County: Colusa and Lake

City: Clearlake

Meadowood Nursing Center
(707) 994-7738 — 3805 Dexter Lane — Clearlake, Ca 95422

Services
How to interpret services information.

Cap.= 99 Type = SNF Medi-Cal: yes Medicare: yes

No current survey information available. Call the facility for services information.

Violations Record
From Dept. of Public Health as of 8/30/2010;
Citations as of 4/29/2011.
Last DHS Certification Inspection = 8/29/2007.
How to interpret violations data.
Year Citations Deficiencies Complaints
  AA A B Rec'd Ca. Avg Rec'd Ca. Avg
2006 0 0 0 37 20.8 37 12.5
2007 0 0 0 32 22.1 35 15.1
2008 0 0 3 8 18.2 43 14.4
2009 0 0 0 0 8.5 20 14
2010 0 0 0 0 11.7 8 6.5
2011 0 0 0 0 NA 0 NA

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City: Colusa

Colusa Regional Medical Center D/P Snf
(530) 458-5821 — 199 East Webster — Colusa, CA 95932

Services
How to interpret services information.

Cap.= 6 Type = D/P SNF Medi-Cal: no Medicare: yes

No current survey information available. Call the facility for services information.

Violations Record
From Dept. of Public Health as of 8/30/2010;
Citations as of 4/29/2011.
Last DHS Certification Inspection = 12/17/2009.
How to interpret violations data.
Year Citations Deficiencies Complaints
  AA A B Rec'd Ca. Avg Rec'd Ca. Avg
2006 0 0 0 17 20.8 1 12.5
2007 0 0 0 21 22.1 1 15.1
2008 0 0 1 3 18.2 2 14.4
2009 0 0 0 9 8.5 0 14
2010 0 0 1 0 11.7 1 6.5
2011 0 0 0 0 NA 0 NA

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City: Lakeport

Evergreen Lakeport Healthcare
(707) 263-6382 — 1291 Craig Avenue — Lakeport, CA 95453

Services
How to interpret services information.

Cap.= 99 Type = SNF Medi-Cal: yes Medicare: yes

From CANHR questionnaire returned 4/21/2005:
"Alzheimer's Unit": NoWanderer alert: No
Locked Ward: No
Types of Residents Accepted: A B D E I L Q R S U V
Types of Residents Not Accepted: F J M N O P T
Languages spoken by direct-care staff: I
Family Council: No Family Council

Violations Record
From Dept. of Public Health as of 8/30/2010;
Citations as of 4/29/2011.
Last DHS Certification Inspection = 8/19/2008.
How to interpret violations data.
Year Citations Deficiencies Complaints
  AA A B Rec'd Ca. Avg Rec'd Ca. Avg
2006 0 0 1 49 20.8 19 12.5
2007 1 1 5 44 22.1 31 15.1
2008 0 0 6 37 18.2 21 14.4
2009 0 0 3 1 8.5 30 14
2010 0 0 1 1 11.7 5 6.5
2011 0 0 0 0 NA 0 NA

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City: Lakeport

Horizon West At The Lake
(707) 263-6101 — 625 16th. Street — Lakeport, CA 95453

Services
How to interpret services information.

Cap.= 90 Type = SNF Medi-Cal: yes Medicare: yes

No current survey information available. Call the facility for services information.

Violations Record
From Dept. of Public Health as of 8/30/2010;
Citations as of 4/29/2011.
Last DHS Certification Inspection = 4/24/2008.
How to interpret violations data.
Year Citations Deficiencies Complaints
  AA A B Rec'd Ca. Avg Rec'd Ca. Avg
2006 0 0 2 42 20.8 29 12.5
2007 0 0 0 23 22.1 31 15.1
2008 0 0 1 31 18.2 21 14.4
2009 0 0 3 2 8.5 33 14
2010 0 0 0 0 11.7 8 6.5
2011 0 0 0 0 NA 0 NA

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City: Williams

Valley West Care Center
(530) 473-5321 — 1224 E ST., P.O. BOX 1059 — Williams, CA 95987

Services
How to interpret services information.

Cap.= 99 Type = SNF Medi-Cal: yes Medicare: yes

No current survey information available. Call the facility for services information.

Violations Record
From Dept. of Public Health as of 8/30/2010;
Citations as of 4/29/2011.
Last DHS Certification Inspection = 3/10/2010.
How to interpret violations data.
Year Citations Deficiencies Complaints
  AA A B Rec'd Ca. Avg Rec'd Ca. Avg
2006 0 0 0 20 20.8 9 12.5
2007 0 0 0 23 22.1 15 15.1
2008 0 0 2 11 18.2 17 14.4
2009 0 0 0 0 8.5 18 14
2010 0 0 0 15 11.7 13 6.5
2011 0 0 0 0 NA 0 NA

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© 2011

California Advocates for Nursing Home Reform
( CANHR )
650 Harrison Street, 2nd Floor
San Francisco, CA 94107
Tel: (800) 474-1116 (consumers only)
Tel: (415) 974-5171