Baldwin Gardens Nursing Center
10786 Live Oak Avenue, Temple City, CA 91780


Baldwin Gardens Nursing Center is nursing home registered in the Centers for Medicare & Medicaid Services (CMS). The Provider Number is 555055. The address is 10786 Live Oak Avenue, Temple City, CA 91780. The zip code is 91780. The phone number is 6264473553.


Baldwin Gardens Nursing Center · 10786 Live Oak Avenue, Temple City, CA 91780

Federal Provider Number 555055
Provider Name BALDWIN GARDENS NURSING CENTER
Address 10786 LIVE OAK AVENUE
TEMPLE CITY, CA 91780
Phone Number 6264473553
SSA County Code 200
County Name Los Angeles
Ownership Type For profit - Corporation
Certified Beds 59
Certified Beds Residents 56
Provider Type Medicare and Medicaid
Resides in Hospital false
Legal Business Name BALDWIN GARDENS NURSING CENTER CORPORATION
Date First Approved to Provide Medicare Medicaid Services 02/01/1977
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 4
Quality Measure Rating 5
Staffing Rating 1
RN Staffing Rating 1
Reported CNA Staffing Hours per Resident per Day 2.56161
Reported LPN Staffing Hours per Resident per Day 0.97946
Reported RN Staffing Hours per Resident per Day 0.07411
Reported Licensed Staffing Hours per Resident per Day 1.05357
Reported Total Nurse Staffing Hours per Resident per Day 3.61518
Reported Physical Therapist Staffing Hours per Resident Per Day 0.08304
Expected CNA Staffing Hours per Resident per Day 2.57183
Expected LPN Staffing Hours per Resident per Day 0.70229
Expected RN Staffing Hours per Resident per Day 1.0587
Expected Total Nurse Staffing Hours per Resident per Day 4.33283
Adjusted CNA Staffing Hours per Resident per Day 2.44395
Adjusted LPN Staffing Hours per Resident per Day 1.15757
Adjusted RN Staffing Hours per Resident per Day 0.0523
Adjusted Total Nurse Staffing Hours per Resident per Day 3.36326
Cycle 1 Total Number of Health Deficiencies 7
Cycle 1 Number of Standard Health Deficiencies 7
Cycle 1 Health Deficiency Score 40
Cycle 1 Standard Survey Health Date 05/20/2017
Cycle 1 Number of Health Revisits 1
Cycle 1 Total Health Score 40
Cycle 2 Total Number of Health Deficiencies 9
Cycle 2 Number of Standard Health Deficiencies 9
Cycle 2 Health Deficiency Score 56
Cycle 2 Standard Health Survey Date 07/30/2016
Cycle 2 Number of Health Revisits 1
Cycle 2 Total Health Score 56
Cycle 3 Total Number of Health Deficiencies 3
Cycle 3 Number of Standard Health Deficiencies 3
Cycle 3 Health Deficiency Score 20
Cycle 3 Standard Health Survey Date 05/22/2015
Cycle 3 Number of Health Revisits 1
Cycle 3 Total Health Score 20
Total Weighted Health Survey Score 42
Total Amount of Fines in Dollars $0.00
Processing Date 08/01/2017

Owner or Manager · Baldwin Gardens Nursing Center

Owner Name Role Association Date
BASTOMSKI, ISRAEL (Individual) 5% OR GREATER DIRECT OWNERSHIP INTEREST
100%
since 05/01/2007
BASTOMSKI, ISRAEL (Individual) DIRECTOR since 04/01/2007
BASTOMSKI, ISRAEL (Individual) MANAGING EMPLOYEE since 04/01/2007

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