Not rated by CMS — ratings are suppressed for new or low-volume facilities.
The next survey window likely opens around November 2026
Estimate from public CMS data, current as of June 2026. Survey timing is at the state agency's discretion.
Citation history
Health deficiencies cited at Foundation Skilled Nursing during CMS and state inspections, most recent first.
Surveyors found that the facility failed to maintain a functioning call light system for 11 of 59 beds, with several residents lacking working call lights or any call light device at their bedside. One cognitively intact resident with muscle weakness and a history of repeated falls reported his call light had worked intermittently since admission, had stopped working again, and that he had previously gotten out of bed and yelled for help and once waited about an hour for incontinence care due to the nonfunctioning call light. In another room, a resident reported having no call light, and her roommate had only a small silver bell despite hand deformities that made its use difficult. The DOM and staff identified loose wall connections, missing cords, and long-standing issues in multiple rooms, with some residents given bells or portable call buttons instead of functioning call lights, while CNAs, an LVN, the scheduler, and the DON gave conflicting accounts of their awareness of these ongoing problems and the reporting process.
A facility area contained accident hazards and staff did not provide adequate supervision to prevent accidents, as observed by surveyors. These lapses resulted in a deficiency related to environmental safety and resident supervision.
A resident with severe cognitive impairment and multiple risk factors for falls experienced three unwitnessed falls within two weeks due to the facility's failure to provide adequate supervision and timely, effective fall prevention interventions. Despite being identified as high risk and requiring supervision while ambulating, the resident was only checked every 15 minutes rather than receiving direct in-room supervision, and interventions were not adjusted after repeated falls.
A resident with moderate cognitive impairment was left at a doctor's office for several hours without a meal due to a failure in transportation arrangements. The resident was ready to return to the facility by noon but was not picked up until the evening, resulting in emotional distress and hunger. The facility's process for managing appointments was not followed, and the Social Services Director did not ensure the resident's timely return.
A resident at high risk for falls was not properly placed on the facility's Red Sneaker Program, a fall prevention initiative. Despite having a fall risk score indicating high risk, the necessary visual symbols and red bracelet were missing, contrary to the facility's policy. The resident's medical history included conditions like osteomyelitis and muscle weakness, but their MDS indicated no cognitive impairment. Interviews with the DON and an LVN confirmed the oversight in implementing the required interventions.
A resident with Alzheimer's and severe cognitive impairment, identified as a high fall risk, experienced an unwitnessed fall resulting in a skin tear. Despite being part of a fall prevention program, the resident was left unsupervised after breakfast, leading to the incident. Staff interviews confirmed the resident's need for supervision, especially when tired, was known but not adequately provided.
The facility failed to maintain a safe and comfortable environment for residents when the dining room temperature fell below the acceptable range of 71 to 81 degrees Fahrenheit. Three residents, including one with dementia and another with COPD, expressed discomfort due to the cold conditions. The Director of Maintenance confirmed the low temperatures, and the Director of Nursing emphasized the importance of maintaining the specified temperature range to ensure a homelike setting.
The facility failed to implement comprehensive care plans for three residents, leading to potential health risks. A resident's medication refusal was not addressed in their care plan, another resident's skin assessments were not conducted, and a third resident's call light was not within reach, contrary to their care plan. These oversights indicate a failure to adhere to care planning policies.
The facility failed to meet professional standards by not explaining medications to residents during administration, not notifying a physician of a resident's medication refusal, and not performing current vital assessments before a hospital transfer. Nurses admitted to not informing residents about their medications, and outdated assessments were used for a resident with shortness of breath.
A resident was given divalproex without a specific diagnosed condition documented in their clinical record. The medication was used off-label for mood disorders, despite effective non-pharmacological interventions. The resident had a history of dementia and other mental health issues, and the facility's policy required a specific diagnosis before administering psychotropic medications.
The facility failed to maintain the required temperature in the high temperature dishwasher, with readings below the necessary 155 degrees Fahrenheit during the wash cycle. This failure could potentially expose 52 out of 55 highly susceptible residents to foodborne illnesses due to cross-contamination. Staff interviews confirmed the importance of correct temperatures for sanitation, and the facility's policy emphasized adherence to manufacturer's recommendations.
