Devonshire Oaks Nursing Center
Devonshire Oaks Nursing Center is a 3-star rated nursing home in Redwood City, CA with 38 beds. CMS sub-ratings: health inspections 4/5, staffing 1/5, quality measures 4/5.
The facility has 68 health violations on record. Federal fines total $655 across 1 enforcement action. Most recent inspection: January 17, 2025.
Staff turnover rate: 64.7% — significantly above the national average.
Data synthesized from CMS.gov and California public inspection records. Reviewed by Christopher F. Nesbitt, Sr., NR-EMT & BU-trained Paralegal.
Inspection History Overview
Data current as of May 7, 2026 · Source: CMS Provider Data
Detailed Inspection Reports
No detailed inspection reports available yet. Check back soon as we're processing new reports daily.
Fines and Penalties by Year
2021 1 penalties totaling $655
Fine
Health Violations by Year
2025 6 violations
Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Arrange for the provision of hospice services or assist the resident in transferring to a facility that will arrange for the provision of hospice services.
2023 17 violations
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
Honor the resident's right to be treated with respect and dignity and to retain and use personal possessions.
Reasonably accommodate the needs and preferences of each resident.
Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.
Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.
Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
Ensure necessary information is communicated to the resident, and receiving health care provider at the time of a planned discharge.
Post nurse staffing information every day.
Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.
Employ sufficient staff with the appropriate competencies and skills sets to carry out the functions of the food and nutrition service, including a qualified dietician.
Provide sufficient support personnel to safely and effectively carry out the functions of the food and nutrition service.
Ensure menus must meet the nutritional needs of residents, be prepared in advance, be followed, be updated, be reviewed by dietician, and meet the needs of the resident.
Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Establish a governing body that is legally responsible for establishing and implementing policies for managing and operating the facility and appoints a properly licensed administrator responsible for managing the facility.
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
2021 10 violations
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Ensure medication error rates are not 5 percent or greater.
Provide sufficient support personnel to safely and effectively carry out the functions of the food and nutrition service.
Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Set up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action.
Permit a resident to return to the nursing home after hospitalization or therapeutic leave that exceeds bed-hold policy.
Provide and implement an infection prevention and control program.
Assess the resident when there is a significant change in condition
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
2020 2 violations
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
2019 20 violations
Prepare residents for a safe transfer or discharge from the nursing home.
Ensure that residents are fully informed and understand their health status, care and treatments.
Develop and implement policies and procedures to prevent abuse, neglect, and theft.
Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.
Notify the resident or the resident’s representative in writing how long the nursing home will hold the resident’s bed in cases of transfer to a hospital or therapeutic leave.
Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Ensure services provided by the nursing facility meet professional standards of quality.
Ensure necessary information is communicated to the resident, and receiving health care provider at the time of a planned discharge.
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Provide enough food/fluids to maintain a resident's health.
Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures.
Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited.
Ensure medication error rates are not 5 percent or greater.
Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.
Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Arrange for the provision of hospice services or assist the resident in transferring to a facility that will arrange for the provision of hospice services.
Develop and implement policies and procedures for flu and pneumonia vaccinations.
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
2018 7 violations
Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
Ensure necessary information is communicated to the resident, and receiving health care provider at the time of a planned discharge.
Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Arrange for the provision of hospice services or assist the resident in transferring to a facility that will arrange for the provision of hospice services.
Provide and implement an infection prevention and control program.
2017 6 violations
1) Receive registry verification that a nurse aide has met the required training and skills that the State requires; and 2) ensure nurse aides receive the required retraining after 24 months if nursing related services were not provided for monetary compensation.
Ensure that residents are fully informed and understand their health status, care and treatments.
Keep the rate of medication errors (wrong drug, wrong dose, wrong time) to less than 5%.
Store, cook, and serve food in a safe and clean way.
Provide routine and emergency drugs through a licensed pharmacist and only under the general supervision of a licensed nurse.
Maintain drug records and properly mark/label drugs and other similar products according to accepted professional standards.
Frequently Asked Questions About Devonshire Oaks Nursing Center
- What violations has Devonshire Oaks Nursing Center received?
- Devonshire Oaks Nursing Center has 68 health and safety violation(s) documented by CMS inspections. All violation data comes from official Medicare inspection reports and is updated regularly from government sources.
- What is the quality rating of Devonshire Oaks Nursing Center?
- Devonshire Oaks Nursing Center has a 3-star rating out of 5 from CMS. This is an average rating, meeting basic quality standards. The rating is based on health inspections, staffing levels, and quality measures.
- When was Devonshire Oaks Nursing Center last inspected?
- Inspection reports are documented by state survey agencies and the Centers for Medicare & Medicaid Services (CMS). Reports typically lag 2-3 months behind the actual inspection date. Visit the facility's full profile page for detailed violation information and inspection history.
- Is Devonshire Oaks Nursing Center safe?
- Safety at Devonshire Oaks Nursing Center should be evaluated based on multiple factors: the facility's CMS rating, recent violation history, and personal visits. We recommend reviewing the complete inspection history, speaking with current residents and families, consulting healthcare professionals, and visiting in person before making placement decisions.
- How do I contact Devonshire Oaks Nursing Center?
- Phone: (650) 366-9503. Address: 3635 Jefferson Avenue, Redwood City, CA. For visiting hours and admission information, call the facility directly.
- What services does Devonshire Oaks Nursing Center offer?
- Devonshire Oaks Nursing Center is a skilled nursing facility with 38 beds. The facility accepts Medicare and Medicaid. For specific services like rehabilitation, memory care, or short-term recovery, contact the facility directly.
- What are better facilities near Redwood City, CA?
- Compare Devonshire Oaks Nursing Center with other nursing homes in Redwood City, CA on our facilities page. Filter by star rating, bed count, and recent inspection results to find the best match for your needs.
Editorial Standards & Data Oversight
Data Source: This report is based on official public inspection records from the Centers for Medicare & Medicaid Services (CMS) Provider Data Catalog.
Editorial Process: Content generated using AI to synthesize complex regulatory data, then reviewed and verified for accuracy by our editorial team.
Professional Review: All content undergoes standards and compliance oversight by Christopher F. Nesbitt, Sr., Nationally Registered EMT & BU-trained Paralegal, using professional regulatory data auditing protocols.
This page is maintained by NursingHomeNews.org and is not affiliated with Devonshire Oaks Nursing Center.