Federal inspection record · CMS data as of October 1, 2026
Smith Ranch Skilled Nursing & Rehabilitation Cente
1550 Silveira Parkway, San Rafael, CA · (415) 499-1000
- Certified beds
- 80
- Residents per day
- 73
- Ownership
- For-Profit
- Chain
- Generations Healthcare
- Medicare / Medicaid
- Medicare + Medicaid
- Certified since
- April 15, 1994
1
How this home got 3 stars
The overall rating isn't an average. CMS starts from the inspection rating and nudges it at most two steps. Here is the arithmetic for this home, using CMS's own rules.
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Health inspections
★★★★★starting point
Everything starts from what state inspectors found on site. This is a ranking against other homes in California.
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Staffing
★★★★★no change
Only a 5-star staffing rating adds a star, and only a 1-star rating removes one. Ratings of 2 to 4 change nothing.
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Quality measures
★★★★★+1 star
Same rule: 5 stars adds one, 1 star takes one away. These measures are mostly reported by the home itself.
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Overall
★★★★★3 of 5
Matches the rating CMS publishes on Care Compare.
2
Where it sits among California homes
Smith Ranch Skilled Nursing & Rehabilitation Cente carries 98 inspection points. That is fewer than 41% of California's 1,154 rated homes.
Inspectors' citations earn points by how serious and how widespread they were (the grid below). CMS then ranks every home in California: the 10% with the fewest points get 5 stars, the 20% with the most get 1 star, and the middle 70% split evenly into 2, 3 and 4.
- 5★ 0–33 pts
- 4★ 33–66 pts
- 3★ 66–96 pts
- 2★ 96–146 pts
- 1★ over 146 pts
Bars show every rated home in California by its weighted inspection score. CMS recalibrates the cut points monthly but holds a home's rating until its own score changes, so a home can sit just outside today's band.
3
What inspectors found
45 health citations on record since 2023. Each one gets a letter: the row says how badly residents were affected, the column how many.
Immediate jeopardyResidents at risk of serious injury or death
Actual harmA resident was hurt
Potential for harmNo one was hurt, but could have been
Minimal harmPaperwork-level problems
Read the rows, not the total. Most citations nationwide are a D: one problem, nobody hurt. Rows G–I mean a resident was harmed; J–L mean inspectors found residents in immediate danger of serious injury or death.
Small numbers in each cell are the inspection points CMS assigns per citation. Those points are what the state curve above ranks.
No citation on record at the harm or immediate-jeopardy level.
Everything else, by area of care
Resident Assessment and Care Planning11E
- D
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
- E
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
- E
Ensure services provided by the nursing facility meet professional standards of quality.
- E
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
- E
Ensure services provided by the nursing facility meet professional standards of quality.
- D
PASARR screening for Mental disorders or Intellectual Disabilities
- E
Ensure services provided by the nursing facility meet professional standards of quality.
- D
Ensure each resident receives an accurate assessment.
- E
Ensure each resident receives an accurate assessment.
- E
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
- D
Ensure services provided by the nursing facility meet professional standards of quality.
Quality of Life and Care11E
- E
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
- D
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
- E
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.
- D
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
- D
Provide enough food/fluids to maintain a resident's health.
- D
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.
- E
Provide care and assistance to perform activities of daily living for any resident who is unable.
- E
Provide activities to meet all resident's needs.
- D
Ensure residents do not lose the ability to perform activities of daily living unless there is a medical reason.
- D
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
- D
Provide safe and appropriate respiratory care for a resident when needed.
Pharmacy Service7E
- D
Ensure that residents are free from significant medication errors.
- D
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
- D
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
Ensure medication error rates are not 5 percent or greater.
- D
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.
- E
Ensure medication error rates are not 5 percent or greater.
- D
Ensure that residents are free from significant medication errors.
Resident Rights7F
- E
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.
- F
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.
- D
Ensure that residents are fully informed and understand their health status, care and treatments.
- D
Reasonably accommodate the needs and preferences of each resident.
- D
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
Allow residents to easily view the nursing home's survey results and communicate with advocate agencies.
- E
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.
Nutrition and Dietary3F
- E
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
- F
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
- F
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Freedom from Abuse, Neglect, and Exploitation2D
- D
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
- D
Protect each resident from the wrongful use of the resident's belongings or money.