The facility failed to maintain an effective pest control program, as flies were observed in the kitchen on two consecutive days. The Certified Dietary Manager acknowledged the lack of a fly light trap and recognized the infection control issue posed by flies. The Registered Dietician expected a pest-free kitchen, emphasizing the risk of illness for residents. The facility did not provide a specific pest control policy, and a review of the FDA Food Code highlighted the need to protect food establishments from pests.
The facility was found to have three rooms (Rooms 1, 2, and 14) each accommodating six residents, exceeding the regulatory limit of four residents per room. Despite this, the rooms were noted to have sufficient space and facilities to meet the residents' needs, and the health and safety of the residents were not deemed to be adversely affected by this arrangement.
A resident at high risk for falls, with severe cognitive impairment and multiple medical conditions, was left unattended by a CNA assigned to provide one-on-one supervision. The CNA briefly left the resident's side to assist another CNA, resulting in the resident falling and sustaining head injuries. The facility lacked a specific policy for one-on-one supervision, contributing to the deficiency.
Failure to Maintain Functioning Call Light System for Multiple Residents
Penalty
Summary
The deficiency involves the facility’s failure to maintain a functioning resident call light system in multiple rooms and beds, including bathrooms and bathing areas, leaving residents without a reliable means to summon staff assistance. Surveyors observed that 11 of 59 beds (8A, 8B, 11A, 11B, 11C, 14A, 14B, 15A, 15B, 17B, 17D) had nonfunctioning or missing call lights. In one room, a resident reported that his call light had worked intermittently since admission and had stopped working again the day before the survey; when he pressed the button, there was no light above the door and no sound or light at the bed station panel. The panel had a splitter adapter with two cords plugged in, but the system did not activate. This resident stated he had previously gotten out of bed on his own and gone to the door to yell for help and that on one occasion he waited about an hour to be cleaned after a bowel movement because the call light was not working. The same resident’s records showed diagnoses including mastoiditis, Bell’s palsy, muscle weakness, and repeated falls, and his MDS BIMS score indicated he was cognitively intact. He reported that the Director of Maintenance (DOM) had attempted to fix the call light about three weeks earlier but was unsuccessful, and that the DOM had said he ordered the wrong part or that parts were not coming in. During the interview, the DOM entered the room with a call light cord, stating he had a work order to replace the cord, but then left the room without replacing it. Later, the DOM stated there were five call lights not working in the facility and that he had received work orders for rooms 8, 11, and 14 on a recent Sunday, and he asserted it was the first time he had heard that the resident’s call light had been intermittently nonfunctional for approximately six weeks. In another room shared by two residents, one resident stated she did not have a call light and believed it had been stolen; surveyors confirmed there was no call light near her bed. The other resident in the same room had a small silver bell on her overbed table instead of a call light, and she had partial deformity of her hands, making use of the bell difficult. Additional observations with the DOM showed that call lights in multiple rooms and beds did not activate when pressed, including beds 8A, 8B, 11C, 14A, 14B, 15A, 15B, 17B, and 17D, and that beds 11A and 11B had no call lights at all. In some cases, the DOM identified loose plugs or bad connections in the wall panels and noted that silver bells or portable call buttons had been used when the call lights were not working. Staff interviews revealed inconsistent awareness and reporting of the call light problems. A CNA assigned to affected rooms stated she was unaware the call lights were not working and that the previous shift had not reported any issues. Another CNA reported that one room’s call light would not work at times because the cord would come slightly out of the panel and had to be pushed back in. An LVN stated she did not know that call lights in a particular room were not working, while another LVN reported that call lights in one room had not worked for about two months and that portable call buttons had been provided. The scheduler, who conducted Angel Rounds for certain rooms, stated that call lights in one room had not been working for approximately two months and that residents were initially given silver bells and later portable call buttons, but she was unaware that one resident in that room did not have a call light or bell. The DON stated that call lights in one room had not been working since January and that portable call lights were given due to connection issues, and she was unaware that a resident in another bed did not have a call light. Review of maintenance request forms showed repeated reports of call light problems over several weeks, including nonworking call lights in room 14 for all beds, a bad wall connection in room 8B, a need for call lights for both beds in another room, and a missing call light in bed 11A. Some forms documented completion dates and comments that call lights were working again or that parts such as split connectors had been ordered. Angel Rounds documentation for certain dates noted a broken call light button in room 11. The facility’s call light policy stated that staff would be educated on proper use of the call system, ensure resident access to call lights, and report problems to a supervisor or maintenance director, and the maintenance director’s job description required maintaining the building and equipment in safe order and ensuring a safe and secure environment for staff, residents, and guests. Despite these policies, survey findings showed multiple nonfunctioning or missing call lights and inconsistent communication and follow-through regarding identified call light issues.
