Windsor Vallejo Nursing & Rehabilitation Center - Vallejo Nursing Home
General Information
UPDATEFederal Provider Number
56238
Provider Name
WINDSOR VALLEJO NURSING & REHABILITATION CENTER
Provider Address
2200 TUOLUMNE STREET
VALLEJO, CA 94589
VALLEJO, CA 94589
Provider Phone Number
(707) 644-7401
Provider SSA County
580
Provider County Name
Solano
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
166
Number of Residents in Certified Beds
145
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
WINDSOR VALLEJO CARE CENTER, LLC
Date First Approved to Provide Medicare and Medicaid services
1970-07-29
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
1
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
3
QM Rating Footnote
Staffing Rating
2
Staffing Rating Footnote
RN Staffing Rating
2
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.35379
Reported LPN Staffing Hours per Resident per Day
0.76345
Reported RN Staffing Hours per Resident per Day
0.44586
Reported Licensed Staffing Hours per Resident per Day
1.20931
Reported Total Nurse Staffing Hours per Resident per Day
3.56310
Reported Physical Therapist Staffing Hours per Resident Per Day
0.07897
Expected CNA Staffing Hours per Resident per Day
2.56770
Expected LPN Staffing Hours per Resident per Day
0.63507
Expected RN Staffing Hours per Resident per Day
1.02819
Expected Total Nurse Staffing Hours per Resident per Day
4.23096
Adjusted CNA Staffing Hours per Resident per Day
2.24929
Adjusted LPN Staffing Hours per Resident per Day
0.99779
Adjusted RN Staffing Hours per Resident per Day
0.32401
Adjusted Total Nurse Staffing Hours per Resident per Day
3.39462
Cycle 1 Total Number of Health Deficiencies
16
Cycle 1 Number of Standard Health Deficiencies
10
Cycle 1 Number of Complaint Health Deficiencies
11
Cycle 1 Health Deficiency Score
171
Cycle 1 Standard Survey Health Date
2014-12-16
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
171
Cycle 2 Total Number of Health Deficiencies
13
Cycle 2 Number of Standard Health Deficiencies
13
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
104
Cycle 2 Standard Health Survey Date
2013-12-13
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
104
Cycle 3 Total Number of Health Deficiencies
7
Cycle 3 Number of Standard Health Deficiencies
7
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
32
Cycle 3 Standard Health Survey Date
2012-11-30
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
32
Total Weighted Health Survey Score
125.50000
Number of Facility Reported Incidents
3
Number of Substantiated Complaints
6
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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