The nursing home failed to keep the area free of hazards and provide enough supervision to prevent accidents. Cited August 2023 — isolated incident, actual harm.
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F-Tag 689 — 42 CFR §483.25(d) — S/S: G
Nursing home report
DEVONSHIRE OAKS NURSING CENTER
REDWOOD CITY, CA · Medicare-certified · 38 beds
In good standing
For-profit
3 of 5 overall
Overall rating: 3 out of 5 stars. Devonshire Oaks Nursing Center has stronger health inspection and quality ratings (4 stars each), but staffing is very low at 1 star; there were no fines in the last 24 months, and recent inspection citations included accident prevention and food safety/temperature issues.
Facility ratings
Health inspections
Staffing
Quality measures
Last inspection: February 18, 2025Penalties, last 24 months: $0
Federal guidance recommends at least 4.1 nursing hours per resident each day. This facility reports not reported.
Resident outcomes
How often residents experience these outcomes, with the direction over the past year.
Long-stay residents on antipsychotic medication
9.1%Steady
Residents with a fall causing major injury
0%Steady
Residents with pressure ulcers (bedsores)
2.3%Worsening
Residents with a urinary tract infection
1.1%Steady
Residents who lost too much weight
12.6%Worsening
Residents who were physically restrained
0%Steady
Residents needing more help with daily activities
9%Improving
Residents whose ability to walk got worse
6.8%Steady
Show all measures
Long-stay residents on antianxiety or sleep medication
8%Improving
Short-stay residents newly given an antipsychotic
0.7%Improving
Residents with a long-term catheter
2.6%Steady
Residents with new or worsening incontinence
12.8%Improving
Residents with depressive symptoms
2.8%Steady
Long-stay residents given the seasonal flu vaccine
85.7%Steady
Long-stay residents given the pneumonia vaccine
95.7%Worsening
Short-stay residents given the seasonal flu vaccine
79.1%Steady
Short-stay residents given the pneumonia vaccine
81.9%Improving
What the inspectors found
The home failed to make sure food was safely sourced, stored, prepared, and served according to professional standards. Cited January 2025 — widespread issue, potential for harm.
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F-Tag 812 — 42 CFR §483.60(i) — S/S: F
The home failed to make food and drinks appealing and served them at a safe, appetizing temperature. Cited November 2021 — widespread issue, potential for harm.
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F-Tag 804 — 42 CFR §483.60 — S/S: F
The home failed to have an ongoing quality review group that finds problems and makes corrective plans. Cited November 2021 — widespread issue, potential for harm.
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F-Tag 867 — 42 CFR §483.75 — S/S: F
The home failed to make sure important discharge information was shared with the resident and the next health care provider. Cited October 2023 — limited pattern, potential for harm.
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F-Tag 661 — 42 CFR §483.21 — S/S: E
Recent history
- INSPECTION
Health inspection found 6 health deficiencies.
See what inspectors found
- INSPECTION
Health inspection found 15 health deficiencies.
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- INSPECTION
Health inspection found 1 health deficiency.
See what inspectors found
Operator & ownership
- Ownership
- For profit - Corporation
- Occupancy
- 32.4 residents on an average day (85% of 38 beds)
- Resident voice
- Resident council
- Medicare history
- Certified for 21 years
Things at a nursing home change — inspections, staffing, ownership, news.
Source: Centers for Medicare & Medicaid Services — public records, updated monthly. GoodStanding presents official records with plain-language summaries. Always visit a facility in person.