Country Villa South Conv Ctr
Country Villa South Conv Ctr Information
| Facility Name | Country Villa South Conv Ctr |
| Location | 3515 Overland Avenue, Los Angeles, CA 90034 |
| County (SSA Code) | Los Angeles (200) |
| Phone Number | 310-839-5201 |
| Certification(s) | Medicare and Medicaid |
| Number of Beds | 87 |
| Average Number of Residents | 70 |
| CCRC Facility? | No |
| Medicare Overall Rating | |
| Survey Rating | |
| Quality Rating | |
| Long Stay Quality Rating | |
| Short Stay Quality Rating | |
| Staff Quality Rating | |
| Registered Nurse Quality Rating |
| Abuse Flag | No |
| Sprinklers Installed | Yes |
| Located In Hospital | No |
| Resident Family Council | Resident |
| Provider Business Name | Legal Business Name Not Available |
| Ownership Type | For profit - Partnership |
| Date First Approved | 1967-01-01 |
| Reported Nurse Aide Staffing Hours per Resident per Day | 2.34523 |
| Reported LPN Staffing Hours per Resident per Day | 1.42994 |
| Reported RN Staffing - Hours per Resident per Day | 0.57358 |
| Reported Licensed Staffing - Hours per Resident per Day (RN + LPN) | 2.00352 |
| Reported Total Nurse Staffing - Hours per Resident per Day (Aide+LPN+RN) | 4.34876 |
| Reported Physical Therapy Staffing - Hours per Resident Per Day | 0.02236 |
| Case-Mix Nurse Aide Staffing - Hours per Resident per Day | 2.14346 |
| Case-Mix LPN Staffing - Hours per Resident per Day | 0.80778 |
| Case-Mix RN Staffing - Hours per Resident per Day | 0.7698 |
| Case-Mix Total Nurse Staffing - Hours per Resident per Day (Aide+LPN+RN) | 3.72104 |
| Adjusted Total Nurse Staffing - Hours per Resident per Day (Aide+LPN+RN) | 3.72601 |
| Total Weighted Health Survey Score for three cycles | 123.333 |
| Rating cycle 1 Standard Survey Health Date | 2019-11-09 |
| Rating cycle 1 - Health Deficiency Score | 38 |
| Rating cycle 1 - Total Health Inspection Score | 76 |
| Date of Rating cycle 2 Standard Health Survey Date | 2018-10-22 |
| Rating cycle 2 - Health Deficiency Score | 76 |
| Date of Rating cycle 3 Standard Health Survey Date | 2017-09-30 |
| Rating cycle 3 - Health Deficiency Score | 120 |
| Rating cycle 3 - Total Health Inspection Score | 120 |
| Number of Facility-Reported Incidents | 12 |
| Number of Substantiated Complaints | 22 |
| Number of Substantiated Complaints | 22 |
| Total Number of Penalties | 0 |
| Data Filing Date | 2020-10-01 |
| Page Last Updated | 2020-11-28 |