01 / INSPECTION LEDGER
Survey cycles in this release
| Cycle | Health date | Health deficiencies | Fire date | Fire deficiencies |
|---|---|---|---|---|
| Cycle 1 | 2024-12-05 | 5 | 2024-12-05 | 21 |
| Cycle 2 | 2022-01-10 | 20 | 2022-01-10 | 5 |
| Cycle 3 | 2019-06-06 | 17 | 2019-06-06 | 4 |
CMS CCN 0558842026-08-01 PROCESSING DATE
NURSING HOME PUBLIC RECORD
Creekside Post-Acute
3580 Payne Avenue · San Jose, CA 95117 · Santa Clara County
Certified beds130CMS provider file
Recent citation rows72current CMS citation release
Penalty rows1current CMS penalties file
Read this record carefully.
The citation files cover the three most recent standard inspections plus qualifying complaint and infection-control inspections in the prior three years. A correction date is a CMS field; this site does not independently verify conditions. Absence from a file is not proof that no issue exists.
02 / CITATION DETAIL
72 rows in the current release
1 rows carry G–L scope/severity codes; 0 carry J–L. 18 tag codes appear on more than one survey date. These counts describe citation rows, not residents or incidents.
2025-09-23 · HEALTHF0684Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Correction field: Deficient, Provider has date of correction · 2025-10-19 · complaint2025-09-23 · HEALTHF0880Severity D · isolated; potential for more than minimal harm
Infection Control Deficiencies
Provide and implement an infection prevention and control program.
Correction field: Deficient, Provider has date of correction · 2025-10-19 · complaint2025-06-10 · HEALTHF0678Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide basic life support, including CPR, prior to the arrival of emergency medical personnel , subject to physician orders and the resident’s advance directives.
Correction field: Deficient, Provider has date of correction · 2025-06-27 · complaint2025-04-15 · HEALTHF0658Severity D · isolated; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Ensure services provided by the nursing facility meet professional standards of quality.
Correction field: Deficient, Provider has date of correction · 2025-04-30 · complaint2024-12-05 · FIREE0039Severity F · widespread; potential for more than minimal harm
Emergency Preparedness Deficiencies
Conduct testing and exercise requirements.
Correction field: Deficient, Provider has date of correction · 2024-12-272024-12-05 · HEALTHF0641Severity D · isolated; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Ensure each resident receives an accurate assessment.
Correction field: Deficient, Provider has date of correction · 2024-12-232024-12-05 · HEALTHF0645Severity D · isolated; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
PASARR screening for Mental disorders or Intellectual Disabilities
Correction field: Deficient, Provider has date of correction · 2024-12-232024-12-05 · HEALTHF0689Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Correction field: Deficient, Provider has date of correction · 2024-12-232024-12-05 · FIREK0161Severity D · isolated; potential for more than minimal harm
Construction Deficiencies
Use approved construction type or materials.
Correction field: Deficient, Provider has date of correction · 2024-12-172024-12-05 · FIREK0211Severity F · widespread; potential for more than minimal harm
Egress Deficiencies
Keep aisles, corridors, and exits free of obstruction in case of emergency.
Correction field: Deficient, Provider has date of correction · 2024-12-182024-12-05 · FIREK0291Severity D · isolated; potential for more than minimal harm
Egress Deficiencies
Install emergency lighting that can last at least 1 1/2 hours.
Correction field: Deficient, Provider has date of correction · 2024-12-262024-12-05 · FIREK0293Severity D · isolated; potential for more than minimal harm
Egress Deficiencies
Have properly located and lighted "Exit" signs.
Correction field: Deficient, Provider has date of correction · 2024-12-182024-12-05 · FIREK0324Severity D · isolated; potential for more than minimal harm
Smoke Deficiencies
Provide properly protected cooking facilities.
Correction field: Deficient, Provider has date of correction · 2024-12-262024-12-05 · FIREK0342Severity D · isolated; potential for more than minimal harm
Smoke Deficiencies
Have a complete alarm system manually initiated and initiated by fire sprinkler system connection.
Correction field: Deficient, Provider has date of correction · 2024-12-262024-12-05 · FIREK0344Severity F · widespread; potential for more than minimal harm
Smoke Deficiencies
Have an alternate power supply for its alarm system.
Correction field: Deficient, Provider has date of correction · 2024-12-262024-12-05 · FIREK0345Severity F · widespread; potential for more than minimal harm
Smoke Deficiencies
Have approved installation, maintenance and testing program for fire alarm systems.
Correction field: Deficient, Provider has date of correction · 2024-12-262024-12-05 · FIREK0347Severity F · widespread; potential for more than minimal harm
Smoke Deficiencies
Properly provide smoke detection systems in areas open to corridors.
Correction field: Deficient, Provider has date of correction · 2024-12-262024-12-05 · FIREK0353Severity F · widespread; potential for more than minimal harm
Smoke Deficiencies
Inspect, test, and maintain automatic sprinkler systems.
