St John Kronstadt Convalescent Center
4432 James Avenue, Castro Valley, CA 94546


St John Kronstadt Convalescent Center is nursing home registered in the Centers for Medicare & Medicaid Services (CMS). The Provider Number is 555016. The address is 4432 James Avenue, Castro Valley, CA 94546. The zip code is 94546. The phone number is 5108897000.


St John Kronstadt Convalescent Center · 4432 James Avenue, Castro Valley, CA 94546

Federal Provider Number 555016
Provider Name ST JOHN KRONSTADT CONVALESCENT CENTER
Address 4432 JAMES AVENUE
CASTRO VALLEY, CA 94546
Phone Number 5108897000
County Name Alameda
Ownership Type Non profit - Church related
Certified Beds 49
Certified Beds Residents 43
Provider Type Medicare and Medicaid
Resides in Hospital false
Legal Business Name ST JOHN KRONSTADT HOME FOR AGED RUSSIAN AMERICANS
Date First Approved to Provide Medicare Medicaid Services 05/14/1976
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 Both
Automatic Sprinkler Systems in All Required Areas Yes
Overall Rating 5
Health Inspection Rating 5
Quality Measure Rating 5
Staffing Rating 5
RN Staffing Rating 5
Reported CNA Staffing Hours per Resident per Day 3.06512
Reported LPN Staffing Hours per Resident per Day 0.61279
Reported RN Staffing Hours per Resident per Day 0.87209
Reported Licensed Staffing Hours per Resident per Day 1.48488
Reported Total Nurse Staffing Hours per Resident per Day 4.55
Reported Physical Therapist Staffing Hours per Resident Per Day 0.03488
Expected CNA Staffing Hours per Resident per Day 2.47839
Expected LPN Staffing Hours per Resident per Day 0.61759
Expected RN Staffing Hours per Resident per Day 0.87825
Expected Total Nurse Staffing Hours per Resident per Day 3.97422
Adjusted CNA Staffing Hours per Resident per Day 3.03459
Adjusted LPN Staffing Hours per Resident per Day 0.82355
Adjusted RN Staffing Hours per Resident per Day 0.74196
Adjusted Total Nurse Staffing Hours per Resident per Day 4.61489
Cycle 1 Total Number of Health Deficiencies 4
Cycle 1 Number of Standard Health Deficiencies 3
Cycle 1 Number of Complaint Health Deficiencies 1
Cycle 1 Health Deficiency Score 12
Cycle 1 Standard Survey Health Date 10/06/2016
Cycle 1 Number of Health Revisits 1
Cycle 1 Total Health Score 12
Cycle 2 Total Number of Health Deficiencies 2
Cycle 2 Number of Standard Health Deficiencies 2
Cycle 2 Health Deficiency Score 4
Cycle 2 Standard Health Survey Date 09/24/2015
Cycle 2 Number of Health Revisits 1
Cycle 2 Total Health Score 4
Cycle 3 Total Number of Health Deficiencies 4
Cycle 3 Number of Standard Health Deficiencies 4
Cycle 3 Health Deficiency Score 20
Cycle 3 Standard Health Survey Date 08/15/2014
Cycle 3 Number of Health Revisits 1
Cycle 3 Total Health Score 20
Total Weighted Health Survey Score 10.667
Number of Facility Reported Incidents 1
Total Amount of Fines in Dollars $0.00
Processing Date 08/01/2017

Owner or Manager · St John Kronstadt Convalescent Center

Owner Name Role Association Date
DANBY, CRAIG (Individual) OPERATIONAL/MANAGERIAL CONTROL since 04/01/2014
GONZALEZ, EDWARD (Individual) OPERATIONAL/MANAGERIAL CONTROL since 01/01/2014
GRIMES, JEREMY (Individual) OPERATIONAL/MANAGERIAL CONTROL since 01/01/2014
KOLOBOFF, CONSTANTINE (Individual) DIRECTOR since 01/01/2007
KOLOBOFF, CONSTANTINE (Individual) OFFICER since 01/01/2007
KUMANSKY, GEORGE (Individual) OFFICER since 01/01/2000
LOUKIANOFF, ALEXANDER (Individual) DIRECTOR since 01/01/2007
MAXIMOW, ANDREW (Individual) DIRECTOR since 01/01/2010
PAVLENKO, STEFAN (Individual) DIRECTOR since 11/22/2004
PAVLENKO, STEFAN (Individual) OFFICER since 01/01/2000
SERENITY 4 MANAGEMENT SERVICES LLC (Organization) OPERATIONAL/MANAGERIAL CONTROL since 01/01/2014
ST JOHN KRONSTADT HOME FOR AGED RUSSIAN AMERICANS (Organization) 5% OR GREATER DIRECT OWNERSHIP INTEREST
100%
since 10/15/1971

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