000 mg at 8:00 p.m., phenytoin 50 mg at 8:00 p.m., or trazodone 75 mg at 9:00 p.m., and there was no documentation explaining why these medications were not administered. Pharmacy records showed levetiracetam 1000 mg and trazodone 75 mg were delivered to the facility at 1:04 a.m. after the scheduled administration times, while a STAT order for phenytoin was delivered at 5:48 p.m. and received by LVN A. The Pharmacy Manager stated that the resident’s medication orders were received too late to meet the 1:00 p.m. delivery and were therefore scheduled for the 9:00 p.m. delivery, and that the facility could have requested all medications as STAT orders but only phenytoin was ordered STAT. The Nursing Supervisor, who admitted the resident and sent the medication orders to the pharmacy, stated he was aware of the 1:00 p.m. delivery time and assumed the medications would arrive by bedtime, so he ordered only phenytoin as STAT. The DON confirmed that LVN A did not administer the three night medications at their scheduled times and that phenytoin, which had been delivered at 5:48 p.m., should have been administered at 8:00 p.m. LVN A stated the resident had not received medications by bedtime and acknowledged that phenytoin, trazodone, and levetiracetam were not administered and that she did not document the reason, citing unfamiliarity with entering notes in the updated medication administration system. The facility’s policy on oral medication administration required medications to be administered in an accurate, safe, and timely manner.
Facility Fails to Maintain Safe and Functional Environment
Penalty
Summary
The facility failed to maintain a safe and functional environment, compromising the safety and well-being of its residents. In Resident 9's room, the toilet was clogged for weeks despite being reported to the staff, and a sign indicated it was out of order. Additionally, the bathroom call light in Resident 9's room was broken, which was confirmed by an LVN and reported to the maintenance staff. The Maintenance Director (MD) admitted to conducting daily rounds but failed to identify the broken call lights, and he did not document his daily maintenance checks. Furthermore, three out of four shower rooms in the facility had multiple broken tiles. The MD was aware of the issue and stated plans to replace the tiles. The facility's policy on physical plant interior maintenance emphasized the importance of maintaining the interior to ensure safety, including checking and repairing ceramic/vinyl flooring. However, these maintenance issues were not addressed in a timely manner, leading to a compromised living environment for the residents.
Failure to Post Oxygen Signage for Residents Using Oxygen Therapy
Penalty
Summary
The facility failed to provide proper oxygen care and treatment services for four residents who were using oxygen concentrators. Observations revealed that Residents 168, 60, 268, and 29 had oxygen concentrators at their bedsides, but there was no oxygen signage posted on their doors. This lack of signage was confirmed during interviews with Licensed Vocational Nurses and the Director of Nursing, who acknowledged that an 'Oxygen in Use' sign should be posted on the doors of residents receiving oxygen therapy. Additionally, Resident 268's nasal cannula was not labeled with the date and time, which was also confirmed by the nursing staff. Resident 29's medical record indicated a physician's order for oxygen support via nasal cannula at 2 liters as needed, yet there was no 'No Smoking' sign posted at the entrance or inside the room. The facility's policy on oxygen administration requires posting an oxygen precaution sign on the resident's door, which was not adhered to in these cases.
Deficiencies in Food Storage and Sanitation Practices
Penalty
Summary
The facility failed to ensure safe food storage practices and sanitary conditions in the kitchen, as observed during a survey. Kitchen staff, including the Dietary Manager and a cook, did not wear proper hair restraints, which is against the facility's policy and the FDA Food Code 2022. Additionally, the facility stored wrinkled and soft green peppers and cucumbers, which the Dietary Manager claimed were still usable because they would be cooked. However, this contradicts the facility's policy on proper food storage to preserve food quality. Further deficiencies were noted with expired food items and equipment. Three spice containers and a vanilla extract bottle were found with expired dates, and the Administrator confirmed these should have been discarded. Three cutting boards had deep cut marks, making them difficult to clean and sanitize effectively, as per FDA guidelines. In the emergency food supply storage, several cans were dented, and one can of nacho cheese sauce was expired, which the Dietary Manager acknowledged should be discarded. These practices potentially risked food contamination and the spread of food-borne illnesses to residents.
