General Information: KNOTT AVENUE CARE CENTER
Nursing home name KNOTT AVENUE CARE CENTER
Address9021 KNOTT AVE
BUENA PARK, CA 90620
Phone number (714) 826-2330
Located within a hospital No
Type of ownership For profit - Corporation
Owner operates multiple homesNo
Accept Medicare or Medicaid Medicare and Medicaid
Continue Care Retirement CommunityNo
Resident and family councils Resident
Certified number of beds 99
Total number of residents 90
Perc of occupied beds 90
Sprinkler status Yes
Number of Facility Reported Incidents0
Number of Substantiated Complaints1
Number of Fines0
Total Amount of Fines$0
Total Number of Penalties0
Total Number of Penalties0
Ratings Summary: KNOTT AVENUE CARE CENTER
Overall rating 3
3
Nursing Home Staffing 3
3
Registered Nurses only 2
2
Health Inspections 2
2
Quality Measures 5
5
Nursing Home Staffing Info: KNOTT AVENUE CARE CENTER
National AverageCalifornia AverageKNOTT AVENUE CARE CENTER
Overall staff rating NA NA 3
3
Registered Nurses only rating NANA 2
2
Total Number of Residents NA NA 90
Total Number of Nurse Staff Hours per Resident per Day 4.11 hours 4.49 hours 5.0 hours
Total Number of Licensed Nurse Staff Hours per Resident per Day 1.64 hours 1.8 hours 2.91 hours
Registered Nurses Hours per Residents per Day 0.81 hours 0.88 hours 0.72 hours
Licensed Practical or Vacation Nurses Hours per Resident per Day 0.83 hours 0.92 hours 2.2 hours
Certified Nursing Assistants Hours per Residents per Day 2.47 hours 2.69 hours 2.09 hours
Physical Therapy Staffing Hours per Resident Per Day 0.1 hours 0.14 hours 0.06 hours
Health Survey: KNOTT AVENUE CARE CENTER
Heath Survey Summary on 2014-01-31
Total Number of Health Deficiencies 14
Scope and Severity of most Severe Health Deficiency Widespread /Minimal harm or potential for actual harm
Heath Survey Summary on 2012-12-31
Total Number of Health Deficiencies 13
Scope and Severity of most Severe Health Deficiency Isolated/Minimal harm or potential for actual harm
Heath Survey Summary on 2011-11-21
Total Number of Health Deficiencies 13
Scope and Severity of most Severe Health Deficiency Isolated/Actual harm
Health Survey Details: KNOTT AVENUE CARE CENTER
Inspection Results: 01/31/2014
Corrected Deficiency Scope and Severity
02/20/2014 Ensure that residents are fully informed and understand their health status, care and treatments. Isolated/Minimal harm or potential for actual harm
02/20/2014 Give residents a notice of rights, rules, services and charges. Isolated/Minimal harm or potential for actual harm
02/20/2014 Develop and implement policies for 1) screening and training employees; and the 2) prevention, identification, investigation, and reporting of any abuse, neglect, mistreatment and misappropriation of property. Isolated/Minimal harm or potential for actual harm
02/20/2014 Provide a safe, clean, comfortable and home-like environment; and allow residents to use personal belongings to the extent possible. Isolated/Minimal harm or potential for actual harm
02/20/2014 Develop a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. Isolated/Minimal harm or potential for actual harm
02/20/2014 Maintain 15 months of resident assessments in the resident's active clinical record. Widespread /Minimal harm or potential for actual harm
02/20/2014 Provide necessary care and services to maintain or improve the highest well being of each resident . Isolated/Minimal harm or potential for actual harm
02/20/2014 Ensure that a nursing home area is free from accident hazards and provide adequate supervision to prevent avoidable accidents. Isolated/Minimal harm or potential for actual harm
02/20/2014 Provide routine and emergency drugs through a licensed pharmacist and only under the general supervision of a licensed nurse. Isolated/Minimal harm or potential for actual harm
02/20/2014 At least once a month, have a licensed pharmacist review each resident's medication(s) and report any irregularities to the attending doctor. Isolated/Minimal harm or potential for actual harm
02/20/2014 Have a program that investigates, controls and keeps infection from spreading. Isolated/Minimal harm or potential for actual harm
02/20/2014 Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public. Isolated/Minimal harm or potential for actual harm
02/20/2014 Keep accurate, complete and organized clinical records on each resident that meet professional standards. Isolated/Minimal harm or potential for actual harm
02/20/2014 Train all employees on what to do in an emergency, and carry out unannounced staff drills. Widespread /Minimal harm or potential for actual harm
Inspection Results: 12/31/2012
Corrected Deficiency Scope and Severity
01/17/2013 Ensure residents maintain acceptable nutritional status. Isolated/Minimal harm or potential for actual harm
01/17/2013 Have a program that investigates, controls and keeps infection from spreading. Isolated/Minimal harm or potential for actual harm
