HEALTH CARE CTR AT THE FORUM AT RANCHO SAN ANTONIO
23600 VIA ESPLENDOR, CUPERTINO, CA 95014 · CCN 555524
Ratings
- Overall
- ★★★★★ 5
- Health inspection
- ★★★★☆ 4
- Quality measures
- ★★★★★ 5
- Staffing
- ★★★★★ 5
Facility
- Ownership type
- Non profit - Other
- Certified beds
- 48
- Avg residents/day
- 38.8
- Phone
- 6509440200
Inspection history vs California & national averages
Cycle 1 is the most recent standard health inspection. Lower total deficiency counts are better.
| Cycle | Inspection date | This facility | California avg | National avg | vs state |
|---|---|---|---|---|---|
| 1 | 2024-07-19 | 13 | 15.6 | 9.5 | -2.6 better |
| 2 | 2023-06-09 | 6 | 17.4 | 9.8 | -11.4 better |
| 3 | 2019-05-03 | 3 | 17.1 | 9.3 | -14.1 better |
Cycle 1 deficiencies by category
| Category | Deficiencies |
|---|---|
| Quality of life and care | 2 |
| Resident assessment and care planning | 3 |
| Nursing and physician services | 1 |
| Resident rights | 3 |
| Nutrition and dietary | 1 |
| Pharmacy service | 2 |
| Infection control | 1 |
Staffing (hours per resident per day)
| Metric | This facility | Turnover |
|---|---|---|
| Total nurse staffing (reported) | 5.25 | 36.4% |
| RN staffing (reported) | 1.23 | 50.0% |
| Total nurse staffing (adjusted) | 5.40 | — |
Fines & penalties
- Total fines
- $0
- Number of fines
- 0
- Number of penalties
- 0
- Payment denials
- 0
Inspection citations (22)
- DF0684Provide appropriate treatment and care according to orders, resident’s preferences and goals.2024-09-06 · Health · corrected 2024-09-20
Potential for more than minimal harm
- DF0550Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.2024-07-19 · Health · corrected 2024-08-18
Potential for more than minimal harm
- EF0578Honor 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.2024-07-19 · Health · corrected 2024-08-18
Potential for more than minimal harm
- DF0582Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.2024-07-19 · Health · corrected 2024-08-18
Potential for more than minimal harm
- DF0641Ensure each resident receives an accurate assessment.2024-07-19 · Health · corrected 2024-08-18
Potential for more than minimal harm
- DF0656Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.2024-07-19 · Health · corrected 2024-08-18
Potential for more than minimal harm
- DF0658Ensure services provided by the nursing facility meet professional standards of quality.2024-07-19 · Health · corrected 2024-08-18
Potential for more than minimal harm
- DF0695Provide safe and appropriate respiratory care for a resident when needed.2024-07-19 · Health · corrected 2024-08-18
Potential for more than minimal harm
- DF0700Try 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.2024-07-19 · Health · corrected 2024-08-18
Potential for more than minimal harm
- DF0732Post nurse staffing information every day.2024-07-19 · Health · corrected 2024-08-18
Potential for more than minimal harm
- DF0758Implement 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.2024-07-19 · Health · corrected 2024-08-18
Potential for more than minimal harm
- EF0761Ensure 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.2024-07-19 · Health · corrected 2024-08-18
Potential for more than minimal harm
- EF0812Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.2024-07-19 · Health · corrected 2024-08-18
Potential for more than minimal harm
- EF0880Provide and implement an infection prevention and control program.2024-07-19 · Health · corrected 2024-08-18
Potential for more than minimal harm
- DF0658Ensure services provided by the nursing facility meet professional standards of quality.2023-06-09 · Health · corrected 2023-07-09
Potential for more than minimal harm
- DF0758Implement 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.2023-06-09 · Health · corrected 2023-07-09
Potential for more than minimal harm
- EF0761Ensure 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.2023-06-09 · Health · corrected 2023-07-09
Potential for more than minimal harm
- EF0812Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.2023-06-09 · Health · corrected 2023-07-09
Potential for more than minimal harm
- EF0880Provide and implement an infection prevention and control program.2023-06-09 · Health · corrected 2023-07-09
Potential for more than minimal harm
- DF0658Ensure services provided by the nursing facility meet professional standards of quality.2019-05-03 · Health · corrected 2019-05-20
Potential for more than minimal harm
- EF0812Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.2019-05-03 · Health · corrected 2019-05-20
Potential for more than minimal harm
- DF0880Provide and implement an infection prevention and control program.2019-05-03 · Health · corrected 2019-05-20
Potential for more than minimal harm
Ownership
| Owner | Type | Role | Percent | Since |
|---|---|---|---|---|
| RANCHO SAN ANTONIO RETIREMENT HOUSING CORPORATION | Organization | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 100% | 1999-07-02 |
| LIFE CARE SERVICES LLC | Organization | OPERATIONAL/MANAGERIAL CONTROL | — | 2012-06-01 |
| JO, DANIEL | Individual | OPERATIONAL/MANAGERIAL CONTROL | — | 2025-02-01 |
| KAO, NANCY | Individual | OPERATIONAL/MANAGERIAL CONTROL | — | 2000-05-01 |
| NELSON, MARK | Individual | OPERATIONAL/MANAGERIAL CONTROL | — | 2024-11-04 |
| EXLINE, RICK | Individual | CORPORATE DIRECTOR | — | 2025-01-01 |
| JOHNSON, EIKO | Individual | CORPORATE DIRECTOR | — | 2023-01-01 |
| BRAUMAN, SHARON | Individual | CORPORATE OFFICER | — | 2020-01-01 |
| BROWN, KATHY | Individual | CORPORATE OFFICER | — | 2024-01-01 |
| BUSH, ELLYN | Individual | CORPORATE OFFICER | — | 2023-01-01 |
| FISHBEIN, MARGERY | Individual | CORPORATE OFFICER | — | 2024-01-01 |
Other facilities in CUPERTINO
| Name | Overall | Beds |
|---|---|---|
| SUNNY VIEW MANOR | ★★★★★ | 48 |
| CUPERTINO HEALTHCARE & WELLNESS CENTER | ★★★☆☆ | 170 |
Source: CMS Provider Data Catalog, Nursing Home Care Compare files (processed 2026-03-01). Citations show the 3 most recent inspection cycles.