Overall Rating
Address
4164 North 4th Avenue
San Bernardino, CA 92407
Contact
9098866786
Certification Date
1974-07-01
CMS Certification Number
05A208
Ownership Type
For profit - Limited Liability company
Number of Certified Beds
78
Average Number of Residents per Day
77.9
Provider Type
Medicaid
Legal Business Name
Legal Business Name Not Available
Affiliated Entity Name
Affiliated Entity ID
Health Inspection Rating
4
Quality Measure Rating
5
Staffing Rating
2
Reported Nurse Aide Staffing Hours per Resident per Day
1.60175
Reported LPN Staffing Hours per Resident per Day
0.75778
Reported RN Staffing Hours per Resident per Day
0.19135
Reported Total Nurse Staffing Hours per Resident per Day
2.55088
Total Number of Nurse Staff Hours per Resident per Day on the Weekend
2.32821
Registered Nurse Hours per Resident per Day on the Weekend
0.11686
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00000
Long-Stay Quality Measure Rating
5
Short-Stay Quality Measure Rating
Total Weighted Health Survey Score
55.333
Number of Facility Reported Incidents
2
Number of Substantiated Complaints
3
Number of Citations from Infection Control Inspections
0
Standard Health Survey Date
2023-11-03
Total Number of Health Deficiencies
6
Number of Standard Health Deficiencies
4
Number of Complaint Health Deficiencies
2
Health Deficiency Score
52
Number of Health Revisits
1
Health Revisit Score
0
Total Health Score
52
Standard Health Survey Date
2022-11-18
Total Number of Health Deficiencies
8
Number of Standard Health Deficiencies
5
Number of Complaint Health Deficiencies
3
Health Deficiency Score
56
Number of Health Revisits
1
Health Revisit Score
0
Total Health Score
56
Standard Health Survey Date
2019-09-06
Total Number of Health Deficiencies
8
Number of Standard Health Deficiencies
8
Number of Complaint Health Deficiencies
0
Health Deficiency Score
64
Number of Health Revisits
1
Health Revisit Score
0
Total Health Score
64
Number of Fines
0
Total Amount of Fines in Dollars
0.00
Number of Payment Denials
0
Total Number of Penalties
0