Inspection Reports for
Apple Valley Place
300 Lyndale Street, Osage, IA, 50461
Back to Facility Profile10 Reports
Inspection Report — Apr 27, 2026
Complaint Investigation
Date: Apr 27, 2026
Visit Reason
Investigation of Complaint #131670-C regarding occupancy agreements and medication management.
Complaint Details
Complaint #131670-C
Findings
The program failed to include additional service charges in the occupancy agreement for one tenant receiving CDAC funding. The program also failed to follow medication management policies, including incomplete medication administration documentation and failure to notify the on-call nurse about low blood sugar levels.
Violations (2)
231C.5 2a Written occupancy agreement required: The program failed to include a description of additional services and their related costs on the occupancy agreement for one tenant receiving Consumer-Directed Attendant Care funding.
481-67.2(2) Program Policies and Procedures: The program failed to follow policies related to medication management and on-call nurse communication for one tenant, including missing medication administration records and failure to notify the on-call nurse of low blood sugar levels.
Inspection Report — Apr 23, 2026
Enforcement
Date: Apr 23, 2026
Visit Reason
Investigation #131670-C was conducted from April 23 to April 28, 2026, regarding compliance with medication management policies and on-call nurse communication at the Apple Valley program.
Complaint Details
Investigation #131670-C
Findings
The program failed to follow its medication management policies and on-call nurse communication procedures for one tenant, Tenant C2. Documentation and interviews revealed missed medication administrations and failure to notify the on-call nurse about low blood sugar levels.
Violations (1)
481-67.2(2) The program failed to follow medication management policies by not documenting administration of torsemide 20 mg from 11/06/25 through 11/10/25 and by not properly communicating low blood sugar events to the on-call nurse. Staff did not notify the on-call nurse when Tenant C2 had unusually low blood sugar levels between 10/22/25 and 10/26/25.
Report Facts
Fine amount: 5000
Inspection Report — Dec 8, 2025
Complaint Investigation
Date: Dec 8, 2025
Visit Reason
Investigation of Complaint #130931-C regarding medication policy compliance and staff training.
Complaint Details
Complaint #130931-C
Findings
The program failed to follow its narcotic medication policy and allowed untrained staff to administer medications. Staff A, who had not completed required medication training, signed medication records and had access to controlled substances contrary to policy.
Violations (2)
481-67.2(3) Program Policies and Procedures: The program failed to follow its established narcotic medications policy. Staff A, who had not completed required medication training, signed as the staff member passing medications for Tenant #1.
481-67.5(2)f(2) Medications: The program failed to ensure only authorized staff accessed controlled substances. Staff A, without approved medication training, had access to Tenant #1's lorazepam stored in a locked cabinet.
Inspection Report — Oct 22, 2025
Date: Oct 22, 2025
Visit Reason
The visit was conducted as a recertification survey and investigation of Incident #128690-I to determine compliance with certification rules for an Assisted Living Program.
Findings
No regulatory insufficiencies were cited during the investigation and recertification visit.
Report Facts
Tenants without cognitive impairment: 46
Tenants with cognitive impairment: 5
Inspection Report — May 7, 2025
Complaint Investigation
Date: May 7, 2025
Visit Reason
Investigation of Complaint #128420-C and Complaint #128418-C at the assisted living facility.
Complaint Details
Investigation of Complaint #128420-C and Complaint #128418-C found no regulatory insufficiencies.
Findings
No regulatory insufficiencies were cited during the investigation of the complaints.
Report Facts
Number of tenants without cognitive impairment: 38
Number of tenants with cognitive impairment: 3
Inspection Report — Mar 31, 2025
Renewal
Date: Mar 31, 2025
Visit Reason
The visit was a recertification visit conducted to determine compliance with certification of an Assisted Living Program for People with Dementia and included an investigation of Incident #127424-I.
Complaint Details
Incident #127424-I
Findings
No regulatory insufficiencies were cited during the investigation of Incident #127424-I or the recertification visit.
Inspection Report — Mar 6, 2024
Complaint Investigation
Date: Mar 6, 2024
Visit Reason
Investigation of complaints #119128-C, #119210-C, #119290-C and #119291-C regarding regulatory insufficiencies at the assisted living program.
Complaint Details
Investigation was triggered by complaints #119128-C, #119210-C, #119290-C and #119291-C.
Findings
The investigation found multiple deficiencies including failure to develop adequate incident reporting policies, failure to provide adequate and appropriate care and treatment to tenants, medication administration errors, inadequate staff training and nurse delegation, incomplete tenant evaluations and service plans, failure to complete nurse reviews, incomplete documentation of nurse's notes by exception, failure to complete medication error and incident reports, and unsafe food temperature practices.
Violations (10)
Failed to develop incident reporting policies and procedures meeting minimum standards including all requirements.
Failed to provide tenants with adequate and appropriate care, treatment and services as scheduled and ordered.
Failed to administer medications and treatments as prescribed by tenant's physician or authorized provider.
