Tampico Terrace Care Center - Walnut Creek Nursing Home
General Information
UPDATEFederal Provider Number
56213
Provider Name
TAMPICO TERRACE CARE CENTER
Provider Address
130 TAMPICO STREET
WALNUT CREEK, CA 94598
WALNUT CREEK, CA 94598
Provider Phone Number
9259337970
Provider SSA County
60
Provider County Name
Contra Costa
Ownership Type
For profit - Corporation
Number of Certified Beds
128
Number of Residents in Certified Beds
81
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
J3TFZ, INC.
Date First Approved to Provide Medicare and Medicaid services
1970-07-09
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
4
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
2.64383
Reported LPN Staffing Hours per Resident per Day
0.99506
Reported RN Staffing Hours per Resident per Day
0.96111
Reported Licensed Staffing Hours per Resident per Day
1.95617
Reported Total Nurse Staffing Hours per Resident per Day
4.60000
Reported Physical Therapist Staffing Hours per Resident Per Day
0.09074
Expected CNA Staffing Hours per Resident per Day
2.68531
Expected LPN Staffing Hours per Resident per Day
0.72348
Expected RN Staffing Hours per Resident per Day
1.20434
Expected Total Nurse Staffing Hours per Resident per Day
4.61313
Adjusted CNA Staffing Hours per Resident per Day
2.41580
Adjusted LPN Staffing Hours per Resident per Day
1.14157
Adjusted RN Staffing Hours per Resident per Day
0.59629
Adjusted Total Nurse Staffing Hours per Resident per Day
4.01943
Cycle 1 Total Number of Health Deficiencies
7
Cycle 1 Number of Standard Health Deficiencies
7
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
48
Cycle 1 Standard Survey Health Date
2014-11-06
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
48
Cycle 2 Total Number of Health Deficiencies
18
Cycle 2 Number of Standard Health Deficiencies
15
Cycle 2 Number of Complaint Health Deficiencies
3
Cycle 2 Health Deficiency Score
116
Cycle 2 Standard Health Survey Date
2013-09-13
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
14
Cycle 3 Number of Standard Health Deficiencies
12
Cycle 3 Number of Complaint Health Deficiencies
2
Cycle 3 Health Deficiency Score
84
Cycle 3 Standard Health Survey Date
2012-06-15
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
84
Total Weighted Health Survey Score
76.66700
Number of Facility Reported Incidents
5
Number of Substantiated Complaints
2
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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