4 Reports
Inspection Report — Jul 22, 2025
Renewal
Date: Jul 22, 2025
Visit Reason
Renewal inspection of the adult foster care family home license.
Findings
The facility was found to be in substantial compliance with the public health code and administrative rules regulating home for the aged facilities.
Inspection Report — Nov 3, 2023
Renewal
Date: Nov 3, 2023
Visit Reason
License renewal notice; no inspection report attached. Administrative review without an on-site visit.
Findings
An administrative review revealed substantial compliance with the public health code and administrative rules regulating home for the aged facilities. The license has been renewed for 12 months.
Report Facts
License length: 12
Inspection Report — Oct 27, 2023
Complaint Investigation
Date: Oct 27, 2023
Visit Reason
Investigation of a complaint received on 2023-10-26 about Resident B providing inconsistent care.
Complaint Details
Resident B fell out of bed and laid on the floor for hours: established. Additional findings regarding service plan omissions and device use: established.
Findings
Two violations were established related to Resident B's care and service plan omissions.
Deficiencies (2)
R 325.1931 Employees; general provisions: Resident B had a fall and was on the floor for hours; the service plan did not include information on the baby monitor and hourly safety checks were not consistently performed.
R 325.1921 Governing bodies, administrators, and supervisors: The service plan lacked information about bedside assistive devices, staff responsibilities, and maintenance schedules, and the facility had no policy on their use.
Report Facts
Corrective action plan due: 15
Inspection Report — Sep 28, 2023
Complaint Investigation
Date: Sep 28, 2023
Visit Reason
Investigation of a complaint received on 2023-09-28 about inadequate care and falls.
Complaint Details
Resident A provided care inconsistent with service plan: not established. Additional findings: not established. Failure to maintain organized program to prevent falls: established.
Findings
One rule violation was established related to failure to maintain an organized program to ensure resident protection and prevent falls. Another allegation regarding treatment with dignity and personal needs was not established.
Deficiencies (1)
R 325.1921 Admission and retention of residents: the facility did not appropriately update Resident A's service plan nor implement appropriate corrective methods to prevent future falls.
Report Facts
Corrective action plan due: 15
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