Health inspection·January 21, 2026

F 0628 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Provide the required documentation or notification related to the resident's needs, appeal rights, or bed-hold policies. Based on interview and record review, for two of two residents (Resident 2 and Resident 3) who were discharged , the facility failed to develop and implement an effective discharge planning process for their transition to post-discharge care when:1.For Resident 2, the facility failed to assist in obtaining a government ID and bank card before discharge. The facility did not arrange primary care or pharmacy services for medication follow-up. This had the potential to result in Resident 2 lacking funds for his ILF (Independent Living Facility) stay and potentially facing homelessness.2.For Resident 3, the facility failed to establish a primary care provider and pharmacy for medication refills after discharge. This failure had the potential to result in unnecessary re-admissions.1.During a review of Resident 2's admission Record (AR) printed 1/15/26, the AR indicated Resident 2 was admitted to the facility in February 2024 with multiple diagnoses that included cognitive communication deficit (impairment in communication such as speaking, listening, reading, or writing caused by impaired memory and attention), depression (persistent sadness, loss of interest in activities) and stage 3 chronic kidney disease (the kidneys have mild to moderate damage and are less able to filter waste and fluid out of your blood). The AR also indicated Resident 2 was discharged from the facility on 12/9/25.During a telephone interview on 1/15/26 at 1:06 p.m. with Family Friend (FF), FF stated Resident 2 was discharged from the facility to an ILF without any means to pay rent, as he had lost his ID and debit card. FF stated, consequently, Resident 2 left the ILF, became homeless, and was eventually taken to the hospital ER for a medical issue.During a review of Resident 2's Social Service Note (SSN), late entry, dated 12/9/25, the SSN indicated Resident 2 was discharged to an ILF. The SSN indicated discharge instructions were reviewed with Resident 2 as provided by the Interdisciplinary Team (IDT, a group composed of individuals representing different departments of the facility) that included follow-up appointments and a medication plan. During an interview on 1/21/26 at 10:38 a.m. with Social Services Director (SSD), SSD stated Resident 2 did not have his ID and debit card. SSD stated that once Resident 2 obtained them, Resident 2 could pay rent at his new residence (ILF). SSD stated she did not assist Resident 2 in acquiring these items before discharge, but Resident 2 received post-discharge instructions on the day of discharge.During a review of Resident 2's Physician's Order dated 12/9/25, the physician's order indicated home health services and a primary care physician appointment after discharge.During a review of Resident 2's Discharge Summary and Post-Care Instructions (DCPCI) dated 12/9/25, the DCPCI indicated the section Post-Discharge Plan of Care Services, Referrals, and Equipment lacked complete information. Specifically, the fields for primary care physician name and appointment details, phone number, address, and pharmacy information were left blank. A copy of the DCPCI was provided to Resident 2 at the time of discharge.During a telephone interview on 1/21/26 at 10:52 a.m. with Independent Living Facility Owner (ILFO), ILFO stated she was unaware Resident 2 lacked an ID or debit card. ILFO stated Resident 2 said he was going to the bank with a friend but did not return. A few days later, a local hospital informed (continued on next page) Any deficiency statement ending with an asterisk (*) denotes a deficiency which the institution may be excused from correcting providing it is determined that other safeguards provide sufficient protection to the patients. (See instructions.) Except for nursing homes, the findings stated above are disclosable 90 days following the date of survey whether or not a plan of correction is provided. For nursing homes, the above findings and plans of correction are disclosable 14 days following the date these documents are made available to the facility. If deficiencies are cited, an approved plan of correction is requisite to continued program participation. LABORATORY DIRECTOR'S OR PROVIDER/SUPPLIER REPRESENTATIVE'S SIGNATURE TITLE (X6) DATE FORM CMS-2567 (02/99) Previous Versions Obsolete Facility ID: If continuation sheet Page 1 of 2 Event ID: 555067 Printed: 05/15/2026 Form Approved OMB No. 0938-0391 Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER: (X2) MULTIPLE CONSTRUCTION 555067 B. Wing A. Building (X3) DATE SURVEY COMPLETED 01/21/2026 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE McClure Post Acute 2910 McClure Street Oakland, CA 94609 For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)