Inspection citations
28’23
34’24
16’25
28’26
106 shown
| Date | Severity | What inspectors found | Visit |
|---|---|---|---|
| Aug 26, 2026 | E · potential | Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | Complaint |
| Aug 26, 2026 | D · potential | Ensure services provided by the nursing facility meet professional standards of quality. | Complaint |
| May 14, 2026 | D · potential | Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | Complaint |
| May 14, 2026 | E · potential | Reasonably accommodate the needs and preferences of each resident. | Complaint |
| May 14, 2026 | E · potential | Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. | Complaint |
| May 14, 2026 | D · potential | Develop and implement policies and procedures to prevent abuse, neglect, and theft. | Complaint |
| May 14, 2026 | D · potential | Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | Complaint |
| May 14, 2026 | D · potential | PASARR screening for Mental disorders or Intellectual Disabilities | Routine |
| May 14, 2026 | D · potential | Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | Complaint |
| May 14, 2026 | D · potential | Ensure services provided by the nursing facility meet professional standards of quality. | Routine |
| May 14, 2026 | D · potential | Provide appropriate pressure ulcer care and prevent new ulcers from developing. | Complaint |
| May 14, 2026 | E · potential | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | Complaint |
| May 14, 2026 | D · potential | Provide enough food/fluids to maintain a resident's health. | Routine |
| May 14, 2026 | E · potential | Provide safe, appropriate dialysis care/services for a resident who requires such services. | Routine |
| May 14, 2026 | D · potential | Ensure that the resident and his/her doctor meet face-to-face at all required visits. | Routine |
| May 14, 2026 | E · potential | Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift. | Routine |
| May 14, 2026 | E · potential | Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being. | Routine |
| May 14, 2026 | E · potential | Observe each nurse aide's job performance and give regular training. | Routine |
| May 14, 2026 | D · potential | Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | Routine |
| May 14, 2026 | D · potential | Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. | Routine |
| May 14, 2026 | E · potential | Provide and implement an infection prevention and control program. | Routine |
| May 14, 2026 | D · potential | Develop and implement policies and procedures for flu and pneumonia vaccinations. | Routine |
| May 14, 2026 | E · potential | Make sure that a working call system is available in each resident's bathroom and bathing area. | Complaint |
| May 14, 2026 | E · potential | Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public. | Routine |
| Mar 16, 2026 | E · potential | Keep all essential equipment working safely. | Complaint |
| Feb 25, 2026 | E · potential | Reasonably accommodate the needs and preferences of each resident. | Complaint |
| Feb 25, 2026 | D · potential | Ensure services provided by the nursing facility meet professional standards of quality. | Complaint |
| Jan 27, 2026 | D · potential | Ensure residents have reasonable access to and privacy in their use of communication methods. | Complaint |
| Dec 26, 2025 | D · potential | Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | Complaint |
| Nov 19, 2025 | E · potential | Reasonably accommodate the needs and preferences of each resident. | Complaint |
| Nov 19, 2025 | E · potential | Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being. | Complaint |
| Aug 19, 2025 | D · potential | Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals. | Complaint |
| Apr 22, 2025 | D · potential | Let each resident or the resident's legal representative access or purchase copies of all the resident's records. | Complaint |
| Apr 22, 2025 | D · potential | Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift. | Complaint |
| Apr 22, 2025 | D · potential | Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. | Complaint |
| Apr 21, 2025 | D · potential | Provide appropriate treatment and care according to orders, resident’s preferences and goals. | Complaint |
| Mar 26, 2025 | D · potential | Ensure services provided by the nursing facility meet professional standards of quality. | Complaint |
| Mar 19, 2025 | D · potential | Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | Complaint |
| Feb 24, 2025 | D · potential | Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. | Complaint |
| Feb 24, 2025 | D · potential | Develop and implement policies and procedures to prevent abuse, neglect, and theft. | Complaint |
| Feb 24, 2025 | D · potential | Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals. | Complaint |
| Feb 20, 2025 | E · potential | Ensure services provided by the nursing facility meet professional standards of quality. | Complaint |
| Jan 23, 2025 | D · potential | Ensure services provided by the nursing facility meet professional standards of quality. | Complaint |
| Jan 23, 2025 | E · potential | Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift. | Complaint |
| Nov 25, 2024 | D · potential | Ensure that residents are fully informed and understand their health status, care and treatments. | Routine |
| Nov 25, 2024 | D · potential | Honor the resident's right to be treated with respect and dignity and to retain and use personal possessions. | Routine |
| Nov 25, 2024 | D · potential | Reasonably accommodate the needs and preferences of each resident. | Routine |
| Nov 25, 2024 | E · potential | Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive. | Routine |
| Nov 25, 2024 | D · potential | 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. | Routine |
| Nov 25, 2024 | D · potential | Assess the resident when there is a significant change in condition | Routine |
| Nov 25, 2024 | D · potential | Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | Routine |
| Nov 25, 2024 | D · potential | Assist a resident in gaining access to vision and hearing services. | Routine |
| Nov 25, 2024 | G · harm | Provide appropriate pressure ulcer care and prevent new ulcers from developing. | Routine |
| Nov 25, 2024 | D · potential | Provide appropriate foot care. | Routine |
| Nov 25, 2024 | D · potential | Provide medically-related social services to help each resident achieve the highest possible quality of life. | Routine |
| Nov 25, 2024 | D · potential | Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | Routine |
| Nov 25, 2024 | D · potential | 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. | Routine |
| Nov 25, 2024 | D · potential | Provide routine and 24-hour emergency dental care for each resident. | Routine |
