Inspection Reports for
Fairbury Assisted Living Facility DBA Cedarwood
828 22ND STREET, FAIRBURY, NE, 68352
Back to Facility ProfileDeficiencies (last 3 years)
Deficiencies (over 3 years)
0.3 deficiencies/year
Deficiencies are regulatory findings recorded during state inspections.
93% better than Nebraska average
Nebraska average: 4.2 deficiencies/yearDeficiencies per year
4
3
2
1
0
Notice
Capacity: 65
Deficiencies: 0
Date: Mar 13, 2025
Visit Reason
The document serves as a renewal application and license verification for Fairbury Assisted Living Facility DBA Cedarwood, confirming licensure through the indicated renewal date and providing related facility and ownership information.
Findings
The documents confirm the facility meets statutory requirements for assisted living licensure, with a licensed capacity of 65 beds, and includes an occupancy permit issued by the Nebraska State Fire Marshal. No inspection findings or deficiencies are reported.
Report Facts
Licensed Capacity: 65
Renewal Application Date: Mar 13, 2025
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Becky Bruce | Administrator | Named as administrator on renewal application. |
| Chance M. Klasek | Authorized Representative | Signed renewal application. |
| Holly Wolff | Authorized Representative | Signed renewal application and listed as President on Board of Directors. |
Notice
Capacity: 65
Deficiencies: 0
Date: Feb 18, 2016
Visit Reason
The document serves as a licensure renewal application for the Fairbury Assisted Living Facility DBA Cedarwood, verifying the facility's license and providing renewal fee information.
Findings
The documents confirm the facility meets statutory requirements as an assisted-living facility, provide ownership and administrative information, and include occupancy permits indicating a maximum capacity of 65 beds.
Report Facts
Total licensed beds: 65
Renewal fees: 950
Renewal fees: 1450
Renewal fees: 1650
Renewal fees: 1950
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Debra Sutton | Administrator | Named as the administrator of the facility in the licensure renewal application. |
Inspection Report
Routine
Census: 43
Deficiencies: 1
Date: Feb 16, 2011
Visit Reason
The inspection was conducted as a compliance inspection of the Fairbury Assisted Living Facility to assess adherence to licensure regulations for assisted-living facilities.
Findings
The facility failed to ensure that 5 out of 5 sampled resident records contained monthly documentation about assistance with activities of daily living, personal care, health maintenance activities, or supervision. Documentation was only done for vital signs monthly, while other activities were documented quarterly.
Deficiencies (1)
Failure to ensure monthly documentation in resident records regarding assistance with activities of daily living, personal care, health maintenance activities, or supervision.
Report Facts
Facility census: 43
Sampled resident records: 5
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Terese Itzen | Registered Nurse | Surveyor conducting the inspection |
| Diana Meyer | Registered Nurse | Surveyor conducting the inspection |
| Debra Sutton | Administrator | Facility administrator named in the report |
Notice
Capacity: 65
Deficiencies: 0
Date: APP2020
Visit Reason
This document serves as a licensure renewal application and verification for Fairbury Assisted Living Facility DBA Cedarwood, confirming the facility's license status and renewal through the indicated expiration date.
Findings
The document certifies that the facility meets statutory requirements as an assisted-living facility and includes ownership, capacity, and licensing information. No inspection findings or deficiencies are reported.
Report Facts
Total licensed beds: 65
Renewal license expiration date: License expires on 2021-04-30 as shown on the renewal card
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Debra Sutton | Administrator | Named as administrator on the renewal application |
| Chance Klasek | Authorized Representative | Signed the renewal application as authorized representative |
| Victor Lee | Authorized Representative | Signed the renewal application as authorized representative and listed as President of the Board of Directors |
Document
Capacity: 65
Deficiencies: 0
Date: APP2022
Visit Reason
This document set includes a licensure renewal application for Fairbury Assisted Living Facility DBA Cedarwood, renewal verification, and occupancy permit documentation.
Findings
No inspection findings or deficiencies are reported in these documents; they primarily serve to verify licensure renewal and occupancy capacity.
Report Facts
Total licensed beds: 65
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Becky Bruce | Administrator | Named as facility administrator on the renewal application (page 2). |
| Chance M. Klasek | Authorized Representative | Signed the renewal application on 3/15/2022 (page 2). |
| Burke Kline | Authorized Representative | Signed the renewal application on 3/15/2022 (page 2) and listed as President of the Board of Directors (page 3). |
| Brandon Lubke | Deputy State Fire Marshal | Inspected the facility and approved the occupancy permit dated 2/28/2022 (page 4). |
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