01/17/2013 Maintain drug records and properly mark/label drugs and other similar products according to accepted professional standards. Isolated/Minimal harm or potential for actual harm
01/17/2013 Prepare food that is nutritional, appetizing, tasty, attractive, well-cooked, and at the right temperature. Isolated/Minimal harm or potential for actual harm
01/17/2013 Ensure that each resident's 1) entire drug/medication regimen is free from unnecessary drugs; and 2) is managed and monitored to achieve highest level of well-being. Isolated/Minimal harm or potential for actual harm
01/17/2013 Keep accurate, complete and organized clinical records on each resident that meet professional standards. Isolated/Minimal harm or potential for actual harm
01/17/2013 Ensure that a nursing home area is free from accident hazards and provide adequate supervision to prevent avoidable accidents. Isolated/Minimal harm or potential for actual harm
01/17/2013 Ensure that residents with limited range of motion receive appropriate treatment and services to increase range of motion or prevent further decrease in range of motion. Isolated/Minimal harm or potential for actual harm
01/17/2013 Give residents proper treatment to prevent new bed (pressure) sores or heal existing bed sores. Isolated/Minimal harm or potential for actual harm
01/17/2013 Provide necessary care and services to maintain or improve the highest well being of each resident . Isolated/Minimal harm or potential for actual harm
01/17/2013 Ensure services provided by the nursing facility meet professional standards of quality. Isolated/Minimal harm or potential for actual harm
01/17/2013 Develop and implement policies for 1) screening and training employees; and the 2) prevention, identification, investigation, and reporting of any abuse, neglect, mistreatment and misappropriation of property. Isolated/Minimal harm or potential for actual harm
01/17/2013 Set up an ongoing quality assessment and assurance group to review quality deficiencies quarterly, and develop corrective plans of action. Isolated/Minimal harm or potential for actual harm
Inspection Results: 11/21/2011
Corrected Deficiency Scope and Severity
01/05/2012 Ensure that residents are fully informed and understand their health status, care and treatments. Isolated/Minimal harm or potential for actual harm
01/05/2012 Properly hold, secure, and manage each resident's personal money which is deposited with the nursing home. Isolated/Minimal harm or potential for actual harm
02/08/2012 Provide necessary care and services to maintain or improve the highest well being of each resident . Isolated/Minimal harm or potential for actual harm
02/08/2012 Ensure that each resident who enters the nursing home without a catheter is not given a catheter, unless medically necessary, and that incontinent patients receive proper services to prevent urinary tract infections and restore normal bladder functions. Isolated/Minimal harm or potential for actual harm
01/05/2012 Ensure that a nursing home area is free from accident hazards and provide adequate supervision to prevent avoidable accidents. Isolated/Minimal harm or potential for actual harm
01/05/2012 Ensure that each resident's 1) entire drug/medication regimen is free from unnecessary drugs; and 2) is managed and monitored to achieve highest level of well-being. Isolated/Actual harm
02/08/2012 1) Provide 3 meals at regular times; 2) serve breakfast within 14 hours of dinner; and 3) offer a snack at bedtime each day. Pattern/Potential for minimal harm
02/08/2012 At least once a month, have a licensed pharmacist review each resident's medication(s) and report any irregularities to the attending doctor. Isolated/Minimal harm or potential for actual harm
01/05/2012 Maintain drug records and properly mark/label drugs and other similar products according to accepted professional standards. Isolated/Minimal harm or potential for actual harm
01/05/2012 Have a program that investigates, controls and keeps infection from spreading. Widespread /Minimal harm or potential for actual harm
02/08/2012 Keep accurate, complete and organized clinical records on each resident that meet professional standards. Pattern/Potential for minimal harm
01/05/2012 Keep clinical record information safe. Pattern/Minimal harm or potential for actual harm
01/05/2012 Set up an ongoing quality assessment and assurance group to review quality deficiencies quarterly, and develop corrective plans of action. Widespread /Minimal harm or potential for actual harm

Fire Safety Survey: KNOTT AVENUE CARE CENTER
Fire Safety Survey Summary on 2014-02-04
Total Number of Fire SafetyDeficiencies 7
Scope and Severity of most Severe Health Deficiency Pattern/Minimal harm or potential for actual harm
Fire Safety Survey Summary on 2013-01-02
