Paradise Valley Estates - Fairfield Nursing Home
General Information
UPDATEFederal Provider Number
555727
Provider Name
PARADISE VALLEY ESTATES
Provider Address
2800 ESTATES DRIVE
FAIRFIELD, CA 94533
FAIRFIELD, CA 94533
Provider Phone Number
(707) 432-1200
Provider SSA County
580
Provider County Name
Solano
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
60
Number of Residents in Certified Beds
13
Provider Type
Medicare
Provider Resides in Hospital
N
Legal Business Name
NORTHERN CALIFORNIA RETIRED OFFICERS COMMUNITY
Date First Approved to Provide Medicare and Medicaid services
1998-07-13
Continuing Care Retirement Community
Y
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
4
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
3
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
3.03846
Reported LPN Staffing Hours per Resident per Day
0.09231
Reported RN Staffing Hours per Resident per Day
1.58846
Reported Licensed Staffing Hours per Resident per Day
1.68077
Reported Total Nurse Staffing Hours per Resident per Day
4.71923
Reported Physical Therapist Staffing Hours per Resident Per Day
0.43846
Expected CNA Staffing Hours per Resident per Day
2.48148
Expected LPN Staffing Hours per Resident per Day
0.86279
Expected RN Staffing Hours per Resident per Day
1.66310
Expected Total Nurse Staffing Hours per Resident per Day
5.00737
Adjusted CNA Staffing Hours per Resident per Day
3.00444
Adjusted LPN Staffing Hours per Resident per Day
0.08880
Adjusted RN Staffing Hours per Resident per Day
0.71366
Adjusted Total Nurse Staffing Hours per Resident per Day
3.79895
Cycle 1 Total Number of Health Deficiencies
6
Cycle 1 Number of Standard Health Deficiencies
6
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
52
Cycle 1 Standard Survey Health Date
2015-02-04
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
52
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
2013-11-01
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
1
Cycle 3 Number of Standard Health Deficiencies
0
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
4
Cycle 3 Standard Health Survey Date
2012-11-28
Cycle 3 Number of Health Revisits
0
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
4
Total Weighted Health Survey Score
26.66700
Number of Facility Reported Incidents
1
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
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