Smith Ranch Skilled Nursing & Rehabilitation Cente

Name: Smith Ranch Skilled Nursing & Rehabilitation Cente
Address: 1550 SILVEIRA PARKWAY, San Rafael, CA, 94903, US
Telephone: 4154991000

1550 Silveira Parkway, San Rafael, CA 94903 · Marin County · 80 certified beds · avg 74 residents/day · certified since Apr 15, 1994

Part of chain: GENERATIONS HEALTHCARE (27 facilities, chain avg rating 4.1★)

2/5

Health inspection rating (on-site)

Serious findings on record

Fines, last 3 years

3.41

Nurse hours/resident/day (adjusted)

What health inspectors found (on-site government inspections — the most independent evidence available)

Health inspection rating: ★★☆☆☆2/5 · CMS overall rating: 3/5

The health inspection star above is graded on a curve within each state — a set share of each state's facilities gets each star level — so a facility can have few citations and still rate 2–3 stars if others in its state did even better. The overall rating combines that inspection score with staffing and self-reported quality measures.

All citations in the current public record (45)

CMS publishes roughly the last three inspection cycles plus recent complaint investigations. Older surveys drop out of the record as new ones are completed.

Date	Severity	What the facility was cited for
Jun 9, 2026	D · Potential for harm, one-off	The facility did not report suspected abuse, neglect, or theft to the proper authorities quickly enough, or did not report the results of its investigation. · from a complaint
Jun 9, 2026	D · Potential for harm, one-off	The facility did not develop or follow a complete care plan for each resident — the written roadmap covering all of a resident's needs, with measurable goals and timelines. · from a complaint
Apr 15, 2026	E · Potential for harm, repeated	The facility did not develop a resident's complete plan of care within 7 days of the full assessment, or the plan wasn't prepared, reviewed, and updated by a team of health professionals as required. · from a complaint
Apr 15, 2026	E · Potential for harm, repeated	The facility provided care that did not meet professional standards of quality — the accepted standards that nurses and other clinicians are expected to follow. · from a complaint
Apr 15, 2026	E · Potential for harm, repeated	The facility did not provide treatment and care that follows the doctor's orders and matches the resident's own preferences and goals. · from a complaint
Apr 15, 2026	E · Potential for harm, repeated	The facility did not protect residents' personal information or did not keep complete, accurate medical records that meet professional standards. · from a complaint
Apr 15, 2026	D · Potential for harm, one-off	The facility did not keep residents free from significant medication errors — such as giving the wrong drug, the wrong dose, or missing a critical medication. · from a complaint
Feb 12, 2026	E · Potential for harm, repeated	The facility did not provide a safe, clean, comfortable, and homelike environment, including safe support for residents' daily living needs.
Feb 12, 2026	E · Potential for harm, repeated	The facility provided care that did not meet professional standards of quality — the accepted standards that nurses and other clinicians are expected to follow.
Feb 12, 2026	E · Potential for harm, repeated	The facility did not get its food from approved, safe sources, or did not store, prepare, and serve food according to professional food safety standards.
Feb 12, 2026	E · Potential for harm, repeated	The facility did not keep all essential equipment working safely — things like heating and cooling systems, kitchen equipment, and medical devices.
Feb 12, 2026	D · Potential for harm, one-off	The facility did not properly complete the required screening (called PASARR) that identifies whether a person entering a nursing home has a mental illness or intellectual disability and needs specialized services.
Feb 12, 2026	D · Potential for harm, one-off	The facility did not provide treatment and care that follows the doctor's orders and matches the resident's own preferences and goals.
Feb 12, 2026	D · Potential for harm, one-off	The facility did not provide pharmacy services that meet each resident's needs, or did not employ or contract with a licensed pharmacist.
Feb 12, 2026	D · Potential for harm, one-off	The facility did not label drugs according to professional standards or did not store them in locked compartments, with controlled drugs (medications with a high risk of misuse) kept under a separate lock.
Feb 12, 2026	D · Potential for harm, one-off	The facility did not have or follow an effective program to prevent and control infections — such as proper hand washing, cleaning, and isolation practices. This is the most commonly cited deficiency nationwide.
May 16, 2025	F · Potential for harm, facility-wide	The facility did not post the names, addresses, and phone numbers of state agencies and advocacy groups, along with a notice that residents may file complaints with the state survey agency.
May 16, 2025	F · Potential for harm, facility-wide	The facility did not get its food from approved, safe sources, or did not store, prepare, and serve food according to professional food safety standards.
May 16, 2025	F · Potential for harm, facility-wide	The facility did not have a written plan describing how it runs its quality improvement program — the ongoing process of finding problems in care and fixing them.
May 16, 2025	E · Potential for harm, repeated	The facility provided care that did not meet professional standards of quality — the accepted standards that nurses and other clinicians are expected to follow.