Failure to Maintain Accident-Free Environment and Adequate Supervision
Penalty
Summary
The facility failed to ensure that an area was free from accident hazards and did not provide adequate supervision to prevent accidents. Surveyors observed that the environment contained hazards that could lead to resident accidents, and staff did not implement sufficient measures to monitor or protect residents from these risks. This deficiency was identified based on direct observations and findings during the survey, which indicated lapses in maintaining a safe environment and in providing necessary supervision to prevent accidents.
Failure to Provide Adequate Supervision and Fall Prevention for High-Risk Resident
Penalty
Summary
A deficiency occurred when a facility failed to provide adequate supervision and implement effective fall prevention interventions for a resident assessed as high risk for falls. The resident, who had diagnoses including osteoporosis, type 2 diabetes, dementia, gait abnormalities, and muscle weakness, was severely cognitively impaired and required supervision while ambulating. Despite being identified as high risk through multiple fall risk assessments and care plans, the resident experienced three unwitnessed falls within a two-week period. The facility's care plans and fall prevention program, including the Red Sneaker Program, outlined interventions such as supervision, environmental safety checks, and regular monitoring. However, the resident was placed on Level 2 supervision, which involved staff checking every 15 minutes, rather than direct in-room supervision, even after repeated falls. The care plans included interventions like assessing dizziness, monitoring for injury, and providing education, but staff acknowledged that the resident's dementia prevented retention of safety education or reminders. Interviews and record reviews revealed that the interdisciplinary team (IDT) did not increase the level of supervision to direct, in-room monitoring until after the third fall. The Director of Nursing confirmed that Level 2 supervision was not effective for this resident, as evidenced by the repeated falls. The facility's own policies required individualized, resident-centered interventions and modification of interventions if falls recurred, but these were not implemented in a timely manner for this resident.
Resident Left at Doctor's Office Due to Transportation Failure
Penalty
Summary
The facility failed to ensure adequate transportation for a resident returning from a doctor's appointment, resulting in the resident being left at the doctor's office for several hours without a meal. The resident, who was moderately cognitively impaired, was admitted with conditions including cellulitis, muscle weakness, and mobility issues. On the day of the incident, the resident was picked up for a morning appointment and was ready to return to the facility by noon, but was not picked up until the evening. Interviews and record reviews revealed that the facility's process for managing resident appointments was not followed. The scheduler received a call from the doctor's office at 12:30 p.m. indicating the resident was ready to be picked up and forwarded the call to the Social Services Director (SSD). The SSD provided the doctor's office with a phone number for transportation but did not follow up to ensure the resident was picked up. The Director of Nursing (DON) later stated that the facility was ultimately responsible for ensuring the resident had something to eat and drink. The incident was documented in the resident's records, noting the delay in transportation and the resident's return to the facility. The facility's policy indicated that social services representatives were responsible for assisting with transportation arrangements, but this was not effectively executed. The resident experienced emotional distress, hunger, and was without a jacket in cold weather, highlighting the facility's failure to uphold the resident's right to dignity and adequate care.
