Miravilla Care Center - Cherry Valley Nursing Home
General Information
UPDATEFederal Provider Number
555492
Provider Name
MIRAVILLA CARE CENTER
Provider Address
9246 AVENIDA MIRAVILLA
CHERRY VALLEY, CA 92223
CHERRY VALLEY, CA 92223
Provider Phone Number
9518453194
Provider SSA County
430
Provider County Name
Riverside
Ownership Type
For profit - Corporation
Number of Certified Beds
59
Number of Residents in Certified Beds
53
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
DAVID KLEIS III LLC
Date First Approved to Provide Medicare and Medicaid services
1991-11-22
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
2
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
5
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
2.71698
Reported LPN Staffing Hours per Resident per Day
0.96981
Reported RN Staffing Hours per Resident per Day
0.64623
Reported Licensed Staffing Hours per Resident per Day
1.61604
Reported Total Nurse Staffing Hours per Resident per Day
4.33302
Reported Physical Therapist Staffing Hours per Resident Per Day
0.06226
Expected CNA Staffing Hours per Resident per Day
2.32267
Expected LPN Staffing Hours per Resident per Day
0.60304
Expected RN Staffing Hours per Resident per Day
0.86401
Expected Total Nurse Staffing Hours per Resident per Day
3.78973
Adjusted CNA Staffing Hours per Resident per Day
2.87025
Adjusted LPN Staffing Hours per Resident per Day
1.33480
Adjusted RN Staffing Hours per Resident per Day
0.55886
Adjusted Total Nurse Staffing Hours per Resident per Day
4.60877
Cycle 1 Total Number of Health Deficiencies
6
Cycle 1 Number of Standard Health Deficiencies
4
Cycle 1 Number of Complaint Health Deficiencies
2
Cycle 1 Health Deficiency Score
60
Cycle 1 Standard Survey Health Date
2014-10-23
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
60
Cycle 2 Total Number of Health Deficiencies
12
Cycle 2 Number of Standard Health Deficiencies
10
Cycle 2 Number of Complaint Health Deficiencies
3
Cycle 2 Health Deficiency Score
122
Cycle 2 Standard Health Survey Date
2013-11-08
Cycle 2 Number of Health Revisits
2
Cycle 2 Health Revisit Score
61
Cycle 2 Total Health Score
61
Cycle 3 Total Number of Health Deficiencies
13
Cycle 3 Number of Standard Health Deficiencies
12
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
52
Cycle 3 Standard Health Survey Date
2012-11-29
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
52
Total Weighted Health Survey Score
99.66700
Number of Facility Reported Incidents
2
Number of Substantiated Complaints
4
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
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