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Facility Information

Facility ID: 100000022

Register Complaint

Arbor Nursing Center

Other previous Names(s) known as:

  • A & C Health Care Services - Arbor
  • Arbor Convalescent Hospital

900 N Church St
Lodi, Ca   95240

County:San Joaquin

Phone:(209) 333-1222

Fax:(209) 333-1816

Managing District Office

Please contact the following Licensing and Certification office for any questions and/or concerns:

Sacramento District Office
3901 Lennane Drive, Suite 210
Sacramento, CA. 95834
Phone Number: (916) 263-5800

License Information

Licensee: Covenant Care Lodi, Llc
27071 Aliso Creek Road, Suite 100
Aliso Viejo, Ca 92656

Licensee Type: Limited Liability Company

License Number: 100000220

License Status: Active

License Category: Skilled Nursing Facility

License Effective Date: 4/16/2014

Expiration Date: 4/15/2015

Total License Capacity: 149

Bed Classification/Services:

Certification Information
Title 18 = Medicare
Title 19 = Medi-Cal (Medicaid)

Provider Category:SNF/NF

Last Certification Inspection Status:In Compliance

Certification Status:Eligible to Participate

Approval Date:4/14/2014

Nursing Home Compare Five Star Quality Ratings are provided by the Medicare.gov - Nursing Home Compare website.

Complaints/Facility Self-Reported Incidents/Inspection Results Summary

Year: 2014

22ComplaintsComplaints

17Facility Self-Reported IncidentsFacility Self-Reported Incidents

0State Enforcement ActionsEnforcement Actions

31Survey DeficienciesSurvey Deficiencies

Year: 2013

18ComplaintsComplaints

11Facility Self-Reported IncidentsFacility Self-Reported Incidents

1State Enforcement ActionsEnforcement Actions

37Survey DeficienciesSurvey Deficiencies

Year: 2012

9ComplaintsComplaints

6Facility Self-Reported IncidentsFacility Self-Reported Incidents

0State Enforcement ActionsEnforcement Actions

20Survey DeficienciesSurvey Deficiencies

Year: 2011

14ComplaintsComplaints

3Facility Self-Reported IncidentsFacility Self-Reported Incidents

3State Enforcement ActionsEnforcement Actions

8Survey DeficienciesSurvey Deficiencies

Year: 2010

21ComplaintsComplaints

9Facility Self-Reported IncidentsFacility Self-Reported Incidents

1State Enforcement ActionsEnforcement Actions

52Survey DeficienciesSurvey Deficiencies

Year: 2009

2ComplaintsComplaints

0Facility Self-Reported IncidentsFacility Self-Reported Incidents

0State Enforcement ActionsEnforcement Actions

43Survey DeficienciesSurvey Deficiencies

Year: 2008

0ComplaintsComplaints

0Facility Self-Reported IncidentsFacility Self-Reported Incidents

3State Enforcement ActionsEnforcement Actions

111Survey DeficienciesSurvey Deficiencies

Year: 2007

0ComplaintsComplaints

0Facility Self-Reported IncidentsFacility Self-Reported Incidents

2State Enforcement ActionsEnforcement Actions

11Survey DeficienciesSurvey Deficiencies

Year: 2006

0ComplaintsComplaints

0Facility Self-Reported IncidentsFacility Self-Reported Incidents

1State Enforcement ActionsEnforcement Actions

26Survey DeficienciesSurvey Deficiencies

Year: 2005

0ComplaintsComplaints

0Facility Self-Reported IncidentsFacility Self-Reported Incidents

1State Enforcement ActionsEnforcement Actions

12Survey DeficienciesSurvey Deficiencies

Year: 2004

0ComplaintsComplaints

0Facility Self-Reported IncidentsFacility Self-Reported Incidents

0State Enforcement ActionsEnforcement Actions

11Survey DeficienciesSurvey Deficiencies

Administration Information

4/16/2009
to Present

Covenant Care Lodi, Llc
Relationship to Facility: Licensee

1/4/2011
to Present

Petersen, Tyah
Relationship to Facility: Administrator

9/17/2011
to Present

Calvan, Dionicia
Relationship to Facility: Director Of Nursing

Ownership Information

To request additional ownership information about this facility, please click the ownership name below.

12/6/2007
to Present

Lodi Skilled Nursing Facility, A Ca Limited Partnership
Relationship to Facility: Property Owner
Percentage of Ownership: 0

Operating Entities

None found