| Nov 25, 2024 | D · potential | Ensure the facility is licensed under applicable State and local law and operates and provides services in compliance with all applicable Federal, State, and local laws, regulations, and codes, and with accepted professional standards. | Routine |
| Nov 25, 2024 | D · potential | Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. | Routine |
| Nov 25, 2024 | F · potential | Provide and implement an infection prevention and control program. | Routine |
| Oct 17, 2024 | D · potential | Ensure services provided by the nursing facility meet professional standards of quality. | Complaint |
| Sep 3, 2024 | D · potential | Reasonably accommodate the needs and preferences of each resident. | Complaint |
| Sep 3, 2024 | E · potential | Make sure there is a pest control program to prevent/deal with mice, insects, or other pests. | Complaint |
| Jul 18, 2024 | D · potential | Develop and implement policies and procedures to prevent abuse, neglect, and theft. | Complaint |
| Jun 15, 2024 | E · potential | Reasonably accommodate the needs and preferences of each resident. | Complaint |
| May 15, 2024 | D · potential | 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. | Complaint |
| May 15, 2024 | E · potential | Provide care and assistance to perform activities of daily living for any resident who is unable. | Complaint |
| May 15, 2024 | E · potential | Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift. | Complaint |
| May 15, 2024 | D · potential | Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being. | Complaint |
| May 2, 2024 | E · potential | Develop and implement policies and procedures to prevent abuse, neglect, and theft. | Complaint |
| Feb 29, 2024 | E · potential | Provide and implement an infection prevention and control program. | Complaint |
| Feb 29, 2024 | E · potential | Educate residents and staff on COVID-19 vaccination, offer the COVID-19 vaccine to eligible residents and staff after education, and properly document each resident and staff member's vaccination status. | Complaint |
| Feb 21, 2024 | E · potential | Ensure each resident receives an accurate assessment. | Complaint |
| Feb 21, 2024 | D · potential | Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | Complaint |
| Feb 21, 2024 | E · potential | Provide care and assistance to perform activities of daily living for any resident who is unable. | Complaint |
| Feb 21, 2024 | D · potential | Ensure that residents are free from significant medication errors. | Complaint |
| Feb 16, 2024 | D · potential | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | Complaint |
| Dec 7, 2023 | E · potential | Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift. | Complaint |
| Nov 7, 2023 | D · potential | Reasonably accommodate the needs and preferences of each resident. | Complaint |
| Nov 7, 2023 | D · potential | Honor the resident's right to voice grievances without discrimination or reprisal and the facility must establish a grievance policy and make prompt efforts to resolve grievances. | Complaint |
| Nov 7, 2023 | D · potential | Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | Complaint |
| Nov 7, 2023 | D · potential | Ensure services provided by the nursing facility meet professional standards of quality. | Complaint |
| Nov 7, 2023 | D · potential | Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. | Complaint |
| Oct 26, 2023 | G · harm | Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | Complaint |
| Mar 2, 2023 | E · potential | Reasonably accommodate the needs and preferences of each resident. | Routine |
| Mar 2, 2023 | D · potential | Honor the resident's right to manage his or her financial affairs. | Routine |
| Mar 2, 2023 | E · potential | Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive. | Routine |
| Mar 2, 2023 | D · potential | Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights. | Routine |
| Mar 2, 2023 | D · potential | Ensure each resident receives an accurate assessment. | Routine |
| Mar 2, 2023 | D · potential | Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals. | Routine |
| Mar 2, 2023 | E · potential | Provide care and assistance to perform activities of daily living for any resident who is unable. | Routine |
| Mar 2, 2023 | E · potential | Provide appropriate treatment and care according to orders, resident’s preferences and goals. | Routine |
| Mar 2, 2023 | E · potential | 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. | Routine |
| Mar 2, 2023 | E · potential | Provide safe, appropriate dialysis care/services for a resident who requires such services. | Routine |
| Mar 2, 2023 | E · potential | Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift. | Routine |
| Mar 2, 2023 | E · potential | Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being. | Routine |
| Mar 2, 2023 | E · potential | Ensure medication error rates are not 5 percent or greater. | Routine |
| Mar 2, 2023 | E · potential | 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. | Routine |
| Mar 2, 2023 | F · potential | Employ sufficient staff with the appropriate competencies and skills sets to carry out the functions of the food and nutrition service, including a qualified dietician. | Routine |
| Mar 2, 2023 | E · potential | Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature. | Routine |
| Mar 2, 2023 | E · potential | Ensure each resident receives and the facility provides food prepared in a form designed to meet individual needs. | Routine |
| Mar 2, 2023 | E · potential | Ensure each resident receives and the facility provides drinks consistent with resident needs and preferences and sufficient to maintain resident hydration. | Routine |
| Mar 2, 2023 | E · potential | Provide and implement an infection prevention and control program. | Routine |
| Mar 2, 2023 | E · potential | Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public. | Routine |
| Mar 2, 2023 | F · potential | Give their staff education on dementia care, and what abuse, neglect, and exploitation are; and how to report abuse, neglect, and exploitation. | Routine |
Medicare's severity letters: A–C minimal harm, D–F potential for more than minimal harm, G–L actual harm or immediate danger. Source: CMS health deficiencies file, processed October 1, 2026.
Questions to ask on a visit
Bakersfield Post Acute
6212 Tudor Way, Bakersfield, CA 93306 · (661) 871-3133
Visit date: ____________ Spoke with: ______________________
Record on file
- Certification
- Medicare and Medi-Cal certified skilled nursing facility
- Medicare number (CCN)
- 555260
- Certified beds
- 99
- Legal owner
- Bakersfield SNF Healthcare LLC
- Part of
- Pacs Group
Full profile on Medicare's Care Compare. Source: CMS, processed October 1, 2026.
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