Federal nursing home survey record · CMS-certified nursing home· Not a state assisted-living licensing record

MASONIC HOME

UNION CITY, CA · 125 certified beds · Last Life Safety survey February 6, 2025

CMS Certification Number 555843 · first certified October 2007

Also on this campus

The same campus holds a state-licensed assisted living facilities, with their own state records on the Assisted Living Index: Acacia Creek - Union City (34400 Mission Blvd.) and Masonic Home for Adults (34400 Mission Blvd.). Matched by the street address the two records share. The records are separate and are never added together.

Ownership

Independently operated (no chain recorded by CMS) · Non profit - Corporation

No change of ownership on CMS record since January 1, 2016, when the records begin.

19
Citations on file
Rolling three-year window
3
Life Safety surveys
In the same window
1
Tags cited more than once
Across separate surveys
8
Inspection & testing records
Of the citations on file

Position within CA

19 citations — more than 47% of the 1,165 certified nursing homes in CA. Compared within CA rather than nationally because which state a facility is in explains about 30% of the variation in citation counts between facilities, while bed count explains under 1%. State survey agencies differ far more than the buildings do. How this is calculated

Improvingfewer citations at the latest survey than at its earlier surveys in the window.

The latest survey found 4 citations; the earlier surveys in the window averaged 7.5. With 3 surveys on file this is a direction of travel, not a conclusion.

When is the next survey likely?

Past the typical window (February 2026 to July 2026). Most CA facilities have been surveyed by July 2027. This facility’s last Life Safety survey was February 2025. Facilities in CA are typically surveyed 12–18 months after the last one (median 14), measured over 1,766 consecutive surveys in the last two years of CMS records.

A range the record supports, not a prediction of a date. State agencies vary widely — from about 11 months in Pennsylvania to three years in Maryland. How the window is measured

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Which alerts

1 inspection-and-testing tag has been cited here at more than one survey. Nationally, that pattern is common: about three quarters of cited facilities have at least one repeated tag, and half of the facilities ever cited for sprinkler inspection and testing are cited for it again. A repeat is usually a recordkeeping gap rather than a new hazard.

Emergency preparedness

2 of the 19 citations on file are Emergency Preparedness E-tags. E-tags are cited under 42 CFR §483.73 and concern the emergency plan, training, drills, communications and supplies. Nationally about half of certified facilities have at least one. The Emergency Preparedness Index

Physical environment (health survey)

4 physical-environment citations on the health survey. Cited by the health surveyors under Appendix PP, not the Life Safety Code surveyor: equipment in safe operating condition, the call system, bed rails, pest control, hazards, the environment. Counted separately from the 19 Life Safety citations above. The Physical Environment Index

  • F-0919 Make sure that a working call system is available in each resident's bathroom and bathing area.
  • F-0921 Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public.
  • F-0689 Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
  • F-0880 Provide and implement an infection prevention and control program.

How that compares

Citations on file over three years

Compared with the median facility in CA, and nationally. Surveyors differ markedly between states, so the CA figure is the meaningful one.

This facility19CA median19National median11
Citations on file over three years, compared
MeasureCitations
This facility19
Median facility in CA19
Median facility nationally11

Survey history

Citations at each Life Safety survey
72019-0882023-0742025-02
Citations at each Life Safety survey
Survey dateCitations
August 2, 20197
July 13, 20238
February 6, 20254

Most-cited tags

Most-cited tags at this facility
K-05112K-02111K-03551K-09181K-05211K-03421K-09211E-00311
Most-cited tags at this facility
TagWhat the surveyor checksTimes citedLast cited
K-0511Have properly installed electrical wiring and gas equipment.22023-07-13
K-0211Keep aisles, corridors, and exits free of obstruction in case of emergency.12025-02-06
K-0355Properly select, install, inspect, or maintain portable fire extinguishes.12023-07-13
K-0918Have generator or other power source capable of supplying service within 10 seconds.12025-02-06
K-0521Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.12023-07-13
K-0342Have a complete alarm system manually initiated and initiated by fire sprinkler system connection.12023-07-13
K-0921Ensure that testing and maintenance of electrical equipment is performed.12025-02-06
E-0031Provide emergency officials' contact information.12019-08-02

What the citations cover

Citations by CMS category
  • Gas, Vacuum, and Electrical Systems Deficiencies 5
  • Smoke Deficiencies 4
  • Services Deficiencies 4
  • Egress Deficiencies 3
  • Other 3
Citations by CMS category
CategoryCitations
Gas, Vacuum, and Electrical Systems Deficiencies5
Smoke Deficiencies4
Services Deficiencies4
Egress Deficiencies3
Emergency Preparedness Deficiencies2
Miscellaneous Deficiencies1

Every citation on file

As published by CMS, newest survey first. Descriptions are CMS’s own wording.

February 6, 2025 — 4 citations

Citations issued on February 6, 2025
TagWhat the surveyor checksStatus
K-0211Keep aisles, corridors, and exits free of obstruction in case of emergency.Deficient, Provider has date of correction (February 28, 2025)
K-0500Meet other general requirements that are deficient.Deficient, Provider has date of correction (February 28, 2025)
K-0918Have generator or other power source capable of supplying service within 10 seconds.Deficient, Provider has date of correction (February 28, 2025)
K-0921Ensure that testing and maintenance of electrical equipment is performed.Deficient, Provider has date of correction (February 28, 2025)

July 13, 2023 — 8 citations

Citations issued on July 13, 2023
TagWhat the surveyor checksStatus
K-0291Install emergency lighting that can last at least 1 1/2 hours.Deficient, Provider has date of correction (July 28, 2023)
K-0325Have properly installed hallway dispensers for alcohol-based hand rub.Deficient, Provider has date of correction (July 28, 2023)
K-0342Have a complete alarm system manually initiated and initiated by fire sprinkler system connection.Deficient, Provider has date of correction (July 28, 2023)
K-0355Properly select, install, inspect, or maintain portable fire extinguishes.Deficient, Provider has date of correction (July 28, 2023)
K-0511Have properly installed electrical wiring and gas equipment.Deficient, Provider has date of correction (July 28, 2023)
K-0521Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.Deficient, Provider has date of correction (July 28, 2023)
K-0711Provide a written emergency evacuation plan.Deficient, Provider has date of correction (July 28, 2023)
K-0920Ensure proper usage of power strips and extension cords.Deficient, Provider has date of correction (July 28, 2023)

August 2, 2019 — 7 citations

Citations issued on August 2, 2019
TagWhat the surveyor checksStatus
E-0030List the names and contact information of those in the facility.Deficient, Provider has date of correction (October 10, 2019)
E-0031Provide emergency officials' contact information.Deficient, Provider has date of correction (October 10, 2019)
K-0293Have properly located and lighted "Exit" signs.Deficient, Provider has date of correction (October 10, 2019)
K-0345Have approved installation, maintenance and testing program for fire alarm systems.Deficient, Provider has date of correction (October 10, 2019)
K-0511Have properly installed electrical wiring and gas equipment.Deficient, Provider has date of correction (October 10, 2019)
K-0914Ensure receptacles at patient bed locations and where general anesthesia is administered, are tested after initial installation, replacement or servicing.Deficient, Provider has date of correction (October 10, 2019)
K-0923Have proper medical gas storage and administration areas.Deficient, Provider has date of correction (October 10, 2019)

Reflects the CMS posting of August 1, 2026. Surveys conducted in the last few months may not appear yet.