Failure to Implement Fall Prevention Program for High-Risk Resident
Penalty
Summary
The facility failed to implement a comprehensive person-centered care plan for a resident identified as being at high risk for falls. The resident, who had a history of falls both at home and within the facility, was not properly placed on the facility's Red Sneaker Program (RSP), a fall prevention initiative. Despite the resident's fall risk care plan being updated after a recent fall, the necessary interventions outlined in the RSP were not executed. This included the absence of visual symbols such as red sneakers by the resident's name placard outside their room, above their bed, and the lack of a red bracelet on the resident. Interviews with the Director of Nursing (DON) and a Licensed Vocational Nurse (LVN) revealed that the resident had a fall risk score of 13, indicating a high risk of falls. The facility's policy required that residents on the RSP be identified with specific symbols and a red bracelet to alert staff of their fall risk. However, during observations, these indicators were missing, and the resident was not wearing the required red bracelet. The DON acknowledged the oversight and confirmed that these measures should have been in place as per the resident's care plan and the facility's fall prevention policy. The resident's medical history included conditions such as osteomyelitis of the vertebra, muscle weakness, cognitive communication deficit, and end-stage renal disease. Despite these conditions, the resident's Minimum Data Set (MDS) indicated no cognitive impairment. The facility's policies on comprehensive person-centered care plans and safety and supervision of residents emphasized the need for targeted interventions to reduce individual risks, which were not adequately implemented in this case.
Inadequate Supervision Leads to Resident Fall
Penalty
Summary
The facility failed to provide adequate supervision to a resident identified as a high fall risk, resulting in an unwitnessed fall. The resident, who has a history of falls and a known behavior of placing herself on the floor when tired, was found on the floor with a skin tear on her right elbow. The incident occurred after the resident ambulated unattended from the dining room, where she had been left unsupervised by a CNA who was assisting another resident. The resident's medical history includes Alzheimer's Disease, Type 2 Diabetes Mellitus, muscle weakness, and dementia, with a severe cognitive impairment as indicated by a BIMS score of 01 out of 15. The resident was part of the facility's Red Sneaker Program, which identifies individuals at high risk for falls. Despite this, the resident frequently walked unsupervised, and staff acknowledged that she required supervision, especially when tired, to prevent falls. Interviews with facility staff, including CNAs, an LVN, the MDS Coordinator, the DON, and the Administrator, revealed that the resident's need for supervision was well-known. The facility's policy emphasized the importance of individualized safety measures and adequate supervision for residents at risk of falls. However, the resident's care plan and fall risk assessments were not effectively implemented, leading to the unwitnessed fall and subsequent injury.
Facility Fails to Maintain Safe Temperature in Dining Room
Penalty
Summary
The facility failed to maintain a safe, comfortable, and homelike environment for three residents when the dining room temperature was below the acceptable range of 71 to 81 degrees Fahrenheit. This deficiency was observed during a survey where residents expressed discomfort due to the cold temperature in the dining room. Resident 22, who has a history of dementia, muscle weakness, and falls, mentioned needing a coat because the dining room was always cold. Resident 29, who is cognitively intact and has conditions such as shortness of breath and osteoarthritis, also reported that the dining room was too cold while wearing a sweater. Resident 42, with chronic obstructive pulmonary disease (COPD) and asthma, stated that the dining room was cold even at night and had previously contracted pneumonia. The Director of Maintenance confirmed the low temperatures in the dining room, with readings of 69, 67, and 69 degrees Fahrenheit. The Director acknowledged that closing the dining room door before meals contributed to the cold environment and emphasized the importance of maintaining the temperature within the specified range to ensure a homelike setting. The Director of Nursing also stated that the facility's expectation was to keep the temperature between 71 and 81 degrees Fahrenheit to provide a safe and comfortable environment for residents. The facility's policy on providing a homelike environment includes maintaining comfortable and safe temperatures. Professional references cited in the report highlight the negative impact of low indoor temperatures on residents, particularly those with dementia and respiratory conditions. These references indicate that deviations from the recommended temperature range can lead to increased agitation and respiratory issues, underscoring the importance of maintaining appropriate indoor temperatures for the well-being of residents.
