Windsor Country Drive Care Center - Fremont Nursing Home
General Information
UPDATEFederal Provider Number
55885
Provider Name
WINDSOR COUNTRY DRIVE CARE CENTER
Provider Address
2500 COUNTRY DRIVE
FREMONT, CA 94536
FREMONT, CA 94536
Provider Phone Number
(510) 792-4242
Provider SSA County
0
Provider County Name
Alameda
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
126
Number of Residents in Certified Beds
114
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
WINDSOR COUNTRY DRIVE CARE CENTER, LLC
Date First Approved to Provide Medicare and Medicaid services
1968-03-11
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
5
Overall Rating Footnote
Health Inspection Rating
3
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
2.62237
Reported LPN Staffing Hours per Resident per Day
0.46930
Reported RN Staffing Hours per Resident per Day
1.05307
Reported Licensed Staffing Hours per Resident per Day
1.52237
Reported Total Nurse Staffing Hours per Resident per Day
4.14474
Reported Physical Therapist Staffing Hours per Resident Per Day
0.16272
Expected CNA Staffing Hours per Resident per Day
2.59853
Expected LPN Staffing Hours per Resident per Day
0.73707
Expected RN Staffing Hours per Resident per Day
1.15592
Expected Total Nurse Staffing Hours per Resident per Day
4.49152
Adjusted CNA Staffing Hours per Resident per Day
2.47622
Adjusted LPN Staffing Hours per Resident per Day
0.52847
Adjusted RN Staffing Hours per Resident per Day
0.68071
Adjusted Total Nurse Staffing Hours per Resident per Day
3.71968
Cycle 1 Total Number of Health Deficiencies
11
Cycle 1 Number of Standard Health Deficiencies
10
Cycle 1 Number of Complaint Health Deficiencies
1
Cycle 1 Health Deficiency Score
48
Cycle 1 Standard Survey Health Date
2014-02-06
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
10
Cycle 2 Number of Standard Health Deficiencies
9
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
52
Cycle 2 Standard Health Survey Date
2012-11-16
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
52
Cycle 3 Total Number of Health Deficiencies
11
Cycle 3 Number of Standard Health Deficiencies
7
Cycle 3 Number of Complaint Health Deficiencies
4
Cycle 3 Health Deficiency Score
32
Cycle 3 Standard Health Survey Date
2011-09-23
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
32
Total Weighted Health Survey Score
46.66700
Number of Facility Reported Incidents
6
Number of Substantiated Complaints
5
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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