May 16, 2025	E · Potential for harm, repeated	The facility did not provide the care needed to maintain or improve residents' movement and flexibility — such as range-of-motion exercises — leading to avoidable decline.
May 16, 2025	D · Potential for harm, one-off	The facility did not make sure residents were fully informed about their own health, care, and treatments in a way they could understand.
May 16, 2025	D · Potential for harm, one-off	The facility did not make reasonable adjustments to fit each resident's individual needs and preferences — things like call buttons within reach, preferred wake-up times, or accessible room setups.
May 16, 2025	D · Potential for harm, one-off	The facility did not provide a safe, clean, comfortable, and homelike environment, including safe support for residents' daily living needs.
May 16, 2025	D · Potential for harm, one-off	The facility did not accurately assess a resident's health and needs. Assessments are the foundation for all the care a resident receives.
May 16, 2025	D · Potential for harm, one-off	The facility did not provide proper care for pressure ulcers (bedsores) or did not do enough to prevent new ones from forming. Bedsores develop when residents stay in one position too long without help moving.
May 16, 2025	D · Potential for harm, one-off	The facility did not provide enough food and fluids to keep residents healthy, such as preventing unplanned weight loss or dehydration.
May 16, 2025	D · Potential for harm, one-off	The facility used feeding tubes without a valid medical reason or the resident's agreement, or did not provide proper care to residents who have feeding tubes.
May 16, 2025	D · Potential for harm, one-off	The facility's medication error rate was 5 percent or higher — meaning too many doses were given incorrectly, such as the wrong drug, dose, or time.
May 16, 2025	D · Potential for harm, one-off	The facility did not label drugs according to professional standards or did not store them in locked compartments, with controlled drugs (medications with a high risk of misuse) kept under a separate lock.
Apr 22, 2025	D · Potential for harm, one-off	The facility did not protect residents from misuse of their belongings or money — this is called misappropriation, and it includes theft or improper use of a resident's property or funds. · from a complaint
Aug 22, 2023	F · Potential for harm, facility-wide	The facility did not get its food from approved, safe sources, or did not store, prepare, and serve food according to professional food safety standards.
Aug 22, 2023	E · Potential for harm, repeated	The facility did not make its inspection results easy for residents to see, or made it hard for residents to contact advocacy agencies like the ombudsman.
Aug 22, 2023	E · Potential for harm, repeated	The facility did not give the resident or their representative written notice of how long it would hold the resident's bed during a hospital stay or approved leave.
Aug 22, 2023	E · Potential for harm, repeated	The facility did not accurately assess a resident's health and needs. Assessments are the foundation for all the care a resident receives.
Aug 22, 2023	E · Potential for harm, repeated	The facility did not develop or follow a complete care plan for each resident — the written roadmap covering all of a resident's needs, with measurable goals and timelines.
Aug 22, 2023	E · Potential for harm, repeated	The facility did not provide the help residents need with basic daily activities — like bathing, dressing, eating, and using the bathroom — for residents who cannot do these things on their own.
Aug 22, 2023	E · Potential for harm, repeated	The facility did not provide activities that meet residents' needs and interests. Nursing homes must offer meaningful activity programs, not just leave residents idle.
Aug 22, 2023	E · Potential for harm, repeated	The facility's medication error rate was 5 percent or higher — meaning too many doses were given incorrectly, such as the wrong drug, dose, or time.
Aug 22, 2023	E · Potential for harm, repeated	The facility did not have or follow an effective program to prevent and control infections — such as proper hand washing, cleaning, and isolation practices. This is the most commonly cited deficiency nationwide.
Aug 22, 2023	D · Potential for harm, one-off	The facility provided care that did not meet professional standards of quality — the accepted standards that nurses and other clinicians are expected to follow.
Aug 22, 2023	D · Potential for harm, one-off	The facility allowed residents to lose the ability to do daily activities — like bathing, dressing, and eating — when there was no medical reason for the decline. Good care helps residents keep the abilities they have.
Aug 22, 2023	D · Potential for harm, one-off	The facility did not provide proper care for pressure ulcers (bedsores) or did not do enough to prevent new ones from forming. Bedsores develop when residents stay in one position too long without help moving. · from a complaint
Aug 22, 2023	D · Potential for harm, one-off	The facility did not provide safe and appropriate respiratory care — such as oxygen, breathing treatments, or care for residents on breathing equipment — for residents who needed it.
Aug 22, 2023	D · Potential for harm, one-off	The facility did not keep residents free from significant medication errors — such as giving the wrong drug, the wrong dose, or missing a critical medication.

