Golden Living Center - Portside
2740 North California Street, Stockton, CA 95204


Golden Living Center - Portside is nursing home registered in the Centers for Medicare & Medicaid Services (CMS). The Provider Number is 555105. The address is 2740 North California Street, Stockton, CA 95204. The zip code is 95204. The phone number is 2094663522.


Golden Living Center - Portside · 2740 North California Street, Stockton, CA 95204

Federal Provider Number 555105
Provider Name GOLDEN LIVING CENTER - PORTSIDE
Address 2740 NORTH CALIFORNIA STREET
STOCKTON, CA 95204
Phone Number 2094663522
SSA County Code 490
County Name San Joaquin
Ownership Type For profit - Corporation
Certified Beds 99
Certified Beds Residents 93
Provider Type Medicare and Medicaid
Resides in Hospital false
Legal Business Name BEVERLY HEALTH AND REHABILITATION SERVICES, INC
Date First Approved to Provide Medicare Medicaid Services 12/29/1978
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 3
Staffing Rating 3
RN Staffing Rating 3
Reported CNA Staffing Hours per Resident per Day 2.45215
Reported LPN Staffing Hours per Resident per Day 0.71559
Reported RN Staffing Hours per Resident per Day 0.50161
Reported Licensed Staffing Hours per Resident per Day 1.2172
Reported Total Nurse Staffing Hours per Resident per Day 3.66935
Reported Physical Therapist Staffing Hours per Resident Per Day 0.01613
Expected CNA Staffing Hours per Resident per Day 2.38533
Expected LPN Staffing Hours per Resident per Day 0.57368
Expected RN Staffing Hours per Resident per Day 0.86113
Expected Total Nurse Staffing Hours per Resident per Day 3.82014
Adjusted CNA Staffing Hours per Resident per Day 2.52244
Adjusted LPN Staffing Hours per Resident per Day 1.03532
Adjusted RN Staffing Hours per Resident per Day 0.43524
Adjusted Total Nurse Staffing Hours per Resident per Day 3.87179
Cycle 1 Total Number of Health Deficiencies 7
Cycle 1 Number of Standard Health Deficiencies 5
Cycle 1 Number of Complaint Health Deficiencies 2
Cycle 1 Health Deficiency Score 32
Cycle 1 Standard Survey Health Date 03/16/2017
Cycle 1 Number of Health Revisits 1
Cycle 1 Total Health Score 32
Cycle 2 Total Number of Health Deficiencies 10
Cycle 2 Number of Standard Health Deficiencies 7
Cycle 2 Number of Complaint Health Deficiencies 3
Cycle 2 Health Deficiency Score 36
Cycle 2 Standard Health Survey Date 03/10/2016
Cycle 2 Number of Health Revisits 1
Cycle 2 Total Health Score 36
Cycle 3 Total Number of Health Deficiencies 5
Cycle 3 Number of Standard Health Deficiencies 4
Cycle 3 Number of Complaint Health Deficiencies 1
Cycle 3 Health Deficiency Score 20
Cycle 3 Standard Health Survey Date 03/19/2015
Cycle 3 Number of Health Revisits 1
Cycle 3 Total Health Score 20
Total Weighted Health Survey Score 31.333
Number of Facility Reported Incidents 8
Number of Substantiated Complaints 2
Total Amount of Fines in Dollars $0.00
Processing Date 08/01/2017

Owner or Manager · Golden Living Center - Portside

Owner Name Role Association Date
BEVERLY ENTERPRISES INC (Organization) OPERATIONAL/MANAGERIAL CONTROL since 03/15/2006
CHANDAR, JOHN (Individual) MANAGING EMPLOYEE since 02/11/2013
CHAVIS, TINA (Individual) OFFICER since 08/15/2006
DRUMM MERGER CO (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 03/15/2006
FILLMORE STRATEGIC INVESTORS LLC (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 03/15/2006
FINN, NICHOLAS (Individual) OFFICER since 11/03/2009
HELM, PAUL (Individual) OFFICER since 01/02/2012
JOSEPH, LARRY (Individual) OFFICER since 08/15/2006
KARICHER, MICHAEL (Individual) OFFICER since 01/02/2012
LAFFOON, DAVID (Individual) OFFICER since 06/01/2011
PEARL SENIOR CARE, LLC. (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 03/15/2006
RASMUSSEN-JONES, HOLLY (Individual) OFFICER since 08/15/2006
ROBERTS, MAUREEN (Individual) DIRECTOR since 01/01/2007
SALAMONE, SALVATORE (Individual) OFFICER since 04/16/2011
SWARTZ, GREGORY (Individual) OFFICER since 08/15/2006
TRUITT, ANN (Individual) OFFICER since 08/15/2006
VARDELL, KATHLEEN (Individual) OFFICER since 08/01/2012
WASHINGTON STATE INVESTMENT BOARD (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 03/15/2006
WILLIAMS, ROBERTA (Individual) OFFICER since 08/15/2006

street_number: 2740
route: North California Street (N California St)
neighborhood, political: Pacific
locality, political: Stockton
admin_level_2, political: San Joaquin County
admin_level_1, political: California (CA)
country, political: United States (US)
postal_code: 95204
postal_code_suffix: 5529
types : premise
latitude: 37.977622
longitude: -121.2901541
latlng: (37.977622, -121.2901541)


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