College Oak Nursing and Rehabilitation Center
Nursing home in Sacramento, CA
Medicare & Medicaid certified3★ overall (CMS)
Public-record details
- Address
- 4635 College Oak Drive, Sacramento, CA 95841
- Phone
- (916) 481-7434
- Listed under
- For-profit
- Medicare CCN
- 056158
- Overall star rating
- 3 of 5 ★★★☆☆
- Health inspection rating
- 3 of 5
- Staffing rating
- 4 of 5
- Quality measures rating
- 4 of 5
- Certified beds
- 120
- Average residents per day
- 115
- Ownership
- For-profit, limited Liability company
- Legal business name
- Spyglass, LLC
- Chain
- Cypress Healthcare Group (13 facilities)
- Certified for
- Medicare and Medicaid
- First approved by Medicare/Medicaid
- Feb 16, 1970
- Changed ownership in last 12 months
- No
- Continuing care retirement community
- No
- Located inside a hospital
- No
- Resident or family council
- Resident council
- Sprinklers in all required areas
- Yes
Inspection record
Most recent standard health inspection: Apr 9, 2026. CMS lists 25 health citations for this facility across its last three standard inspection cycles and complaint inspections (Oct 5, 2023 to May 29, 2026): 6 from complaint inspections, 2 at the “actual harm” level or higher, including 1 at “immediate jeopardy”.
| Inspection | Citation | Severity |
|---|---|---|
| May 29, 2026 | Provide the required documentation or notification related to the resident's needs, appeal rights, or bed-hold policies. | D |
| Apr 9, 2026 | Honor the resident's right to share a room with spouse or roommate of choice and receive written notice before a change is made. | D |
| Apr 9, 2026 | Provide safe, appropriate pain management for a resident who requires such services. | D |
| Apr 9, 2026 | 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… | D |
| Apr 9, 2026 | Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. | D |
| Apr 9, 2026 | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | F |
| Nov 20, 2025 | Provide the required documentation or notification related to the resident's needs, appeal rights, or bed-hold policies. | D |
| Nov 20, 2025 | Ensure the transfer/discharge meets the resident's needs/preferences and that the resident is prepared for a safe transfer/discharge. | J |
| Feb 7, 2025 | Reasonably accommodate the needs and preferences of each resident. | D |
| Feb 7, 2025 | Encode each resident’s assessment data and transmit these data to the State within 7 days of assessment. | D |
| Feb 7, 2025 | Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | D |
| Feb 7, 2025 | Ensure services provided by the nursing facility meet professional standards of quality. | D |
Fines and payment denials
CMS records 1 fine totalling $9,814 in the last three years.
| Nov 20, 2025 | Fine: $9,814 |
Staffing
- Total nurse staffing per resident per day
- 4.33 hours
- Registered nurse (RN) time per resident per day
- 0.81 hours
- Nurse aide time per resident per day
- 2.55 hours
- Total nurse staffing on weekends
- 3.92 hours
- Nursing staff turnover (yearly)
- 40%
- RN turnover (yearly)
- 47%
- Administrators who left in the past year
- 0
A citation is what inspectors found on one date; most are corrected within weeks. Look for patterns — the same problem cited in several inspections — and for anything at the G–L level (actual harm or immediate jeopardy). The full inspection narrative (Form CMS-2567) is linked from Medicare Care Compare, and your state long-term care ombudsman can tell you about complaints.
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