Crestwood Manor - Vallejo - Vallejo Nursing Home
General Information
UPDATEFederal Provider Number
05A028
Provider Name
CRESTWOOD MANOR - VALLEJO
Provider Address
115 ODDSTAD DRIVE
VALLEJO, CA 94589
VALLEJO, CA 94589
Provider Phone Number
7075520215
Provider SSA County
580
Provider County Name
Solano
Ownership Type
For profit - Corporation
Number of Certified Beds
246
Number of Residents in Certified Beds
35
Provider Type
Medicaid
Provider Resides in Hospital
N
Legal Business Name
Legal Business Name Not Available
Date First Approved to Provide Medicare and Medicaid services
1979-05-01
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Resident
Automatic Sprinkler Systems in All Required Areas
Yes
Rating Detail Information
Overall Rating
5
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
3
Staffing Rating Footnote
RN Staffing Rating
3
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
1.73143
Reported LPN Staffing Hours per Resident per Day
0.61571
Reported RN Staffing Hours per Resident per Day
0.34000
Reported Licensed Staffing Hours per Resident per Day
0.95571
Reported Total Nurse Staffing Hours per Resident per Day
2.68714
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00000
Expected CNA Staffing Hours per Resident per Day
1.85574
Expected LPN Staffing Hours per Resident per Day
0.48509
Expected RN Staffing Hours per Resident per Day
0.63759
Expected Total Nurse Staffing Hours per Resident per Day
2.97843
Adjusted CNA Staffing Hours per Resident per Day
2.28933
Adjusted LPN Staffing Hours per Resident per Day
1.05349
Adjusted RN Staffing Hours per Resident per Day
0.39845
Adjusted Total Nurse Staffing Hours per Resident per Day
3.63668
Cycle 1 Total Number of Health Deficiencies
4
Cycle 1 Number of Standard Health Deficiencies
4
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
56
Cycle 1 Standard Survey Health Date
2013-11-15
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
56
Cycle 2 Total Number of Health Deficiencies
0
Cycle 2 Number of Standard Health Deficiencies
0
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
0
Cycle 2 Standard Health Survey Date
2012-10-26
Cycle 2 Number of Health Revisits
0
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
7
Cycle 3 Number of Standard Health Deficiencies
6
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
28
Cycle 3 Standard Health Survey Date
2012-04-02
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
28
Total Weighted Health Survey Score
32.66700
Number of Facility Reported Incidents
3
Number of Substantiated Complaints
0
Number of Fines
0
Total Amount of Fines in Dollars
0
Number of Payment Denials
0
Total Number of Penalties
0
Location
Processing Date
2015-06-01
Nursiong Homes Nearby
Windsor Vallejo Nursing & Rehabilitation Center
2200 Tuolumne Street |
VALLEJO CA 94589 | 0.1 mile away
Springs Road Healthcare
1527 Springs Road |
VALLEJO CA 94591 | 1.9 miles away
Heartwood Avenue Healthcare
1044 Heartwood Ave. |
VALLEJO CA 94590 | 2.3 miles away
Fairfield Post-acute Rehab
1255 Travis Blvd |
FAIRFIELD CA 94533 | 13.7 miles away
Greenfield Care Center Of Fairfield
1260 Travis Blvd |
FAIRFIELD CA 94533 | 13.7 miles away
La Mariposa Care And Rehab Center
1244 Travis Blvd |
FAIRFIELD CA 94533 | 13.8 miles away
Paradise Valley Estates
2800 Estates Drive |
FAIRFIELD CA 94533 | 16.8 miles away
Orchard Post Acute Care
101 S Orchard Ave |
VACAVILLE CA 95688 | 20.3 miles away
Vacaville Convalescent & Rehab
585 Nut Tree Court |
VACAVILLE CA 95687 | 22.5 miles away
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