Devonshire Oaks Nursing Center - Redwood City Nursing Home
General Information
UPDATEFederal Provider Number
555813
Provider Name
DEVONSHIRE OAKS NURSING CENTER
Provider Address
3635 JEFFERSON AVENUE
REDWOOD CITY, CA 94062
REDWOOD CITY, CA 94062
Provider Phone Number
(650) 366-9503
Provider SSA County
510
Provider County Name
San Mateo
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
38
Number of Residents in Certified Beds
30
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
ST. THERESE CONVALESCENT HOSPITAL ,INC.
Date First Approved to Provide Medicare and Medicaid services
2004-11-08
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Both
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
4
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
2.57667
Reported LPN Staffing Hours per Resident per Day
0.57167
Reported RN Staffing Hours per Resident per Day
1.03000
Reported Licensed Staffing Hours per Resident per Day
1.60167
Reported Total Nurse Staffing Hours per Resident per Day
4.17834
Reported Physical Therapist Staffing Hours per Resident Per Day
0.19000
Expected CNA Staffing Hours per Resident per Day
2.38120
Expected LPN Staffing Hours per Resident per Day
0.54439
Expected RN Staffing Hours per Resident per Day
0.98829
Expected Total Nurse Staffing Hours per Resident per Day
3.91388
Adjusted CNA Staffing Hours per Resident per Day
2.65512
Adjusted LPN Staffing Hours per Resident per Day
0.87159
Adjusted RN Staffing Hours per Resident per Day
0.77874
Adjusted Total Nurse Staffing Hours per Resident per Day
4.30327
Cycle 1 Total Number of Health Deficiencies
3
Cycle 1 Number of Standard Health Deficiencies
3
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
20
Cycle 1 Standard Survey Health Date
2014-03-11
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
20
Cycle 2 Total Number of Health Deficiencies
12
Cycle 2 Number of Standard Health Deficiencies
7
Cycle 2 Number of Complaint Health Deficiencies
5
Cycle 2 Health Deficiency Score
60
Cycle 2 Standard Health Survey Date
2013-04-22
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
60
Cycle 3 Total Number of Health Deficiencies
6
Cycle 3 Number of Standard Health Deficiencies
6
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
48
Cycle 3 Standard Health Survey Date
2012-06-25
Cycle 3 Number of Health Revisits
2
Cycle 3 Health Revisit Score
24
Cycle 3 Total Health Score
72
Total Weighted Health Survey Score
42.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
3
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
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