Above average — CMS composite of the measures below.
The next survey window likely opens around December 2026
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 California Pacific Medical Ctr- Davies Campus Hosp during CMS and state inspections, most recent first.
PRN psychotropic medication orders for two residents were not limited to 14 days and lacked documentation to support extension. One resident had a PRN lorazepam order for anxiety and insomnia with no end date, and another had an active PRN lorazepam order for seizures without the required stop date or supporting clinical rationale in the record. The Pharm and NM both acknowledged the missing documentation and the facility policy required PRN psychotherapeutic drugs to be limited to 14 days unless documentation supported continued use.
Failure to Obtain Ordered Resident Weights: The facility did not obtain ordered weights for two residents with malnutrition. One resident had only stated weights documented instead of an actual admission weight and weekly weights, and the other resident had multiple missing daily weights despite orders for admission and daily weighing. The RD noted actual weights were needed for assessment and that missing weights made treatment planning difficult.
Unnecessary Remeron Use Without Documented Diagnosis: A resident was prescribed Remeron 15 mg at bedtime, but the chart did not show a depression diagnosis or other documented clinical rationale for use. The RN Leader and Pharm both reviewed the record and could not find target behaviors or diagnosis supporting the antidepressant, although a checkbox showed the medication had been discussed with the care team. The facility policy required documentation of behavioral symptoms, diagnosis, and justification for the chosen treatment.
Food was not stored in a sanitary manner when a container of soup and an opened bag of meatballs were found without dates, and food debris plus decomposing produce were found on the floor of the walk-in refrigerator and freezer. The FSM acknowledged the items should have been dated and stated the areas should have been cleaned daily, noting staff may not have been cleaning them regularly.
PRN Psychotropic Orders Lacked Required Stop Dates or Supporting Documentation
Penalty
Summary
The facility failed to ensure that PRN psychotropic medications for two residents were limited to 14 days or supported by attending physician or prescribing practitioner documentation for extension. During a concurrent interview and record review, Resident 30’s hospital medication detail showed an order for Lorazepam 2 mg at bedtime PRN for anxiety and trouble sleeping with no end date listed. The Pharmacy Manager stated the medication was a low-dose psychotropic prescribed PRN, acknowledged that a 14-day stop date should have been added, and was unable to locate clinical documentation supporting use beyond the 14-day limit. During another concurrent interview and record review, Resident 10’s hospital medication detail showed an active order for Lorazepam 2 mg every 5 minutes PRN for seizures, with instructions to administer 2 mg IV Ativan if a convulsive seizure lasted more than 2 minutes. The Nurse Manager stated the order was active in the electronic medical record and was PRN, but was unable to locate documentation supporting use beyond the 14-day limit. The Pharmacy Manager later confirmed that pharmacy staff had access to manually add stop dates to PRN psychotropic medication orders unless rationale from the attending physician or prescribing practitioner was documented.
Failure to Obtain Ordered Resident Weights
Penalty
Summary
The facility failed to monitor weights according to physician orders for two residents with malnutrition. One resident was admitted with multiple diagnoses including malnutrition, and the manage orders directed staff to obtain a weekly weight. Review of the record showed only stated weights, and the Nurse Manager confirmed the resident was not placed on a scale for an actual admission weight or weekly weights. No clinical reason was found in the record to explain why the ordered admission and weekly weights were not obtained. A second resident was also admitted with multiple diagnoses including malnutrition, and the manage orders directed staff to obtain a weight on admission and daily. During record review, the Nurse Manager stated weights were not obtained or documented on nine scheduled days. No clinical rationale was found in the record for the missing daily weights. The Registered Dietitian stated actual weights and physician orders were part of the assessment process and that missing weights made it difficult to recommend treatment plans.
Unnecessary Remeron Use Without Documented Diagnosis
Penalty
Summary
Resident 14 was prescribed Remeron 15 mg at bedtime, but the record review did not identify a diagnosis of depression or any related diagnosis. The resident was admitted to the SNF on 12/19/2025 and had multiple diagnoses, none of which were depression-related. During a concurrent interview and record review, the RN Leader stated she would search for diagnoses and target behaviors to explain why Remeron was prescribed, including documentation of an actual depression diagnosis and monitoring for symptoms such as self-isolation, insomnia, loss of interest, or tearfulness, but she was unable to find documentation for those items. During a concurrent interview and record review, the Pharmacy Manager stated an antidepressant should not be prescribed without an active diagnosis of depression or another form of depression, and that if the indication was not documented there would be discussion with the care team. The Pharmacy Manager searched the resident’s records and was unable to find a diagnosis supporting Remeron use after admission, although a checkbox indicated the medication had been discussed with the care team. The facility policy titled Post Acute Services - Behavior Monitoring and Psychotherapeutic Drug Use required documentation of behavioral symptoms, diagnosis with a description of symptoms, discussion of differential psychiatric and medical diagnosis, and justification for the chosen treatment.
Food Storage and Sanitation Lapses in Kitchen
Penalty
Summary
Food was not stored in a sanitary manner in the kitchen when a container of soup and an opened bag of meatballs were found without dates. During a concurrent observation and interview with the Food Service Manager (FSM), the FSM acknowledged the soup should have been dated for that day and the meatballs should have been dated when the bag was opened. Food debris, an avocado, a packet of parsley, and a packet of cilantro were also found on the floor of the walk-in refrigerator and freezer. The parsley and cilantro appeared limp and slimy, were releasing moisture and odors, and some dark greenish fluid from the decomposing bags was leaking onto the refrigerator floor. The FSM stated staff should have been cleaning these areas daily and acknowledged staff may not have been cleaning them on a daily basis due to the decomposed state of the parsley and cilantro.
What surveyors are citing around you — mapped
All 10 risk areas, ranked with evidence
Repeat citations, what's rising near you, and quality measures — ranked so department heads know exactly where to look first.
Illustrative
What surveyors actually found near you
We read the 939 citations issued within 25 miles in the last 12 months — including the 1 immediate-jeopardy cases — and tell you exactly what happened, in plain English, matched to your record.
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.
Illustrative
A prioritized, do-first checklist
Every risk area becomes concrete audit steps drawn from real citations at facilities like yours — run them this week, before your window opens.
Illustrative
Risk indicators are statistical estimates from public CMS data — not predictions, findings, or compliance advice.
Nursing homes near San Francisco
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Hayes Convalescent Hospital | 0.7 mi | ★★★★★ | 2 | 0 |
| San Francisco Health Care | 0.7 mi | ★★★★★ | 5 | 0 |
| Central Gardens Post Acute | 0.9 mi | ★★★★★ | 0 | 0 |
| Sequoias San Francisco Convalescent Hospital | 1.1 mi | ★★★★★ | 13 | 0 |
| Victorian Post Acute | 1.3 mi | ★★★★★ | 0 | 0 |
Every risk area ranked, a do-first checklist, and your local survey patterns
Built specifically for California Pacific Medical Ctr- Davies Campus Hosp.
100% money-back within 48 hours.
Trusted data, never guesswork. Every citation, penalty, rating and Plan of Correction on this page is sourced from public CMS records (latest release July 2026) and official state health department websites.