Inspection trend by year

Citations from standard inspections decreased between the last two inspection cycles (14 → 9).

Year	Citations	Worst severity that year
2023	14	F
2025	15	F
2026	16	E

Counts reflect the current CMS public record (~3 inspection cycles plus complaint investigations); years with no surveys show no row. Inspection frequency varies, so compare severity as well as counts.

Fines and enforcement (last 3 years)

No fines or payment denials in the published 3-year window.

Nurse staffing (from payroll records, adjusted for how much care residents need)

Measure	This facility	California avg	U.S. avg	Where it stands
Total nurse staffing (hours per resident per day)	3.41	4.31	3.95	bottom 7% in California; bottom 32% in the U.S.
Registered Nurse hours	0.34	0.61	0.69	bottom 18% in California; bottom 14% in the U.S.
Weekend total nurse staffing	3.05	3.90	3.50	bottom 5% in California; bottom 33% in the U.S.
Weekend RN hours (not acuity-adjusted)	0.26	0.51	0.48	bottom 25% in California; bottom 24% in the U.S.
Total nursing staff turnover (%)	32.5	36.7	45.8	top 39% in California; top 19% in the U.S.
RN turnover (%)	12.5	38.1	42.9	top 8% in California; top 6% in the U.S.

Hours are per resident per day, case-mix adjusted by CMS so facilities caring for sicker residents can be compared fairly (same basis as the CMS staffing star). "Top X%" means better than most facilities: more staffing hours, or lower turnover. Raw (unadjusted) reported hours: total 4.19, RN 0.42, weekend 3.75. Staffing rating: 3/5.

Self-reported quality measures

Note: these ratings are based on data the facility reports about itself to CMS. They are not independently verified by inspectors, and can look better than inspection findings. Give more weight to the inspection results above.

Quality measures rating: 5/5 · long-stay residents: 5/5 · short-stay residents: 5/5

Who owns this facility

For profit - Limited Liability company

Owner / manager	Type	Role	Stake	Since
Mastrocola, Lois	Individual	Indirect Ownership Interest	NOT APPLICABLE	07/20/2017
Olds, Thomas	Individual	Indirect Ownership Interest	NOT APPLICABLE	07/20/2017
Smith, Fred	Individual	Indirect Ownership Interest	NOT APPLICABLE	07/20/2017
Amilcar, Alberta	Individual	Operational/Managerial Control	NOT APPLICABLE	07/11/2023
Amilcar, Alberta	Individual	ADP of the SNF	NOT APPLICABLE	07/11/2023
Arguel, Angelo Clyde	Individual	Operational/Managerial Control	NOT APPLICABLE	03/17/2025
Arguel, Angelo Clyde	Individual	ADP of the SNF	NOT APPLICABLE	03/17/2025
Bmo Bank National Association	Organization	5% or Greater Security Interest	NOT APPLICABLE	10/06/2021
Bmo Bank National Association	Organization	Operational/Managerial Control	NOT APPLICABLE	10/06/2021
Bmo Bank National Association	Organization	ADP of the SNF	NOT APPLICABLE	10/06/2021
Coleman, Kelsey	Individual	Operational/Managerial Control	NOT APPLICABLE	05/13/2016
Coleman, Kelsey	Individual	ADP of the SNF	NOT APPLICABLE	05/13/2016
Daly, Megan	Individual	Operational/Managerial Control	NOT APPLICABLE	06/30/2003
Daly, Megan	Individual	ADP of the SNF	NOT APPLICABLE	06/30/2003
Deguzman, Dina	Individual	Operational/Managerial Control	NOT APPLICABLE	01/21/2020
Deguzman, Dina	Individual	ADP of the SNF	NOT APPLICABLE	01/21/2020
Gutierrez, Jesus	Individual	Operational/Managerial Control	NOT APPLICABLE	10/31/2023
Gutierrez, Jesus	Individual	ADP of the SNF	NOT APPLICABLE	10/31/2023
Life Generations Healthcare, LLC	Organization	Operational/Managerial Control	NOT APPLICABLE	07/20/2017
Life Generations Healthcare, LLC	Organization	ADP of the SNF	NOT APPLICABLE	07/20/2017

Questions to ask on your visit

Generated from this facility's actual citation record — bring them to a tour and ask the administrator directly.

