Kyakameena Care Center - Berkeley Nursing Home
General Information
UPDATEFederal Provider Number
55715
Provider Name
KYAKAMEENA CARE CENTER
Provider Address
2131 CARLETON STREET
BERKELEY, CA 94704
BERKELEY, CA 94704
Provider Phone Number
5108432131
Provider SSA County
0
Provider County Name
Alameda
Ownership Type
For profit - Individual
Number of Certified Beds
60
Number of Residents in Certified Beds
55
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
SANHYD INC
Date First Approved to Provide Medicare and Medicaid services
1967-03-20
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
3
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
2
QM Rating Footnote
Staffing Rating
4
Staffing Rating Footnote
RN Staffing Rating
4
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.36273
Reported LPN Staffing Hours per Resident per Day
0.81364
Reported RN Staffing Hours per Resident per Day
0.60364
Reported Licensed Staffing Hours per Resident per Day
1.41727
Reported Total Nurse Staffing Hours per Resident per Day
3.78001
Reported Physical Therapist Staffing Hours per Resident Per Day
0.08818
Expected CNA Staffing Hours per Resident per Day
2.26427
Expected LPN Staffing Hours per Resident per Day
0.59521
Expected RN Staffing Hours per Resident per Day
0.81156
Expected Total Nurse Staffing Hours per Resident per Day
3.67104
Adjusted CNA Staffing Hours per Resident per Day
2.56040
Adjusted LPN Staffing Hours per Resident per Day
1.13459
Adjusted RN Staffing Hours per Resident per Day
0.55577
Adjusted Total Nurse Staffing Hours per Resident per Day
4.15055
Cycle 1 Total Number of Health Deficiencies
17
Cycle 1 Number of Standard Health Deficiencies
13
Cycle 1 Number of Complaint Health Deficiencies
4
Cycle 1 Health Deficiency Score
76
Cycle 1 Standard Survey Health Date
2015-02-26
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
76
Cycle 2 Total Number of Health Deficiencies
13
Cycle 2 Number of Standard Health Deficiencies
12
Cycle 2 Number of Complaint Health Deficiencies
2
Cycle 2 Health Deficiency Score
72
Cycle 2 Standard Health Survey Date
2014-01-13
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
5
Cycle 3 Number of Standard Health Deficiencies
3
Cycle 3 Number of Complaint Health Deficiencies
2
Cycle 3 Health Deficiency Score
24
Cycle 3 Standard Health Survey Date
2012-10-11
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
24
Total Weighted Health Survey Score
66.00000
Number of Facility Reported Incidents
4
Number of Substantiated Complaints
8
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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