Failure to Implement Comprehensive Care Plans
Penalty
Summary
The facility failed to develop and implement comprehensive person-centered care plans for three residents, leading to potential risks for their health and safety. Resident 13's care plan did not include interventions for his refusal of medications, which was not documented or communicated to the attending physician. This oversight occurred despite multiple refusals of his inhaler, which could exacerbate his Chronic Obstructive Pulmonary Disease (COPD). The Licensed Vocational Nurse (LVN) and the Minimum Data Set Nurse (MDSN) acknowledged the absence of a specific care plan addressing the medication refusal, indicating a failure to adhere to the facility's care planning policy. Resident 8's care plan was not implemented for skin assessments, resulting in a lack of monitoring for skin tears, bruising, or wounds. During observations, a wound was noted on Resident 8's forearm, which she reported was not being treated by the staff. The Registered Nurse Supervisor (RNS) confirmed that there was no documentation of the wound in Resident 8's medical record, and the care plan did not include wound care for the forearm. The facility's policy required daily skin checks during activities of daily living and showers, but these were not consistently documented or communicated to the nursing staff. Resident 16's care plan was not followed regarding the placement of the call light within reach, which is crucial for a resident with a history of falls and severe cognitive impairment. The call light was observed out of reach, and the resident expressed difficulty in accessing it. The Activity Assistant and Certified Nursing Assistant (CNA) confirmed the call light was not within reach, contrary to the care plan's intervention to prevent falls. The Director of Nursing (DON) stated that the call light should always be within reach, highlighting a failure to implement the care plan as intended.
Failure to Meet Professional Standards in Medication Administration and Resident Assessment
Penalty
Summary
The facility failed to provide services that met professional standards of practice for several residents. Registered Nurse (RN) 1 and Licensed Vocational Nurse (LVN) 1 did not explain the medication names and indications to multiple residents during medication administration. This oversight was observed during medication pass observations, where medications were administered without informing the residents about the medications they were receiving. Interviews with the nurses confirmed that they did not explain the medications, acknowledging that residents have the right to know the medications they are receiving. The facility also failed to notify the attending physician of a resident's ongoing refusal of a prescribed inhaler. The resident had multiple episodes of refusal, which were not documented or communicated to the physician as required by the facility's policy. This lack of communication and documentation could potentially affect the resident's health condition, as the inhaler was prescribed to manage a chronic lung disease. Additionally, the facility did not perform current oxygen saturation and respiration assessments on a resident before transporting them to the hospital for shortness of breath. The assessments used were outdated, and there was no documentation of vital signs taken prior to the hospital transfer. The Registered Nurse Supervisor acknowledged that vital signs should have been checked and documented before the transfer, as per the facility's policy.
Unnecessary Psychotropic Medication Administration
Penalty
Summary
The facility failed to ensure that a resident was free from unnecessary psychotropic medications. Resident 39 was administered divalproex, an anticonvulsant medication, without a specific condition diagnosed and documented in the clinical record. The medication was prescribed for an unspecified mood disorder manifested by irritability and abusive language, despite the fact that non-pharmacological interventions had been documented as effective. The Pharmacist Consultant acknowledged that divalproex was being used off-label for mood disorders and that other medications could have been used on-label for the resident's diagnoses. Observations and interviews revealed that Resident 39 had bruising on her forehead, nose, and around her left eye, and had fallen out of bed. The resident had a history of dementia, muscle weakness, unspecified psychosis, and unspecified mood disorder. The Director of Nursing stated that divalproex was being used as a mood stabilizer and acknowledged that the expectation was for residents to have a specific diagnosis before administering psychotropic medications. The facility's policy indicated that medications should not be administered without a clinical indication to treat a specific condition, and non-pharmacological approaches should be used to minimize the need for medications.
