Sequoias, The - Portola Valley Nursing Home
General Information
UPDATEFederal Provider Number
55466
Provider Name
SEQUOIAS, THE
Provider Address
501 PORTOLA ROAD
PORTOLA VALLEY, CA 94028
PORTOLA VALLEY, CA 94028
Provider Phone Number
(650) 851-1501
Provider SSA County
510
Provider County Name
San Mateo
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
43
Number of Residents in Certified Beds
22
Provider Type
Medicare
Provider Resides in Hospital
N
Legal Business Name
NORTHERN CALIFORNIA PRESBYTERIAN HOMES AND SERVICES INC
Date First Approved to Provide Medicare and Medicaid services
1967-01-18
Continuing Care Retirement Community
Y
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
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
3.82500
Reported LPN Staffing Hours per Resident per Day
1.10000
Reported RN Staffing Hours per Resident per Day
2.05227
Reported Licensed Staffing Hours per Resident per Day
3.15227
Reported Total Nurse Staffing Hours per Resident per Day
6.97727
Reported Physical Therapist Staffing Hours per Resident Per Day
0.27500
Expected CNA Staffing Hours per Resident per Day
2.67144
Expected LPN Staffing Hours per Resident per Day
0.60119
Expected RN Staffing Hours per Resident per Day
0.91630
Expected Total Nurse Staffing Hours per Resident per Day
4.18893
Adjusted CNA Staffing Hours per Resident per Day
3.51324
Adjusted LPN Staffing Hours per Resident per Day
1.51865
Adjusted RN Staffing Hours per Resident per Day
1.67353
Adjusted Total Nurse Staffing Hours per Resident per Day
6.71404
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
28
Cycle 1 Standard Survey Health Date
2014-09-22
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
28
Cycle 2 Total Number of Health Deficiencies
5
Cycle 2 Number of Standard Health Deficiencies
5
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
32
Cycle 2 Standard Health Survey Date
2013-09-12
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
32
Cycle 3 Total Number of Health Deficiencies
3
Cycle 3 Number of Standard Health Deficiencies
3
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
12
Cycle 3 Standard Health Survey Date
2012-10-08
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
12
Total Weighted Health Survey Score
26.66700
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
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