Inspection Reports for
Brownstown Forest View Assisted Living

R 325.1921 Governing bodies, administrators, and supervisors: the facility did not maintain an organized program to provide room and board, protection, supervision, assistance, and supervised personal care for its residents as Resident A did not receive care in accordance with his service plan and medication administration record.

R 325.1921 Governing bodies, administrators, and supervisors: the home did not maintain an organized program to provide room and board, protection, supervision, assistance, and supervised personal care for its residents.

R 325.1931 Employees; general provisions: the home failed to maintain adequate staffing and did not assign shift supervisors, resulting in residents not receiving care consistent with their service plans.

R 325.1932 Resident’s medications: prescribed medications were not administered as ordered, narcotic books were not properly maintained, and medications were not securely stored.

R 325.1964 Interiors: ceilings were cracked with peeling paint and multiple unoccupied rooms were unsecured and used for storage.

R 325.1970 Water supply systems: hot water temperature exceeded the regulated range of 105 to 120 degrees Fahrenheit in staff bathroom and resident rooms.

R 325.1921 Governing bodies, administrators, and supervisors: the facility failed to maintain an organized program to provide room and board, protection, supervision, assistance, and supervised personal care for residents, including unsecured doors, unsafe storage of furniture and equipment, and missing documentation for residents' care.

R 325.1970 Water supply systems: the facility does not maintain a water management program; multiple toilets had standing water with sediment and foul smell, and water temperatures in resident and employee areas exceeded the allowed range of 105 to 120 degrees Fahrenheit.

R 325.1931 Employees; general provisions: The home did not provide protection and safety to Resident A and did not follow the service plan, resulting in Resident A leaving the building and expiring outside in the elements on the night of 01/31/2026.

R 325.1921 Governing bodies, administrators, and supervisors: The home lacked an organized program to provide protection, supervision, and supervised personal care; staff shared key fobs, lacked access to electronic charting, and failed to follow the service plan or search for Resident A when missing.

R 325.1931 Employees; general provisions: the home did not have adequate and sufficient staff on duty at all times who are awake, fully dressed, and capable of providing for resident needs consistent with the resident service plans. Documentation did not support assigned care tasks completed, medication carts were soiled, narcotic books missing signatures, and staff files lacked required education and competency documentation.

R 325.1921 Governing bodies, administrators, and supervisors: the home failed to maintain an organized program to provide protection, supervision, assistance, and supervised personal care for its residents as Resident A was left unsupervised and inadequately cared for on 3/23/2025.

R 325.1931 Employees; general provisions: the home did not treat Resident A with dignity and failed to attend to her personal needs including protection and safety consistent with her service plan.

R 325.1922 Admission and retention of residents: Resident B's tuberculosis screening was completed more than 12 months prior to admission.

R 325.1923 Employee’s health: Staff person SP1 was unable to provide initial tuberculosis screening and a TB Risk Assessment.

R 325.1964 Interiors: Multiple areas of paint flaking and peeling on walls and ceiling, missing bathroom tiles in unit 213, dust buildup on air vents, oversized air filter with dust and debris, surgical glove covering humidifier drain, water damage and peeling paint in soiled linen room ceiling, water dripping into bucket from boiler room pipe, open ceiling with water damage and mold in boiler room.

R 325.1964 Interiors: Continuous exhaust ventilation was not functioning in rooms 124, 125, 201, 212, 224, and common areas on first and second floors.

R 325.1972 Solid wastes: Large garbage can was observed overflowing in the hall between kitchen and laundry room.

R 325.1976 Kitchen and dietary: Refrigerators in resident rooms were not monitored, laundry room refrigerator had spillage and buildup, breakroom refrigerator door was broken and ajar with no thermometer noted, and an ice scoop was noted in the ice chest on the first floor unit.

R 325.1979 General maintenance and storage: Two office areas on first floor used as storage with multiple items on floor and overflowing boxes with resident paperwork; clean linen room used for storage of lift, boxes, and personal items; garbage noted on water cart; two electrical strips draped over open desk drawer; free standing oxygen tank in room 210 and one propping door open to room.

R 325.1932 Resident medications: Resident A, B, and C had multiple medications on various shifts with holes/missed documentation to confirm medication administration.

R 325.1979 General maintenance and storage: heating and cooling vents had significant dust and debris buildup and paint on the ceiling was cracked and peeling.

R 325.1921 Governing bodies, administrators, and supervisors: the facility failed to maintain an organized program to provide room and board, protection, supervision, assistance, and supervised personal care as evidenced by improper transfer of Resident E and inability to provide shower sheets for Residents A, B, C, and D.

R 325.1931 Employees; general provisions: employee files for SP2 and SP3 lacked training records, substantiating a violation of staff training requirements.

R 325.1933 Personal care of residents: the facility did not ensure that Resident A was bathed weekly or twice weekly as scheduled, evidenced by shower sheet documentation.

R 325.1922 Admission and retention of residents: the licensee placed residents and staff at risk due to Resident A’s repeated verbal and physical attacks and sexually inappropriate behavior.

R 325.1931 Employees; general provisions: Resident A’s service plan is missing important detail related to his personal care needs and the amount of assistance he requires.

R 325.1932 Resident medications: Associate 1 was scheduled and reasonably believed to have passed medications on 8/08/2023 without completing required medication training, which lacks adequate protection for residents.