Dishwasher Temperature Deficiency
Penalty
Summary
The facility failed to adhere to professional standards for food service safety when the high temperature dishwasher did not reach the required temperature during the wash cycle. Observations revealed that the dishwasher's temperature was below the necessary 155 degrees Fahrenheit, with readings as low as 145 degrees Fahrenheit. Dietary Aide 1, responsible for operating the dishwasher, incorrectly stated that the wash cycle temperature should be above 135 degrees Fahrenheit, while the actual requirement was 155 degrees Fahrenheit as per the dishwasher's data plate. This discrepancy in temperature could potentially expose 52 out of 55 highly susceptible residents to foodborne illnesses due to cross-contamination. Interviews with various staff members, including the Certified Dietary Manager and the Registered Dietician, confirmed the importance of maintaining the correct dishwasher temperatures for sanitation and infection control. The facility's policy and procedure for dishwashing emphasized the need for the dishwasher to operate within the manufacturer's recommended temperatures, and if not achievable, to resort to manual dishwashing. Despite these guidelines, the dishwasher was not consistently reaching the required temperatures, posing a risk to resident safety.
Deficiency in Pest Control Program
Penalty
Summary
The facility failed to maintain an effective pest control program, as evidenced by the presence of flies in the kitchen area on two consecutive days. On the first day, a fly was observed flying around the food serving area. The following day, two flies were seen in the kitchen by the food serving and dishwasher areas during an observation and interview with the Certified Dietary Manager (CDM). The CDM acknowledged the presence of a fly fan at the back entrance but noted the absence of a fly light trap to attract and eliminate flies. The CDM also mentioned that pest control services were scheduled once a month and recognized that flies posed an infection control issue, potentially leading to illness among residents consuming food from the kitchen. The Registered Dietician (RD) expressed an expectation for the kitchen to be free of flies and pests, emphasizing the risk of residents becoming ill. The RD indicated that the CDM was responsible for ensuring the kitchen's cleanliness and pest-free status. A review of the facility's infection control policy highlighted the goal of maintaining a safe, sanitary, and comfortable environment to prevent disease transmission. However, the facility did not provide a specific policy for pest control or kitchen sanitation upon request. Additionally, a professional reference from the FDA Food Code 2022 underscored the importance of protecting food establishments from insects and rodents to prevent contamination of food and food-contact surfaces.
Exceeding Resident Capacity in Rooms
Penalty
Summary
The facility failed to comply with the regulation that limits the number of residents per room to a maximum of four. During the survey conducted from August 19 to August 23, 2024, it was observed that three rooms (Rooms 1, 2, and 14) each accommodated six residents, exceeding the allowed capacity. Despite this non-compliance, the report notes that the rooms were adequately equipped to meet the residents' needs, providing sufficient space for nursing care, ambulation, and storage. The report also mentions that the health and safety of the residents would not be adversely affected by the continuance of this waiver, suggesting that the facility had previously been granted a waiver for this requirement.
Inadequate Supervision Leads to Resident Fall and Injury
Penalty
Summary
The facility failed to ensure adequate supervision for a resident who was at high risk for falls, resulting in the resident falling and sustaining injuries. The resident, who had severe cognitive impairment and multiple medical conditions including dementia and muscle weakness, was assessed to require one-on-one observation for safety. Despite this assessment, a CNA left the resident unattended to assist another CNA with a different resident, leading to the resident's fall. The incident occurred during the night shift when the resident was restless and attempting to get out of bed frequently. The resident had been given medications for anxiety and pain, which could cause drowsiness and unsteady gait, increasing the risk of falls. The CNA assigned to the resident's one-on-one care left the resident's side briefly, believing the resident was asleep, and closed the curtain for privacy while assisting another resident. During this time, the resident fell and sustained lacerations and contusions to the head, necessitating transfer to the emergency department. Interviews with facility staff, including the Administrator, LVN, and DON, confirmed that the resident's one-on-one supervision was not maintained as required. The facility did not have a specific policy and procedure for one-on-one supervision, which contributed to the failure in providing adequate supervision. The DON acknowledged that the CNA should not have left the resident unattended, and the lack of a policy for one-on-one supervision was noted as a deficiency.
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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 Fresno
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Veterans Home Of California - Fresno | 3.9 mi | — | 13 | 0 |
| Fresno Postacute Care | 4.6 mi | — | 16 | 0 |
| Healthcare Centre Of Fresno | 5 mi | — | 3 | 0 |
| Community Subacute And Transitional Care Center | 5.9 mi | — | 12 | 0 |
| Oakwood Gardens Care Center | 6.4 mi | — | 2 | 0 |
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