Infection Control Deficiencies in Equipment Cleaning, Laundry Handling, and Equipment Storage
Penalty
Summary
The facility failed to implement proper infection control practices in three distinct areas. Firstly, a Licensed Vocational Nurse (LVN) used alcohol pads instead of the recommended disinfectant wipes to clean a shared glucometer after use on a resident. This was contrary to the manufacturer's instructions and the facility's in-service training, which specified the use of Clorox or Sani-cloths with a three-minute dwell time for effective disinfection. The Director of Nursing confirmed that alcohol pads were not advised for cleaning equipment as they do not effectively kill bacteria. Secondly, a housekeeping staff member was observed transporting a soiled curtain without placing it in a plastic bag or closed bin, which is against the facility's policy for handling dirty laundry. The curtain had visible stains, and the staff member acknowledged the mistake. Lastly, a breathing treatment mask belonging to a resident was found improperly stored on a bedside drawer instead of in a plastic bag, as required by the facility's policy to prevent contamination. The Infection Preventionist confirmed the correct procedure for storing such equipment.
Ineffective Pest Control Program Leads to Roach and Spider Presence
Penalty
Summary
The facility failed to maintain an effective pest control program, resulting in the presence of cockroaches and spiders within the premises. During a kitchen tour, roach carcasses were found in traps near the ice machine and behind kitchen containers, while spider carcasses were found in a trap in the dry storage room. Interviews with staff revealed that sightings of live and dead roaches had been reported, but the pest control company did not consistently replace traps unless deemed necessary. The facility's Pest Control/Sightings Log confirmed the presence of roaches in the kitchen, and the FDA's Food Code mandates that premises be free of pests and that dead pests be removed to prevent accumulation. Additionally, a resident reported seeing live roaches in her room on two occasions, but only one sighting was documented in the facility's log. The Maintenance Director was unaware of any reports regarding pests in resident rooms, and there were no written logs of deep cleaning actions taken in response to pest sightings. The facility's policy required maintaining a written report of pest sightings and remedial actions, which was not followed. Interviews with staff indicated inconsistencies in the deep cleaning process, with some staff not fully emptying rooms as required by the facility's plan of correction.
Resident's Dignity Compromised Due to Inadequate Privacy Measures
Penalty
Summary
The facility failed to maintain the dignity and privacy of a resident, identified as Resident 52, during care. Resident 52, who was admitted with diagnoses including muscle wasting, dementia, and a psychotic disorder, was observed sitting in a shower chair in the hallway with part of their lower back exposed. Despite being covered with a blanket, the right side of Resident 52's buttocks was visible to the public. This incident occurred while a Certified Nursing Assistant (CNA) was wheeling the resident, and the Director of Nursing (DON) was present in the hallway. The DON confirmed the observation and acknowledged that Resident 52's buttocks should have been fully covered to prevent exposure. The facility's policy on Resident Dignity and Personal Privacy emphasizes the importance of draping and dressing residents appropriately to avoid exposure and embarrassment, as well as maintaining privacy during personal hygiene activities. The failure to adhere to this policy compromised Resident 52's dignity.
Resident's Call Light Not Within Reach
Penalty
Summary
The facility failed to accommodate the care needs of a resident when the resident's call light was not within reach, which is essential for requesting assistance. The resident, who was admitted with diagnoses including Parkinsonism, vascular dementia, and rhabdomyolysis, had a moderate cognitive impairment as indicated by a BIMS score of 9. The resident's care plan, updated in January 2025, highlighted the risk of falls and specified that the call light should be within reach to ensure safety. During an observation, the resident was found sitting in a wheelchair and repeatedly verbalizing the inability to find the call light. A CNA later found the call light on the bed of the resident's roommate and attached it to the resident's bed. The Director of Nursing confirmed that call lights should be within residents' reach, as per the facility's policy. This oversight had the potential to affect the resident's ability to request prompt assistance.
Medication Administration Not in Accordance with Physician's Order
Penalty
Summary
The facility failed to adhere to professional standards of nursing practice when a Licensed Vocational Nurse (LVN) did not administer medication according to the physician's order for a resident. During a medication administration observation, the LVN prepared and administered seven medications to the resident, including metformin, which was supposed to be given with meals twice a day at 8:00 a.m. and 6:00 p.m. However, the metformin was administered late at 10:12 a.m., without being given with a meal or snack, as the resident had breakfast between 7:00 a.m. and 7:30 a.m. The LVN acknowledged that metformin should be given with meals or at least thirty minutes after eating, and confirmed that no snacks were offered to the resident before administering the medication. The Director of Nurses (DON) stated that it is expected for all nurses to administer medications according to physician orders and facility policy. The facility's policy on oral medication administration also indicated that medications should be administered with food according to the physician's order or manufacturer's specification.
