| General |
| City |
| Los Angeles |
Castro Valley |
| State attribute explanation |
| Ca |
Ca |
| Street |
| 12121 Santa Monica Boulevard |
20259 Lake Chabot Rd. |
| Zip Code |
| 90,025 |
94,546 |
| Phone |
| 3,108,260,821 |
5,103,513,700 |
|
Overall Star Rating |
| 2 |
2 |
|
Health Inspections Star Rating |
| 2 |
1 |
|
Nurse Staffing Star Rating |
| 3 |
4 |
|
Quality Measures Star Rating |
| 4 |
2 |
|
RN Only Star Rating |
| 3 |
3 |
|
Number of Certified Beds |
| 93 |
91 |
|
Total Number of Residents |
| 83 |
66 |
|
Percent of Occupied Beds |
| 89 % |
73 % |
| Health Survey Date |
| 5/6/2012 |
5/4/2012 |
| Fire Survey Date |
| 5/11/2012 |
5/23/2012 |
| Sprinkler Status |
| Fully Sprinklered |
Fully Sprinklered |
| Program Participation |
| Medicare And Medicaid |
Medicare And Medicaid |
| Type of Ownership |
| For Profit - Partnership |
For Profit - Corporation |
| Located Within a Hospital? |
| No |
No |
| Multi Nursing Home Ownership? |
| Yes |
Yes |
| Resident and Family Councils |
| Both |
Resident |
| Continuing Care Retirement Community? |
| No |
No |
| Quality Indicator Survey? |
| No |
No |
| Special Focus Facility? |
| No |
No |
| Civil Money Penalty Count |
| 75.2 |
75.2 |
| Total Enforcement Actions Count |
| 75.2 |
75.2 |
| # of deficiencies |
|
12 |
|
| Staff Information |
| Number of Residents |
| 83 |
66 |
| Number of RN Hours Per Resident Per Day |
| 0.72 |
0.62 |
| Number of LPN/LVN Hours Per Resident Per Day |
| 0.93 |
0.78 |
| Total Number of Licensed Staff Hours Per Resident Per Day |
| 1.65 |
1.4 |
| Number of CNA Hours Per Resident Per Day |
| 0.14 |
0.04 |
| Number Therapy Hours Per Resident Per Day |
| 0.14 |
0.04 |
| Environmental Deficiencies |
| Deficiency #1 |
|
Scope: Fewlevel Of Harm: 2deficiency: Make Sure That The Nursing Home Area Is Free From Accident Hazards And Risks And Provides Supervision To Prevent Avoidable Accidents.survey Date: 04/05/2012date Of Correction: 06/05/2012 |
| Deficiency #2 |
|
Scope: Manylevel Of Harm: 2deficiency: Have A Program That Investigates, Controls And Keeps Infection From Spreading.survey Date: 02/17/2011date Of Correction: 03/18/2011 |
| Deficiency #3 |
|
Scope: Somelevel Of Harm: 2deficiency: Have A Program That Investigates, Controls And Keeps Infection From Spreading.survey Date: 07/07/2009date Of Correction: 08/12/2009 |
| Mistreatment Deficiencies |
| Deficiency #1 |
|
Scope: Fewlevel Of Harm: 2deficiency: Develop Policies That Prevent Mistreatment, Neglect, Or Abuse Of Residents Or Theft Of Resident Property.survey Date: 05/26/2010date Of Correction: 06/14/2010 |
| Resident Rights Deficiencies |
| Deficiency #1 |
|
Scope: Fewlevel Of Harm: 2deficiency: Make Sure Each Resident Has The Right To Have A Choice Over Activities, Their Schedules And Health Care According To His Or Her Interests, Assessment, And Plan Of Care.survey Date: 05/09/2012date Of Correction: 06/05/2012 |
| Deficiency #2 |
|
Scope: Fewlevel Of Harm: 2deficiency: Provide Care For Residents In A Way That Keeps Or Builds Each Resident's Dignity And Respect Of Individuality.survey Date: 05/09/2012date Of Correction: 06/05/2012 |
| Deficiency #3 |
|
Scope: Fewlevel Of Harm: 2deficiency: Make Sure Each Resident Has The Right To Have A Choice Over Activities, Their Schedules And Health Care According To His Or Her Interests, Assessment, And Plan Of Care.survey Date: 04/05/2012date Of Correction: 06/05/2012 |
| Deficiency #4 |
|
Scope: Fewlevel Of Harm: 2deficiency: Provide Care For Residents In A Way That Keeps Or Builds Each Resident's Dignity And Respect Of Individuality.survey Date: 04/05/2012date Of Correction: 06/05/2012 |
| Quality Care Deficiencies |
| Deficiency #1 |
|