Correction field: Deficient, Provider has date of correction · 2024-12-262024-12-05 · FIREK0363Severity E · pattern; potential for more than minimal harm
Smoke Deficiencies
Install corridor and hallway doors that block smoke.
Correction field: Deficient, Provider has date of correction · 2024-12-182024-12-05 · FIREK0711Severity D · isolated; potential for more than minimal harm
Miscellaneous Deficiencies
Provide a written emergency evacuation plan.
Correction field: Deficient, Provider has date of correction · 2024-12-262024-12-05 · FIREK0741Severity D · isolated; potential for more than minimal harm
Miscellaneous Deficiencies
Have posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed.
Correction field: Deficient, Provider has date of correction · 2024-12-262024-12-05 · FIREK0761Severity F · widespread; potential for more than minimal harm
Miscellaneous Deficiencies
To conduct inspection, testing and maintenance of fire doors by qualified individuals.
Correction field: Deficient, Provider has date of correction · 2024-12-172024-12-05 · FIREK0914Severity F · widespread; potential for more than minimal harm
Gas, Vacuum, and Electrical Systems Deficiencies
Ensure receptacles at patient bed locations and where general anesthesia is administered, are tested after initial installation, replacement or servicing.
Correction field: Deficient, Provider has date of correction · 2024-12-192024-12-05 · FIREK0918Severity F · widespread; potential for more than minimal harm
Gas, Vacuum, and Electrical Systems Deficiencies
Have generator or other power source capable of supplying service within 10 seconds.
Correction field: Deficient, Provider has date of correction · 2024-12-2703 / ENFORCEMENT FILE
Penalties reported by CMS
Fine amounts and payment-denial days are shown exactly as aggregated from the current penalties file. They do not imply an unpaid balance.
| Date | Type | Fine amount | Payment-denial days |
|---|---|---|---|
| 2024-07-18 | Fine | $20,248 | 0 |
04 / OWNERSHIP DISCLOSURES
Who appears in the CMS file
- FORBRIGHT BANKOrganization · 5% OR GREATER SECURITY INTERESTNOT APPLICABLE · since 06/01/2022
- RODRIGUEZ, CURTISIndividual · CORPORATE OFFICERNOT APPLICABLE · since 06/01/2022
- TILFORD, TOBYIndividual · CORPORATE OFFICERNOT APPLICABLE · since 06/01/2022
- LINKS HEALTHCARE GROUP LLCOrganization · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 06/01/2022
- LINKS SUPPORT SERVICES, LLCOrganization · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 06/01/2022
- BEARDSLEY, MARYIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 06/01/2022
- BERNHOLZ, VICTORIAIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 06/01/2022
- CARTER, MELISSAIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 06/01/2022
- FROJELIN, ANTONETTEIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 06/01/2022
- REICHERT, JOSIEIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 06/01/2022
- RODRIGUEZ, CURTISIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 06/01/2022
- ROMNEY, GUNNERIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 07/03/2024
- SABOUNCHI, SAMANIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 06/01/2022
- TILFORD, TOBYIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 06/01/2022
- EIDE BAILLY LLPOrganization · ADP OF THE SNFNOT APPLICABLE · since 06/01/2022
- LINKS HEALTHCARE GROUP LLCOrganization · ADP OF THE SNFNOT APPLICABLE · since 06/27/2025
- LINKS SUPPORT SERVICES, LLCOrganization · ADP OF THE SNFNOT APPLICABLE · since 06/27/2025
- BEARDSLEY, MARYIndividual · ADP OF THE SNFNOT APPLICABLE · since 06/01/2022
Names and roles are self-reported CMS disclosure fields. Exact-name pages do not prove that similarly named people or organizations are the same entity.
05 / CMS STAFFING FIELDS
Reported hours and turnover
Staffing fields are provider-reported and case-mix context matters. CMS applies footnotes and exclusions not reproduced as a new score here.
Total nurse hours4.15per resident day
RN hours0.77per resident day
Weekend nurse hours3.83per resident day
Staff turnover57.2%CMS reported field
06 / LOCAL RECORDS
Open the San Jose ledger →Other published facilities nearby
A Grace Sub Acute & Skilled Care166 beds · CMS overall 4/580 citation rowsAlmaden Health And Rehabilitation Center77 beds · CMS overall 4/577 citation rowsCanyon Springs Post-Acute199 beds · CMS overall 4/5109 citation rowsCourtyard Care Center76 beds · CMS overall 3/574 citation rowsEmpress Care Center, Llc67 beds · CMS overall 4/568 citation rowsHerman Health Care Center99 beds · CMS overall 1/5107 citation rowsInspire Behavioral Health116 beds · CMS overall 2/567 citation rowsLincoln Glen Skilled Nursing59 beds · CMS overall 5/550 citation rows