| General |
| City |
| Fairfield |
Los Angeles |
| State attribute explanation |
| Ca |
Ca |
| Street |
| 1255 Travis Blvd |
909 S Lake Street |
| Zip Code |
| 94,533 |
90,006 |
| Phone |
| 7,074,250,623 |
2,133,857,301 |
|
Overall Star Rating |
| 4 |
3 |
|
Health Inspections Star Rating |
| 4 |
2 |
|
Nurse Staffing Star Rating |
| 4 |
4 |
|
Quality Measures Star Rating |
| 4 |
4 |
|
RN Only Star Rating |
| 5 |
3 |
|
Number of Certified Beds |
| 99 |
66 |
|
Total Number of Residents |
| 88 |
62 |
|
Percent of Occupied Beds |
| 89 % |
94 % |
| Health Survey Date |
| 12/8/2011 |
4/7/2011 |
| Fire Survey Date |
| 12/28/2011 |
4/1/2011 |
| Sprinkler Status |
| Fully Sprinklered |
Fully Sprinklered |
| Program Participation |
| Medicare And Medicaid |
Medicare And Medicaid |
| Type of Ownership |
| For Profit - Corporation |
For Profit - Corporation |
| Located Within a Hospital? |
| No |
No |
| Multi Nursing Home Ownership? |
| Yes |
Yes |
| Resident and Family Councils |
| Resident |
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 |
|
2 |
|
| Staff Information |
| Number of Residents |
| 88 |
63 |
| Number of RN Hours Per Resident Per Day |
| 1.23 |
0.63 |
| Number of LPN/LVN Hours Per Resident Per Day |
| 0.67 |
0.54 |
| Total Number of Licensed Staff Hours Per Resident Per Day |
| 1.89 |
1.18 |
| Number of CNA Hours Per Resident Per Day |
| 0.18 |
0.03 |
| Number Therapy Hours Per Resident Per Day |
| 0.18 |
0.03 |
| Environmental Deficiencies |
| Deficiency #1 |
|
Scope: Somelevel Of Harm: 2deficiency: Make Sure There Is A Pest Control Program To Prevent/deal With Mice, Insects, Or Other Pests.survey Date: 05/23/2012date Of Correction: Not Available |
| Resident Rights Deficiencies |
| Deficiency #1 |
|
Scope: Fewlevel Of Harm: 2deficiency: Immediately Tell The Resident, The Resident's Doctor And A Family Member Of The Resident Of Situations (injury/decline/room, Etc.) That Affect The Resident.survey Date: 05/22/2012date Of Correction: 06/07/2012 |
| Quality Measures Q1 |
| Percent of long-stay residents who received an antipsychotic medication |
| 10.5 % |
27 % |
| Percent of long-stay residents whose need for help with daily activities has increased |
| 0.3 % |
|
| Percent of long-stay residents who self-report moderate to severe pain |
|
28.2 % |
| Percent of long-stay high-risk residents with pressure ulcers |
| 9.1 % |
|
| Percent of long-stay residents who lose too much weight |
| 5.3 % |
75.2 % |
| Percent of long-stay low-risk residents who lose control of their bowels or bladder |
|
20.5 % |
| Percent of long-stay residents who have had a catheter inserted and left in their bladder |
| 6.2 % |
2.1 % |
| Percent of long-stay residents with a urinary tract infection |
| 1.8 % |
4.7 % |
| Percent of long-stay residents who have depressive symptoms |
| 75.2 % |
75.2 % |
| Percent of long-stay residents who were physically restrained |
| 75.2 % |
1.50 % |
| Percent of short-stay residents who self-report moderate to severe pain |
| 62.8 % |
|
| Percent of short-stay residents assessed and given, appropriately, the seasonal influenza vaccine |
| 91.3 % |
|
| Percent of short-stay residents with Pressure ulcers that are new or worsened |
| 86.1 % |
|
| Percent of short-stay residents who newly received an antipsychotic medication |
| 0.6 % |
75.2 |
| Percent of long-stay residents experiencing one or more falls with major injury |
| 75.2 % |
3.1 % |
| Quality Measures Q3 |
| Percent of long-stay residents who received an antipsychotic medication |
| 10.1:1 |
26.8 % |
| Percent of long-stay residents whose need for help with daily activities has increased |
| 1.2 % |
|
| Percent of long-stay residents who self-report moderate to severe pain |
| 37.7 % |
23.1 % |
| Percent of long-stay high-risk residents with pressure ulcers |
| 5.5 % |
1.6 % |
| Percent of long-stay residents who lose too much weight |
| 7.1 % |
75.2 % |
| Percent of long-stay low-risk residents who lose control of their bowels or bladder |
| 62.5 % |
22.9 % |
| Percent of long-stay residents who have had a catheter inserted and left in their bladder |
| 5.4 % |
2.20 % |
| Percent of long-stay residents with a urinary tract infection |
| 5.9 % |
7 % |
| Percent of long-stay residents who have depressive symptoms |
| 75.2 % |
75.2 % |
| Percent of long-stay residents who were physically restrained |
| 75.2 % |
1.6 % |
| Percent of long-stay residents experiencing one or more falls with major injury |
| 1.1 % |
2.1 % |
| Percent of short-stay residents who self-report moderate to severe pain |
| 57.5 % |
|
| Percent of short-stay residents assessed and given, appropriately, the seasonal influenza vaccine |
| 92.5 % |
|
| Percent of short-stay residents with Pressure ulcers that are new or worsened |
| 87.7 % |
|
| Percent of short-stay residents who newly received an antipsychotic medication |
| 4.3 % |
|