Infection Control2E
- D
Provide and implement an infection prevention and control program.
- E
Provide and implement an infection prevention and control program.
Environmental1E
- E
Keep all essential equipment working safely.
Administration1F
- F
Have a plan that describes the process for conducting QAPI and QAA activities.
Inspection history
2026-02-12
16 health deficiencies · 3 fire-safety deficiencies
Top issue: Resident Assessment and Care Planning (6 deficiencies)
2025-05-16
15 health deficiencies · 5 fire-safety deficiencies
Top issue: Quality of Life and Care (4 deficiencies)
2023-08-22
14 health deficiencies · 12 fire-safety deficiencies
Top issue: Quality of Life and Care (5 deficiencies)
4
Nursing time per resident, per day
Each resident here gets about 4 h 7 min of nursing staff time a day, 20 min of it from a registered nurse.
This home
4 h 7 min
California average
4 h 33 min
U.S. average
3 h 54 min
- Registered nurse
- Licensed practical nurse
- Nurse aide
Turnover: 38% of nursing staff and 50% of registered nurses left in the past year, along with 1 administrator.
Reported hours from payroll data the home submits to CMS, divided by its daily resident count. Not adjusted for how sick residents are.
5
Resident outcomes
Quality measures compared with state and national averages. Most come from assessments the home itself reports.
| Measure | This home | State | U.S. |
|---|---|---|---|
| Number of hospitalizations per 1000 long-stay resident days0.5 pts worse | 2.7 | 2.2 | 1.8 |
| Number of outpatient emergency department visits per 1000 long-stay resident days0.5 pts worse | 2.0 | 1.5 | 1.7 |
| Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine1.3 pts better | 100.0% | 98.7% | 93.7% |
| Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine2.1 pts better | 100.0% | 97.9% | 95.3% |
| Percentage of long-stay residents experiencing one or more falls with major injury1.1 pts worse | 2.7% | 1.6% | 3.2% |
| Percentage of long-stay residents who have depressive symptoms6.9 pts better | 0.7% | 7.6% | 13.5% |
| Percentage of long-stay residents who lose too much weight2.1 pts worse | 6.2% | 4.1% | 5.1% |
| Percentage of long-stay residents who received an antianxiety or hypnotic medication1.5 pts worse | 15.2% | 13.7% | 19.5% |
| Percentage of long-stay residents who received an antipsychotic medication4.6 pts better | 7.7% | 12.3% | 15.4% |
| Percentage of long-stay residents who were physically restrained0.3 pts better | 0.0% | 0.3% | 0.1% |
| Percentage of long-stay residents whose ability to walk independently worsened8.9 pts better | 0.0% | 8.9% | 12.7% |
| Percentage of long-stay residents whose need for help with daily activities has increased8.6 pts better | 1.6% | 10.2% | 13.5% |
| Percentage of long-stay residents with a catheter inserted and left in their bladder0.7 pts better | 0.0% | 0.7% | 0.7% |
| Percentage of long-stay residents with a urinary tract infection1.2 pts better | 0.0% | 1.2% | 1.5% |
| Percentage of long-stay residents with new or worsened bowel or bladder incontinence8.3 pts better | 1.5% | 9.8% | 18.3% |
| Percentage of long-stay residents with pressure ulcers0.5 pts better | 3.8% | 4.3% | 4.5% |
| Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine5.4 pts better | 100.0% | 94.6% | 82.3% |
| Percentage of short-stay residents who had an outpatient emergency department visit1.3 pts worse | 12.4% | 11.1% | 11.8% |
| Percentage of short-stay residents who newly received an antipsychotic medication0.2 pts better | 1.1% | 1.3% | 1.5% |
| Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine6.4 pts better | 99.5% | 93.1% | 80.1% |
| Percentage of short-stay residents who were rehospitalized after a nursing home admission1.2 pts better | 21.4% | 22.6% | 23.4% |
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Who owns and runs it
32 owners and managers reported to CMS. The last column counts how many nursing homes each one is tied to.
