Whitney Oaks Care Center
3529 Walnut Avenue, Carmichael, CA 95608


Whitney Oaks Care Center is nursing home registered in the Centers for Medicare & Medicaid Services (CMS). The Provider Number is 056410. The address is 3529 Walnut Avenue, Carmichael, CA 95608. The zip code is 95608. The phone number is 9164888601.


Whitney Oaks Care Center · 3529 Walnut Avenue, Carmichael, CA 95608

Federal Provider Number 056410
Provider Name WHITNEY OAKS CARE CENTER
Address 3529 WALNUT AVENUE
CARMICHAEL, CA 95608
Phone Number 9164888601
SSA County Code 440
County Name Sacramento
Ownership Type For profit - Corporation
Certified Beds 126
Certified Beds Residents 107
Provider Type Medicare and Medicaid
Resides in Hospital false
Legal Business Name QUEEN ANN'S LACE HOLDINGS, LLC
Date First Approved to Provide Medicare Medicaid Services 10/17/1973
Continuing Care Retirement Community false
Special Focus Facility false
Most Recent Health Inspection More Than 2 Years Ago false
Changed Ownership Last 12 Months false
With Resident Family Council Resident
Automatic Sprinkler Systems in All Required Areas Yes
Overall Rating 4
Health Inspection Rating 2
Quality Measure Rating 5
Staffing Rating 4
RN Staffing Rating 4
Reported CNA Staffing Hours per Resident per Day 2.63879
Reported LPN Staffing Hours per Resident per Day 1.00607
Reported RN Staffing Hours per Resident per Day 1.06075
Reported Licensed Staffing Hours per Resident per Day 2.06682
Reported Total Nurse Staffing Hours per Resident per Day 4.70561
Reported Physical Therapist Staffing Hours per Resident Per Day 0.10421
Expected CNA Staffing Hours per Resident per Day 2.48665
Expected LPN Staffing Hours per Resident per Day 0.73116
Expected RN Staffing Hours per Resident per Day 1.31162
Expected Total Nurse Staffing Hours per Resident per Day 4.52943
Adjusted CNA Staffing Hours per Resident per Day 2.60382
Adjusted LPN Staffing Hours per Resident per Day 1.14207
Adjusted RN Staffing Hours per Resident per Day 0.60428
Adjusted Total Nurse Staffing Hours per Resident per Day 4.18769
Cycle 1 Total Number of Health Deficiencies 14
Cycle 1 Number of Standard Health Deficiencies 11
Cycle 1 Number of Complaint Health Deficiencies 3
Cycle 1 Health Deficiency Score 84
Cycle 1 Standard Survey Health Date 11/08/2016
Cycle 1 Number of Health Revisits 1
Cycle 1 Total Health Score 84
Cycle 2 Total Number of Health Deficiencies 13
Cycle 2 Number of Standard Health Deficiencies 8
Cycle 2 Number of Complaint Health Deficiencies 5
Cycle 2 Health Deficiency Score 68
Cycle 2 Standard Health Survey Date 11/06/2015
Cycle 2 Number of Health Revisits 1
Cycle 2 Total Health Score 68
Cycle 3 Total Number of Health Deficiencies 18
Cycle 3 Number of Standard Health Deficiencies 15
Cycle 3 Number of Complaint Health Deficiencies 4
Cycle 3 Health Deficiency Score 80
Cycle 3 Standard Health Survey Date 12/05/2014
Cycle 3 Number of Health Revisits 1
Cycle 3 Total Health Score 80
Total Weighted Health Survey Score 78
Number of Facility Reported Incidents 3
Number of Substantiated Complaints 12
Total Amount of Fines in Dollars $0.00
Processing Date 08/01/2017

Owner or Manager · Whitney Oaks Care Center

Owner Name Role Association Date
ALLPRO, INC. (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 01/01/2015
ANDERSON, NICKLAS (Individual) OFFICER since 01/15/2017
ANDERSON, NICKLAS (Individual) OPERATIONAL/MANAGERIAL CONTROL since 01/15/2017
AUBURN MANOR HOLDING CORP (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 01/01/2015
BALLIF, MARK (Individual) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 01/01/2015
BAY BRIDGE CAPITAL PARTNERS, LLC (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 01/01/2015
CALIFORNIA OPCO LLC (Organization) 5% OR GREATER DIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 11/01/2014
CROSSWINDS TRUST (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 01/01/2015
DAHL, KYLE (Individual) MANAGING EMPLOYEE since 06/01/2013
DAHL, KYLE (Individual) OFFICER since 06/01/2013
EDMONDS, AARON (Individual) OFFICER since 06/01/2013
EDMONDS, AARON (Individual) OPERATIONAL/MANAGERIAL CONTROL since 06/01/2013
FLOWER FARM GROUP, LLC (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 01/01/2015
HAKIM, NAVEED (Individual) OFFICER since 01/15/2017
HAKIM, NAVEED (Individual) OPERATIONAL/MANAGERIAL CONTROL since 01/15/2017
HEALTHCARE FINANCIAL SOLUTIONS, LLC (Organization) 5% OR GREATER MORTGAGE INTEREST since 11/30/2015
HORIZON WEST HEALTHCARE, INC. (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 01/01/2015
HUBBARD, PAUL (Individual) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 01/01/2015
NEW SISU HOLDCO, LLC (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 01/01/2015
OPCO HOLDINGS LLC (Organization) 5% OR GREATER DIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 01/01/2015
PLUM HEALTHCARE GROUP, LLC (Organization) 5% OR GREATER DIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 06/07/2011
PUGH, PHYLLIS (Individual) OFFICER since 08/01/2013
PUGH, PHYLLIS (Individual) OPERATIONAL/MANAGERIAL CONTROL since 08/01/2013

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