"When abuse or theft is suspected, who do you notify, how fast, and how do you inform the family?"
"Can you show me an example care plan, and how are families included when it's created and updated?"
"Who is on the team that builds each resident's care plan, and how quickly is it in place after admission?"
"Can you tell me what this citation involved and what steps you took to bring care back up to standard?"
"How do you make sure each resident's care follows the doctor's orders, and what changed after this citation?"
"How do you keep residents' medical records accurate, complete, and secure?"
"What systems do you use to prevent medication errors, and what happens when one occurs?"
"Can we tour the resident rooms, bathrooms, and common areas today, including areas not on the usual tour route?"
"What is your current ratio of nursing staff to residents on day, evening, and weekend shifts?"
"Can I see the results and plan of correction from your most recent state inspection?"

Nearby facilities (within 20 miles)

Facility	Distance	City	Overall	Inspection	Flags
Professional Post Acute Center	0.8 mi	San Rafael, CA	★★★☆☆	2/5
Pine Ridge Care Center	0.8 mi	San Rafael, CA	★★★★★	3/5
Northgate Postacute Care	0.8 mi	San Rafael, CA	★★☆☆☆	2/5	abuse
Marin Post Acute	1.3 mi	San Rafael, CA	★★☆☆☆	2/5	abuse
Villa Marin	1.6 mi	San Rafael, CA	★★★★★	4/5
San Rafael Healthcare & Wellness Center, LP	3.1 mi	San Rafael, CA	★★☆☆☆	2/5
The Tamalpais	5.1 mi	Greenbrae, CA	★★★★★	4/5
South Marin Health & Wellness Center	5.2 mi	Greenbrae, CA	★★★★☆	3/5
Novato Healthcare Center	6.0 mi	Novato, CA	★☆☆☆☆	1/5	abuse
The Redwoods, a Community of Seniors	8.6 mi	Mill Valley, CA	★★☆☆☆	2/5
Richmond Post Acute Care	11.0 mi	Richmond, CA	★★★★☆	4/5
Creekside Healthcare Center	11.2 mi	San Pablo, CA	★★★★★	4/5

Compare this facility with the 3 closest →

All facilities in San Rafael →

Facility data as of CMS processing date 2026-08-01. CCN 555595.

The Care File

Visit checklist — Smith Ranch Skilled Nursing & Rehabilitation Cente

1550 Silveira Parkway, San Rafael, CA 94903 · 4154991000

Health inspection rating 2/5 · CMS overall 3/5· Fines (3y): $0

Questions for the administrator:

☐ "When abuse or theft is suspected, who do you notify, how fast, and how do you inform the family?"
☐ "Can you show me an example care plan, and how are families included when it's created and updated?"
☐ "Who is on the team that builds each resident's care plan, and how quickly is it in place after admission?"
☐ "Can you tell me what this citation involved and what steps you took to bring care back up to standard?"
☐ "How do you make sure each resident's care follows the doctor's orders, and what changed after this citation?"
☐ "How do you keep residents' medical records accurate, complete, and secure?"
☐ "What systems do you use to prevent medication errors, and what happens when one occurs?"
☐ "Can we tour the resident rooms, bathrooms, and common areas today, including areas not on the usual tour route?"
☐ "What is your current ratio of nursing staff to residents on day, evening, and weekend shifts?"
☐ "Can I see the results and plan of correction from your most recent state inspection?"

While you're there, notice:

☐ Smell and cleanliness in hallways, not just the lobby
☐ How staff speak to residents; call lights answered promptly
☐ Residents up, dressed, and engaged (visit mealtimes and a weekend if you can)

Data: CMS Provider Data Catalog, version 2026-08-01 · CCN 555595 · Verify at medicare.gov/care-compare · Printed from The Care File (thecarefile.com)