Show ownership list
| Name | Role | Share | Homes |
|---|---|---|---|
| Amilcar, Alberta | Operational/Managerial Control · Individual | 0% | 1 facilities |
| Amilcar, Alberta | Adp Of The SNF · Individual | 0% | 1 facilities |
| Arguel, Angelo Clyde | Operational/Managerial Control · Individual | 0% | 1 facilities |
| Arguel, Angelo Clyde | Adp Of The SNF · Individual | 0% | 1 facilities |
| Bmo Bank, N.a. | 5% Or Greater Security Interest · Organization | 0% | 25 facilities |
| Bmo Bank, N.a. | Operational/Managerial Control · Organization | 0% | 25 facilities |
| Bmo Bank, N.a. | Adp Of The SNF · Organization | 0% | 25 facilities |
| Coleman, Kelsey | Operational/Managerial Control · Individual | 0% | 1 facilities |
| Coleman, Kelsey | Adp Of The SNF · Individual | 0% | 1 facilities |
| Daly, Megan | Operational/Managerial Control · Individual | 0% | 1 facilities |
| Daly, Megan | Adp Of The SNF · Individual | 0% | 1 facilities |
| Deguzman, Dina | Operational/Managerial Control · Individual | 0% | 1 facilities |
| Deguzman, Dina | Adp Of The SNF · Individual | 0% | 1 facilities |
| Gutierrez, Jesus | Operational/Managerial Control · Individual | 0% | 1 facilities |
| Gutierrez, Jesus | Adp Of The SNF · Individual | 0% | 1 facilities |
| Life Generations Healthcare, LLC | Operational/Managerial Control · Organization | 0% | 12 facilities |
| Life Generations Healthcare, LLC | Adp Of The SNF · Organization | 0% | 12 facilities |
| Mastrocola, Lois | Indirect Ownership Interest · Individual | 0% | 27 facilities |
| Mastrocola, Lois | Operational/Managerial Control · Individual | 0% | 27 facilities |
| Mastrocola, Lois | Adp Of The SNF · Individual | 0% | 27 facilities |
| Nain, Kabir | Operational/Managerial Control · Individual | 0% | 1 facilities |
| Nain, Kabir | Adp Of The SNF · Individual | 0% | 1 facilities |
| Niaki, Michael | Operational/Managerial Control · Individual | 0% | 1 facilities |
| Niaki, Michael | Adp Of The SNF · Individual | 0% | 1 facilities |
| Olds, Thomas | Indirect Ownership Interest · Individual | 0% | 27 facilities |
| Olds, Thomas | Operational/Managerial Control · Individual | 0% | 27 facilities |
| Olds, Thomas | Adp Of The SNF · Individual | 0% | 27 facilities |
| San Rafael Re, LLC | Adp Of The SNF · Organization | 0% | 1 facilities |
| Smith, Fred | Indirect Ownership Interest · Individual | 0% | 5 facilities |
| Smith, Fred | Adp Of The SNF · Individual | 0% | 5 facilities |
| Theragen, LLC | Operational/Managerial Control · Organization | 0% | 4 facilities |
| Theragen, LLC | Adp Of The SNF · Organization | 0% | 4 facilities |
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Fire safety
20 life-safety citations (sprinklers, exits, alarms). These don't count toward the star rating.
Smoke9E
- D
Install corridor and hallway doors that block smoke.
- D
Inspect, test, and maintain automatic sprinkler systems.
- E
Have approved installation, maintenance and testing program for fire alarm systems.
- D
Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.
- D
Install a fire alarm system that can be heard throughout the facility.
- D
Properly select, install, inspect, or maintain portable fire extinguishes.
- D
Install corridor and hallway doors that block smoke.
- C
Follow proper procedures when the fire alarm was out of service for more than 4 hours.
- C
Follow proper procedures when the automatic sprinkler systems was out of service for more than 10 hours.
Gas, Vacuum, and Electrical Systems5E
- D
Ensure proper usage of power strips and extension cords.
- D
Have proper medical gas storage and administration areas.
- D
Meet requirements for the use of electrical equipment.
- D
Ensure proper usage of power strips and extension cords.
- E
Meet requirements for the use of electrical equipment.
Emergency Preparedness2C
- C
Provide emergency officials' contact information.
- C
Provide primary/alternate means for communication.
Egress2E
- E
Keep aisles, corridors, and exits free of obstruction in case of emergency.
- D
Have properly located and lighted "Exit" signs.
Miscellaneous1E
- E
Provide a written emergency evacuation plan.
Construction1D
- D
Use approved construction type or materials.
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