Piedmont Gardens Health Facility

Name: Piedmont Gardens Health Facility
Address: 110 41ST STREET, Oakland, CA, 94611, US
Telephone: 5106547172

110 41st Street, Oakland, CA 94611 · Alameda County · 94 certified beds · avg 64 residents/day · certified since Jul 7, 1969

Part of chain: HUMANGOOD (17 facilities, chain avg rating 4.5★)

5/5

Health inspection rating (on-site)

Serious findings on record

Fines, last 3 years

4.88

Nurse hours/resident/day (adjusted)

What health inspectors found (on-site government inspections — the most independent evidence available)

Health inspection rating: ★★★★★5/5 · CMS overall rating: 5/5

The health inspection star above is graded on a curve within each state — a set share of each state's facilities gets each star level — so a facility can have few citations and still rate 2–3 stars if others in its state did even better. The overall rating combines that inspection score with staffing and self-reported quality measures.

All citations in the current public record (11)

CMS publishes roughly the last three inspection cycles plus recent complaint investigations. Older surveys drop out of the record as new ones are completed.

Date	Severity	What the facility was cited for
Jan 30, 2025	E · Potential for harm, repeated	The facility did not develop or follow a complete care plan for each resident — the written roadmap covering all of a resident's needs, with measurable goals and timelines.
Jan 30, 2025	E · Potential for harm, repeated	The facility did not have or follow an effective program to prevent and control infections — such as proper hand washing, cleaning, and isolation practices. This is the most commonly cited deficiency nationwide.
Jan 30, 2025	D · Potential for harm, one-off	The facility did not provide a safe, clean, comfortable, and homelike environment, including safe support for residents' daily living needs.
Nov 17, 2022	E · Potential for harm, repeated	The facility did not provide treatment and care that follows the doctor's orders and matches the resident's own preferences and goals.
Nov 17, 2022	E · Potential for harm, repeated	The facility did not get its food from approved, safe sources, or did not store, prepare, and serve food according to professional food safety standards.
Nov 17, 2022	D · Potential for harm, one-off	The facility allowed residents to lose the ability to do daily activities — like bathing, dressing, and eating — when there was no medical reason for the decline. Good care helps residents keep the abilities they have.
Nov 17, 2022	D · Potential for harm, one-off	The facility did not have a licensed pharmacist review each resident's complete medication regimen and medical chart every month, or did not follow its own rules for reporting medication problems.
Nov 17, 2022	D · Potential for harm, one-off	The facility did not have a working program to monitor how antibiotics are used. Tracking antibiotic use helps make sure these drugs are given only when needed and remain effective.
Apr 11, 2019	E · Potential for harm, repeated	The facility did not label drugs according to professional standards or did not store them in locked compartments, with controlled drugs (medications with a high risk of misuse) kept under a separate lock.
Apr 11, 2019	D · Potential for harm, one-off	The facility did not develop or follow a complete care plan for each resident — the written roadmap covering all of a resident's needs, with measurable goals and timelines.
Apr 11, 2019	D · Potential for harm, one-off	The facility did not provide safe and appropriate pain management for a resident who needed it.

Inspection trend by year

Citations from standard inspections decreased between the last two inspection cycles (5 → 3).

Year	Citations	Worst severity that year
2019	3	E
2022	5	E
2025	3	E

Counts reflect the current CMS public record (~3 inspection cycles plus complaint investigations); years with no surveys show no row. Inspection frequency varies, so compare severity as well as counts.

Fines and enforcement (last 3 years)

No fines or payment denials in the published 3-year window.

Nurse staffing (from payroll records, adjusted for how much care residents need)

Measure	This facility	California avg	U.S. avg	Where it stands
Total nurse staffing (hours per resident per day)	4.88	4.31	3.95	top 18% in California; top 15% in the U.S.
Registered Nurse hours	1.15	0.61	0.69	top 7% in California; top 11% in the U.S.
Weekend total nurse staffing	4.63	3.90	3.50	top 12% in California; top 10% in the U.S.
Weekend RN hours (not acuity-adjusted)	0.91	0.51	0.48	top 9% in California; top 8% in the U.S.
Total nursing staff turnover (%)	21.2	36.7	45.8	top 9% in California; top 4% in the U.S.
RN turnover (%)	33.3	38.1	42.9	top 40% in California; top 33% in the U.S.

Hours are per resident per day, case-mix adjusted by CMS so facilities caring for sicker residents can be compared fairly (same basis as the CMS staffing star). "Top X%" means better than most facilities: more staffing hours, or lower turnover. Raw (unadjusted) reported hours: total 4.76, RN 1.12, weekend 4.51. Staffing rating: 5/5.

Self-reported quality measures

Note: these ratings are based on data the facility reports about itself to CMS. They are not independently verified by inspectors, and can look better than inspection findings. Give more weight to the inspection results above.

