Citrus Valley Medical Center - Ic Campus - D/p Snf - Covina Nursing Home
General Information
UPDATEFederal Provider Number
555610
Provider Name
CITRUS VALLEY MEDICAL CENTER - IC CAMPUS - D/P SNF
Provider Address
210 W. SAN BERNARDINO RD.
COVINA, CA 91723
COVINA, CA 91723
Provider Phone Number
6263317331
Provider SSA County
200
Provider County Name
Los Angeles
Ownership Type
Non profit - Corporation
Number of Certified Beds
25
Number of Residents in Certified Beds
12
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
Y
Legal Business Name
CITRUS VALLEY MEDICAL CENTER INC
Date First Approved to Provide Medicare and Medicaid services
1994-10-20
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
None
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
4
QM Rating Footnote
Staffing Rating
5
Staffing Rating Footnote
RN Staffing Rating
5
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
3.28750
Reported LPN Staffing Hours per Resident per Day
0.00000
Reported RN Staffing Hours per Resident per Day
5.71667
Reported Licensed Staffing Hours per Resident per Day
5.71667
Reported Total Nurse Staffing Hours per Resident per Day
9.00417
Reported Physical Therapist Staffing Hours per Resident Per Day
0.45417
Expected CNA Staffing Hours per Resident per Day
2.70423
Expected LPN Staffing Hours per Resident per Day
1.23279
Expected RN Staffing Hours per Resident per Day
2.28014
Expected Total Nurse Staffing Hours per Resident per Day
6.21717
Adjusted CNA Staffing Hours per Resident per Day
2.98293
Adjusted LPN Staffing Hours per Resident per Day
0.00000
Adjusted RN Staffing Hours per Resident per Day
1.87335
Adjusted Total Nurse Staffing Hours per Resident per Day
5.83785
Cycle 1 Total Number of Health Deficiencies
8
Cycle 1 Number of Standard Health Deficiencies
8
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
44
Cycle 1 Standard Survey Health Date
2015-03-29
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
44
Cycle 2 Total Number of Health Deficiencies
7
Cycle 2 Number of Standard Health Deficiencies
7
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
32
Cycle 2 Standard Health Survey Date
2013-12-14
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
9
Cycle 3 Number of Standard Health Deficiencies
9
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
44
Cycle 3 Standard Health Survey Date
2012-09-08
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
44
Total Weighted Health Survey Score
40.00000
Number of Facility Reported Incidents
0
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
Covina Rehabilitation Center
261 W. Badillo Street |
COVINA CA 91723 | 0.1 mile away
Royal Crest Health Care
519 W. Badillo St. |
COVINA CA 91722 | 0.4 mile away
The Rowland
330 W. Rowland Ave. |
COVINA CA 91723 | 0.7 mile away
Glendora Grand, Inc
805 W. Arrow Hwy. |
GLENDORA CA 91740 | 1.6 miles away
Beacon Healthcare Center
919 N Sunset Ave |
WEST COVINA CA 91790 | 2.4 miles away
Clara Baldwin Stocker Home
527 S Valinda Avenue |
WEST COVINA CA 91790 | 2.4 miles away
Gladstone Care And Rehabilitat
435 E. Gladstone Avenue |
GLENDORA CA 91740 | 2.8 miles away
West Haven Healthcare
1495 West Cameron Ave. |
WEST COVINA CA 91790 | 3 miles away
Doctors Hosp Of West Covina
725 S. Orange Avenue |
WEST COVINA CA 91790 | 3.2 miles away
Arbor Glen Care Center
1033 E. Arrow Highway |
GLENDORA CA 91740 | 3.2 miles away
West Covina Healthcare Center
850 S. Sunkist Ave. |
WEST COVINA CA 91790 | 3.4 miles away
Kindred Transitional Care And Rehab-foothil
401 W. Ada Ave. |
GLENDORA CA 91741 | 3.4 miles away
Mesa Glen Care Center
638 E Colorado Avenue |
GLENDORA CA 91740 | 3.4 miles away
Victoria Care Center
3541 Puente Avenue |
BALDWIN PARK CA 91706 | 3.6 miles away
Coast Care Convalescent Center
14518 E. Los Angeles St. |
BALDWIN PARK CA 91706 | 3.8 miles away
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