Improper Garbage Disposal and Sanitation Issues
Penalty
Summary
The facility failed to maintain a sanitary environment as evidenced by observations during a facility tour. A dumpster used for garbage disposal was found with a broken lid that was not fully closed. Additionally, leftover foods, including cooked rice and food scraps, along with two empty food boxes, a green plastic bottle, and several cardboards and papers, were observed on the ground in the facility's garbage storage area. These conditions were confirmed by the Director of Maintenance, who acknowledged that the garbage lid should be fully closed and all waste should be placed inside the garbage bin to prevent attracting rodents and pests. The Administrator also confirmed during an interview that the dumpster lid should be fully closed and waste should be properly disposed of to prevent pest and rodent attraction. The facility's undated policy and procedures on Pest Control indicated the need to keep facility grounds free of trash and brush and to maintain a clean dumpster area with the lid closed.
Broken Window Screen in Kitchen
Penalty
Summary
The facility failed to maintain a safe environment by not ensuring the integrity of a window screen in the kitchen area. During an observation with the Director of Maintenance, it was noted that the screen mesh covering the window leading to the kitchen sink was broken at the bottom, creating a small gap. This gap had the potential to allow rodents and pests to enter the kitchen, posing a risk to residents' health and safety. The Director of Maintenance confirmed the observation and acknowledged that the window screen should have been kept in good repair to prevent such issues. The facility's undated Pest Control policy indicated that screens on windows that open should be maintained intact.
Infection Control Lapses in PPE and Glove Use
Penalty
Summary
The facility failed to implement proper infection control practices in three observed instances. First, a Licensed Vocational Nurse (LVN B) was seen walking in the hallway with gloves on, which she acknowledged was against protocol. The Director of Nursing (DON) confirmed that staff should not wear gloves in the hallway. Second, a housekeeper (HKP C) was observed using the same gloves to clean two different resident rooms, Room AA and Room BB, without changing them in between. HKP C admitted to this oversight, and the DON reiterated that gloves should be changed after cleaning one room and before moving to another. Third, a Certified Nursing Assistant (CNA D) entered a COVID-19 isolation room to feed a resident while wearing a surgical mask instead of the required N95 mask. CNA D acknowledged the mistake, and the DON confirmed that an N95 mask should be worn when entering a COVID-19 isolation room. The facility's policies on standard precautions and the use of personal protective equipment (PPE) were reviewed, highlighting the need for proper glove use and the requirement of an N95 respirator in such situations.
Ineffective Pest Control Leads to Cockroach Infestation
Penalty
Summary
The facility failed to maintain an effective pest control program, resulting in the presence of live cockroaches in residents' rooms. Resident 4's room was inspected and treated for cockroaches and rodents on multiple occasions, including on 5/31/24, 6/12/24, and 7/2/24. Despite these treatments, Resident 4 reported seeing many cockroaches in his room, including on his bed side rails and under his bed. He resorted to placing a cockroach trap in his room, which caught five dead cockroaches, and observed five live cockroaches crawling out from under a basket. The maintenance director confirmed the presence of both dead and live cockroaches in Resident 4's room. Additionally, a registered nurse reported cockroaches in Resident 5's room after a CNA and the resident observed them. The maintenance director reviewed the maintenance work requests for both Resident 4's and Resident 5's rooms and acknowledged that the facility's pest control measures were ineffective. This ongoing issue of cockroach infestation, despite repeated treatments, indicates a significant deficiency in the facility's pest control program.
Resident Privacy Not Maintained During Transport
Penalty
Summary
The facility failed to treat a resident with respect and dignity when a certified nursing assistant (CNA) did not provide adequate privacy during transportation from the resident's room to the shower room. During an observation, the resident was seen sitting on a shower chair with only the front of her body covered by a linen sheet, leaving her back and buttocks exposed. This lack of coverage occurred as the resident was being transported through the hallway. In a concurrent interview, the CNA acknowledged the oversight, admitting that she missed covering the back of the resident's body and should have ensured the resident was fully covered before moving her. The director of nursing (DON) confirmed that staff are expected to cover residents' bodies to maintain privacy during such transport, as outlined in the facility's policy on tub baths and showers.
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Resident with a documented fall history left unattended on the patio; found on the ground with a hip fracture.
Walk-in cooler logs missing for 12 days; expired supplements in the medication room fridge.
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Nursing homes near San Jose
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Stonebrook Health And Rehabilitation | 1.1 mi | ★★★★★ | 2 | 0 |
| Woodlands Healthcare Center | 1.2 mi | ★★★★★ | 2 | 0 |
| Plum Tree Care Center | 1.3 mi | ★★★★★ | 0 | 0 |
| Childrens Hc Org No Ca -pediatric Hospital D/p Snf | 1.6 mi | ★★★★★ | 0 | 0 |
| The Terraces Of Los Gatos | 1.8 mi | ★★★★★ | 0 | 0 |
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