Total Number of Fire SafetyDeficiencies 4
Scope and Severity of most Severe Health Deficiency Isolated/Minimal harm or potential for actual harm
Fire Safety Survey Summary on 2011-11-23
Total Number of Fire SafetyDeficiencies 7
Scope and Severity of most Severe Health Deficiency Pattern/Minimal harm or potential for actual harm
Fire Safety Survey: KNOTT AVENUE CARE CENTER
Fire Safety Survey Results: 02/04/2014
Corrected Deficiency Severity
02/19/2014 Approved construction type or materials. Pattern/Minimal harm or potential for actual harm
02/19/2014 Corridor and hallway doors that block smoke. Isolated/Minimal harm or potential for actual harm
02/19/2014 Smoke barrier doors that can resist smoke for at least 20 minutes. Pattern/Minimal harm or potential for actual harm
02/19/2014 Automatic sprinkler systems that have been maintained in working order. Pattern/Minimal harm or potential for actual harm
02/19/2014 Posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed. Widespread/Potential for minimal harm
02/19/2014 Properly protected cooking facilities. Isolated/Minimal harm or potential for actual harm
02/19/2014 Proper medical gas storage and administration areas. Isolated/Minimal harm or potential for actual harm
Fire Safety Survey Results: 01/02/2013
Corrected Deficiency Severity
01/14/2013 An approved installation, maintenance and testing program for fire alarm systems. Isolated/Minimal harm or potential for actual harm
01/14/2013 Weekly inspections and monthly testing of generators. Widespread/Potential for minimal harm
01/14/2013 Record of quarterly fire drills for each shift under varying conditions. Widespread/Potential for minimal harm
01/14/2013 Exits that are accessible at all times. Isolated/Minimal harm or potential for actual harm
Fire Safety Survey Results: 11/23/2011
Corrected Deficiency Severity
12/12/2011 Record of quarterly fire drills for each shift under varying conditions. Isolated/Minimal harm or potential for actual harm
12/12/2011 Approved construction type or materials. Isolated/Minimal harm or potential for actual harm
12/12/2011 An approved installation, maintenance and testing program for fire alarm systems. Pattern/Minimal harm or potential for actual harm
12/12/2011 Automatic sprinkler systems that have been maintained in working order. Isolated/Minimal harm or potential for actual harm
12/12/2011 Weekly inspections and monthly testing of generators. Isolated/Minimal harm or potential for actual harm
12/12/2011 Properly installed electrical wiring and equipment. Pattern/Minimal harm or potential for actual harm
12/12/2011 An approved back-up procedure for a faulty fire alarm system. Widespread/Potential for minimal harm

Resident Complaints: KNOTT AVENUE CARE CENTER
Date Complaint Substantiated: 05/08/2013
CorrectedCategoryDeficiencySeverity
06/08/2013Provide medically-related social services to help each resident achieve the highest possible quality of life. D

Quality Measures: KNOTT AVENUE CARE CENTER
Quality Measures National Average California Average KNOTT AVENUE CARE CENTER
Overall quality rating NA NA 5
5
Long-Stay Residents
Percent of Long Stay Residents Whose Need for Help with ADLs has Increased 15.4% 11.7% 4.8%
Percent of Long Stay Residents Who Self Report Moderate to Severe Pain 8.3% 5.9% 3.0%
Percent of High Risk Long Stay Residents With Pressure Ulcers 6.1% 6.2% 12.8%
Percent of Long Stay Residents Who Lose Too Much Weight 7.2% 5.8% 6.2%
Percent of Low Risk Long Stay Residents Who Lose Control of Their Bowel or Bladder 43.9% 45.3% %
Percent of Long Stay Residents with a Catheter Inserted and Left in Their Bladder 3.2% 3.3% 7.0%
Percent of Long Stay Residents With a Urinary Tract Infection 6.2% 5.3% 0.4%
Percent of Long Stay Residents Who Have Depressive Symptoms 6.3% 1.8% 0.0%
Percent of Long Stay Residents Who Were Physically Restrained 1.4% 2.1% 0.0%
Percent of Long Stay Residents Experiencing One or More Falls with Major Injury 3.2% 1.6% 0.0%
Percent of Long Stay Residents Assessed and Appropriately Given the Seasonal Influenza Vaccine 92.7% 92.3% 100.0%
Percent of Long Stay Residents Assessed and Appropriately Given the Pneumococcal Vaccine 94.3% 94.6% 100.0%
Percent of Long Stay Residents Who Received an Antipsychotic Medication 20.7% 16.5% 9.1%
Short-Stay Residents
Percent of Short Stay Residents Who Self Report Moderate to Severe Pain 19.2% 16.9% 22.5%
Percent of Short Stay Residents With Pressure Ulcers That Are New or Worsened 1.2% 0.9% 0.0%
Percent of Short Stay Residents Who Were Assessed and Appropriately Given the Seasonal Influenza Vaccine 83.4% 81.1% 97.4%
Percent of Short Stay Residents Assessed and Appropriately Given the Pneumococcal Vaccine 82.4% 79.8% 98.0%
Percent of Short Stay Residents Who Newly Received an Antipsychotic Medication 2.6% 2.0% 1.9%

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