Scope: Fewlevel Of Harm: 2deficiency: Provide Necessary Care And Services To Maintain The Highest Well Being Of Each Resident .survey Date: 05/26/2010date Of Correction: 06/14/2010 |
| Resident Assessment Deficiencies |
| Deficiency #1 |
|
Scope: Fewlevel Of Harm: 2deficiency: Develop A Complete Care Plan That Meets All Of A Resident's Needs, With Timetables And Actions That Can Be Measured.survey Date: 05/08/2012date Of Correction: 06/08/2012 |
| Deficiency #2 |
|
Scope: Fewlevel Of Harm: 2deficiency: Develop A Complete Care Plan That Meets All Of A Resident's Needs, With Timetables And Actions That Can Be Measured.survey Date: 04/18/2012date Of Correction: 06/05/2012 |
| Administration Deficiencies |
| Deficiency #1 |
|
Scope: Fewlevel Of Harm: 2deficiency: Post Nurse Staffing Information/data On A Daily Basis.survey Date: 05/09/2012date Of Correction: 06/05/2012 |
| Quality Measures Q1 |
| Percent of long-stay residents who received an antipsychotic medication |
| 15.5 % |
16.1 % |
| Percent of long-stay residents whose need for help with daily activities has increased |
| 0.5 - 2.0 |
75.2 % |
| Percent of long-stay residents who self-report moderate to severe pain |
| 9.3 % |
|
| Percent of long-stay high-risk residents with pressure ulcers |
| 4.5 % |
14.6 % |
| Percent of long-stay residents who lose too much weight |
| 75.2 % |
6.6 % |
| Percent of long-stay residents who have had a catheter inserted and left in their bladder |
| 3.4 % |
1.3 % |
| Percent of long-stay residents with a urinary tract infection |
| 1.7 % |
8.2 % |
| Percent of long-stay residents who have depressive symptoms |
| 75.2 % |
75.2 % |
| Percent of long-stay residents who were physically restrained |
| 4.8 % |
3.3 % |
| Percent of short-stay residents who self-report moderate to severe pain |
| 21.5 % |
|
| Percent of short-stay residents assessed and given, appropriately, the seasonal influenza vaccine |
| 16.1 % |
64.3 % |
| Percent of short-stay residents with Pressure ulcers that are new or worsened |
| 10.9 % |
66.7 % |
| Percent of short-stay residents who newly received an antipsychotic medication |
| 75.2 |
75.2 |
| Percent of long-stay residents experiencing one or more falls with major injury |
| 75.2 % |
3.3 % |
| Quality Measures Q3 |
| Percent of long-stay residents who received an antipsychotic medication |
| 18.6 (65.5) |
12.9 (55.2) |
| Percent of long-stay residents whose need for help with daily activities has increased |
| 0.4 % |
1.3 % |
| Percent of long-stay residents who self-report moderate to severe pain |
| 10.2 % |
10.4 % |
| Percent of long-stay high-risk residents with pressure ulcers |
| 10.3:1 |
12.2 % |
| Percent of long-stay residents who lose too much weight |
| 0.5 - 2.0 |
6.8 % |
| Percent of long-stay low-risk residents who lose control of their bowels or bladder |
| 26.7 % |
27 % |
| Percent of long-stay residents who have had a catheter inserted and left in their bladder |
| 4.4 % |
1.6 % |
| Percent of long-stay residents with a urinary tract infection |
| 5.4 % |
9.9:1 |
| Percent of long-stay residents who have depressive symptoms |
| 1.1 % |
1.1 % |
| Percent of long-stay residents who were physically restrained |
| 4.7 % |
3.1 % |
| Percent of long-stay residents experiencing one or more falls with major injury |
| 1 % |
2 % |
| Percent of short-stay residents who self-report moderate to severe pain |
| 19 % |
33.3 % |
| Percent of short-stay residents assessed and given, appropriately, the seasonal influenza vaccine |
| 15.9:1 |
51.9 % |
| Percent of short-stay residents with Pressure ulcers that are new or worsened |
| 9.7 % |
58.6 % |
| Percent of short-stay residents who newly received an antipsychotic medication |
| 2.1 % |
75.2 % |