Failed to maintain accurate documentation of staff training and ensure staff received nurse delegation training.
Failed to complete tenant evaluations within 30 days of occupancy and as needed with significant change.
Failed to document nurse's notes by exception for significant events and changes in tenant condition.
Failed to complete medication error reports and incident reports as required.
Failed to develop and update service plans based on evaluations and tenant needs.
Failed to complete nurse reviews every 90 days and as needed with changes in tenant health status.
Failed to ensure food was cooked and held at safe temperatures as required.
Report Facts
Total tenants: 36
Tenants without cognitive impairment: 33
Tenants with cognitive impairment: 3
Medication errors - January 2024: 53
Medication errors - January 2024: 541
Medication errors - February 2024: 74
Medication errors - February 2024: 371
Medication errors - March 2024 (3/1 to 3/5): 19
Medication errors - March 2024 (3/1 to 3/5): 72
Food temperature: 123
Food temperature: 77
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Staff A | Mentioned in relation to medication administration errors, training deficiencies, and wound care. | |
| Staff B | Observed administering medications improperly and mentioned in relation to training deficiencies. | |
| Staff C | Mentioned in relation to training deficiencies. | |
| Staff D | Mentioned in relation to training deficiencies. | |
| Staff F | Mentioned in relation to training deficiencies. | |
| Staff G | Mentioned in relation to training deficiencies. | |
| Staff J | Mentioned in relation to training deficiencies and inaccurate training records. | |
| Staff K | Dietary Supervisor | Interviewed regarding food temperature practices. |
| Staff L | Mentioned in relation to training deficiencies. | |
| Executive Director | Interviewed confirming policies, training, and temperature logs. | |
| Director of Clinical Services | Interviewed confirming evaluations, nurse reviews, incident and medication error reports, and service plans. |
Inspection Report — Dec 20, 2023
Complaint Investigation
Date: Dec 20, 2023
Visit Reason
Investigation of Complaint #117527-C and recertification visit to determine compliance with certification of a Dedicated Dementia Specific Assisted Living Program.
Complaint Details
Complaint #117527-C triggered the investigation focusing on emergency response and other regulatory compliance issues.
Findings
The Program failed to follow emergency response policies affecting tenant safety, failed to ensure medications were administered by qualified staff and as prescribed, failed to provide adequate staff training and evaluations, failed to maintain proper documentation including nurse's notes and incident reports, failed to update service plans timely and obtain signatures, failed to conduct nurse reviews every 90 days, failed to provide food safety and dementia-specific training to staff, and failed to have operating door alarms on all exit doors in the dementia-specific unit.
Violations (15)
Failed to follow emergency response policy related to pendant system failures and delayed responses.
Medications administered by staff without department-approved medication manager course.
Medications not administered as prescribed for multiple tenants.
Staff did not receive training on all delegated tasks within 30 days of employment.
Failed to complete tenant evaluations within 30 days of occupancy.
Failed to complete tenant evaluations with significant change.
Failed to document nurse's notes by exception for multiple tenants.
Failed to complete incident reports for tenant behaviors and falls.
Failed to update service plans as needed and base them on evaluations.
Failed to obtain signed service plans prior to occupancy.
Failed to obtain signed service plans within 30 days of occupancy.
Failed to complete nurse reviews every 90 days and as needed.
Failed to provide food safety training prior to handling food and annually for staff.
Failed to provide eight hours of dementia-specific education and training within 30 days of hire for staff.
Failed to have operating door alarms on each exit door in dementia-specific program.
Report Facts
Total tenants: 37
Number of tenants without cognitive impairment: 35
Number of tenants with cognitive impairment: 2
Number of deficiencies cited: 14
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Staff A | Mentioned in relation to emergency response and food safety training deficiencies | |
| Staff B | Mentioned in relation to emergency response, medication administration, training, and food safety | |
| Staff C | Mentioned in relation to emergency response, medication administration, training, and food safety | |
| Staff D | Mentioned in relation to food safety and training deficiencies | |
| Staff E | Mentioned in relation to medication administration, training, and food safety | |
| Staff F | Mentioned in relation to food safety and dementia training deficiencies | |
| Director of Clinical Services | Director of Clinical Services | Interviewed regarding multiple findings including evaluations, nurse reviews, training, and service plans |
| Executive Director | Executive Director | Interviewed regarding door alarm system and facility practices |
Inspection Report — Jun 28, 2022
Renewal
Date: Jun 28, 2022
Visit Reason
Recertification visit conducted to determine compliance with certification of an Assisted Living Program.
Findings
No regulatory insufficiencies were cited during the recertification visit.
Inspection Report — Mar 25, 2021
Renewal
Date: Mar 25, 2021
Visit Reason
The inspection was conducted as a recertification to determine compliance with certification for an Assisted Living Program, including an onsite infection control survey.
Findings
No regulatory insufficiencies or deficiencies were cited during the recertification and infection control survey.
Report Facts
Number of tenants without cognitive disorder: 48
Number of tenants with cognitive disorder: 0
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