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

From CANHR questionnaire returned 10/20/2002:
"Alzheimer's Unit": NoWanderer alert: Yes
Locked Ward: No
Types of Residents Accepted: D E I L O P Q S T U V
Types of Residents Not Accepted: A B F J M N R
Languages spoken by direct-care staff: I Y
Family Council: Yes

Violations Record
From Dept. of Public Health as of 2/25/2008;
Citations as of 4/23/2008.
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
2002 0 0 3 51 12.7 49 5.8
2003 0 0 1 16 15 44 8.5
2004 0 0 1 27 17.8 27 9.2
2005 0 0 0 24 19.6 31 10.4
2006 0 0 0 37 20.8 37 12.5
2007 0 0 0 21 21.2 35 14.7

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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

From CANHR questionnaire returned 3/4/1998:
"Alzheimer's Unit": NoWanderer alert: No
Locked Ward: No
Types of Residents Accepted: A D E F I L M O
Types of Residents Not Accepted: J N
Languages spoken by direct-care staff: I gg ii jj kk
Family Council: Not Specified

Violations Record
From Dept. of Public Health as of 2/25/2008;
Citations as of 4/23/2008.
Last DHS Certification Inspection = 11/14/2007.
How to interpret violations data.
Year Citations Deficiencies Complaints
  AA A B Rec'd Ca. Avg Rec'd Ca. Avg
2002 0 0 0 11 12.7 0 5.8
2003 0 0 0 18 15 2 8.5
2004 0 0 0 14 17.8 0 9.2
2005 0 0 0 15 19.6 0 10.4
2006 0 0 0 17 20.8 1 12.5
2007 0 0 0 21 21.2 1 14.7

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City: Lakeport

Evergreen Lakeport Healthcare Center
(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 2/25/2008;
Citations as of 4/23/2008.
Last DHS Certification Inspection = 6/14/2007.
How to interpret violations data.
Year Citations Deficiencies Complaints
  AA A B Rec'd Ca. Avg Rec'd Ca. Avg
2002 0 0 0 13 12.7 8 5.8
2003 0 0 1 28 15 24 8.5
2004 0 0 1 15 17.8 4 9.2
2005 0 0 3 26 19.6 25 10.4
2006 0 0 1 40 20.8 19 12.5
2007 1 1 5 42 21.2 31 14.7

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City: Lakeport

Lakeport Skilled Nursing Center, Inc.
(707) 263-6101 — 625 16th. Street — Lakeport, CA 95453

Services
How to interpret services information.

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

From CANHR questionnaire returned 1/1/1997:
"Alzheimer's Unit": YesWanderer alert: Yes
Locked Ward: No
Types of Residents Accepted: A B D E I L O
Types of Residents Not Accepted: F J M N
Languages spoken by direct-care staff: A I pp
Family Council: No Family Council

Violations Record
From Dept. of Public Health as of 2/25/2008;
Citations as of 4/23/2008.
Last DHS Certification Inspection = 2/28/2007.
How to interpret violations data.
Year Citations Deficiencies Complaints
  AA A B Rec'd Ca. Avg Rec'd Ca. Avg
2002 0 0 3 40 12.7 14 5.8
2003 0 0 0 43 15 19 8.5
2004 0 1 5 41 17.8 13 9.2
2005 0 1 3 53 19.6 32 10.4
2006 0 0 2 42 20.8 29 12.5
2007 0 0 0 23 21.2 31 14.7

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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

From CANHR questionnaire returned 3/18/1993:
"Alzheimer's Unit": YesWanderer alert: Yes
Locked Ward: Yes
Types of Residents Accepted: B F I J L N S
Types of Residents Not Accepted: A O
Languages spoken by direct-care staff:
Family Council: Yes

Violations Record
From Dept. of Public Health as of 2/25/2008;
Citations as of 4/23/2008.
Last DHS Certification Inspection = 6/6/2007.
How to interpret violations data.
Year Citations Deficiencies Complaints
  AA A B Rec'd Ca. Avg Rec'd Ca. Avg
2002 0 0 0 4 12.7 8 5.8
2003 0 0 0 5 15 8 8.5
2004 0 0 0 7 17.8 15 9.2
2005 0 0 0 11 19.6 6 10.4
2006 0 0 0 20 20.8 9 12.5
2007 0 0 0 23 21.2 15 14.7

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© 2007

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