Quality measures rating: 4/5 · long-stay residents: 4/5 · short-stay residents: 4/5

Who owns this facility

Non profit - Corporation

Owner / manager	Type	Role	Stake	Since
Humangood Norcal	Organization	5% or Greater Direct Ownership Interest	100%	01/01/1969
Baker Tilly Advisory Group LP	Organization	ADP of the SNF	NOT APPLICABLE	03/21/2025
Baker Tilly Advisory Group, LP	Organization	ADP of the SNF	NOT APPLICABLE	03/21/2025
Baker Tilly Us LLP	Organization	ADP of the SNF	NOT APPLICABLE	10/15/2024
Baker, Judith	Individual	Corporate Director	NOT APPLICABLE	04/25/2012
Baker, Judith	Individual	Operational/Managerial Control	NOT APPLICABLE	05/01/2016
Battison, William	Individual	Corporate Director	NOT APPLICABLE	05/01/2016
Battison, William	Individual	Operational/Managerial Control	NOT APPLICABLE	05/01/2016
Brown, Herman	Individual	Corporate Director	NOT APPLICABLE	05/01/2016
Brown, Herman	Individual	Corporate Officer	NOT APPLICABLE	05/01/2016
Christopherson, Joanne	Individual	Corporate Director	NOT APPLICABLE	03/20/2025
Christopherson, Joanne	Individual	Operational/Managerial Control	NOT APPLICABLE	03/20/2025
Cochrane, John	Individual	Corporate Officer	NOT APPLICABLE	08/10/2009
Cochrane, John	Individual	Operational/Managerial Control	NOT APPLICABLE	08/10/2009
Dhugga, Gurpreet	Individual	Operational/Managerial Control	NOT APPLICABLE	01/01/2013
Dhugga, Gurpreet	Individual	ADP of the SNF	NOT APPLICABLE	01/01/2013
Feller, Irene	Individual	Corporate Director	NOT APPLICABLE	01/26/2021
Feller, Irene	Individual	Operational/Managerial Control	NOT APPLICABLE	01/26/2021
Gesinger, Jana	Individual	Operational/Managerial Control	NOT APPLICABLE	06/01/2021
Gesinger, Jana	Individual	ADP of the SNF	NOT APPLICABLE	06/01/2021

Questions to ask on your visit

Generated from this facility's actual citation record — bring them to a tour and ask the administrator directly.

"Can you show me an example care plan, and how are families included when it's created and updated?"
"Who leads your infection prevention program, and how do you make sure staff follow practices like hand hygiene every day?"
"Can we tour the resident rooms, bathrooms, and common areas today, including areas not on the usual tour route?"
"How do you make sure each resident's care follows the doctor's orders, and what changed after this citation?"
"What did your most recent kitchen inspection find, and can I see how food is stored and prepared?"
"How do you help residents maintain their daily living skills, and how do you measure whether it's working?"
"Does a pharmacist review every resident's medications and chart monthly, and how are their concerns acted on?"
"Who oversees antibiotic use here, and how do you decide when an antibiotic is really needed?"
"What is your current ratio of nursing staff to residents on day, evening, and weekend shifts?"
"Can I see the results and plan of correction from your most recent state inspection?"

Nearby facilities (within 20 miles)

Facility	Distance	City	Overall	Inspection
The Rehabilitation Center of Oakland	0.6 mi	Oakland, CA	★☆☆☆☆	1/5
Oakland Healthcare & Wellness Center	0.7 mi	Oakland, CA	★★★★★	4/5
Lake Merritt Healthcare Center LLC	0.8 mi	Oakland, CA	★★☆☆☆	2/5
St Paul's Towers	1.1 mi	Oakland, CA	★★★★★	4/5
McClure Post Acute	1.2 mi	Oakland, CA	★★★★★	5/5
Medical Hill Healthcare Center	1.2 mi	Oakland, CA	★★★★★	4/5
Lake Park Healthcare Center	1.5 mi	Oakland, CA	★★★☆☆	3/5
Berkeley Pines Skilled Nursing Center	2.1 mi	Berkeley, CA	★★☆☆☆	2/5
Bay Area Healthcare Center	2.2 mi	Oakland, CA	★★★★★	5/5
Ashby Care Center	2.3 mi	Berkeley, CA	★★☆☆☆	2/5
Oakland Heights Nursing and Rehabilitation	2.4 mi	Oakland, CA	★★★★★	4/5
Elmwood Care Center	2.4 mi	Berkeley, CA	★★★☆☆	3/5

Compare this facility with the 3 closest →

All facilities in Oakland →

Facility data as of CMS processing date 2026-08-01. CCN 056096.

The Care File

Visit checklist — Piedmont Gardens Health Facility

110 41st Street, Oakland, CA 94611 · 5106547172

Health inspection rating 5/5 · CMS overall 5/5· Fines (3y): $0

Questions for the administrator:

☐ "Can you show me an example care plan, and how are families included when it's created and updated?"
☐ "Who leads your infection prevention program, and how do you make sure staff follow practices like hand hygiene every day?"
☐ "Can we tour the resident rooms, bathrooms, and common areas today, including areas not on the usual tour route?"
☐ "How do you make sure each resident's care follows the doctor's orders, and what changed after this citation?"
☐ "What did your most recent kitchen inspection find, and can I see how food is stored and prepared?"
☐ "How do you help residents maintain their daily living skills, and how do you measure whether it's working?"
☐ "Does a pharmacist review every resident's medications and chart monthly, and how are their concerns acted on?"
☐ "Who oversees antibiotic use here, and how do you decide when an antibiotic is really needed?"
☐ "What is your current ratio of nursing staff to residents on day, evening, and weekend shifts?"
☐ "Can I see the results and plan of correction from your most recent state inspection?"

While you're there, notice:

☐ Smell and cleanliness in hallways, not just the lobby
☐ How staff speak to residents; call lights answered promptly
☐ Residents up, dressed, and engaged (visit mealtimes and a weekend if you can)

Data: CMS Provider Data Catalog, version 2026-08-01 · CCN 056096 · Verify at medicare.gov/care-compare · Printed from The Care File (thecarefile.com)