5 Reports
Inspection Report — Mar 24, 2026
Renewal
Date: Mar 24, 2026
Visit Reason
Renewal inspection of the adult foster care family home license.
Findings
The home was found to be in non-compliance with 4 rules; a written corrective action plan was required before the license is renewed.
Deficiencies (4)
R 325.1954 Meal and food records: the facility does not maintain a 3-month period of meal census.
R 325.1970 Water supply systems: water temperature assessed in multiple rooms recorded higher than the recommended regulated rate of 120 degrees Fahrenheit.
R 325.1976 Kitchen and dietary: multiple items in walk-in refrigerator and dry storage were opened and not dated, including cheese, frozen potatoes, and noodles.
R 325.1976 Kitchen and dietary: the facility does not maintain food temperature logs, refrigerator logs, and freezer logs.
Report Facts
Corrective action plan due: 15
Inspection Report — Jan 29, 2025
Complaint Investigation
Date: Jan 29, 2025
Visit Reason
Investigation of a complaint received on 2025-01-28 about inadequate care and medication administration.
Complaint Details
Resident A lacked care consistent with her service plan: established. Resident A did not receive her medications as prescribed: established. Additional findings: none.
Findings
Two violations were established related to inconsistent care with the service plan and failure to administer medications as prescribed.
Deficiencies (2)
R 325.1931 Employees; general provisions: the facility did not provide care consistent with Resident A's service plan, with discrepancies between the service plan and medication administration records and incomplete documentation.
R 325.1932 Resident medications: staff did not consistently administer Resident A's medications as prescribed, with multiple doses left undocumented or administered contrary to instructions.
Report Facts
Corrective action plan due: 15
Inspection Report — Jan 16, 2025
Complaint Investigation
Date: Jan 16, 2025
Visit Reason
Investigation of a complaint received on 2025-01-15 about Resident B entering Resident A's room and staff not responding to call light for 20 minutes.
Complaint Details
Resident B entered Resident A’s room and staff did not respond to call light for 20 minutes: established. Additional findings: failure to notify department of administrator change, failure to update service plans, and failure to monitor bed rails: established.
Findings
Four rule violations were established related to supervision, notification of administrator change, service plan updates, and failure to assure an organized program for resident care.
Deficiencies (4)
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 as Resident B entered Resident A’s room and staff did not respond to call light promptly.
R 325.1913 Licenses and permits; general provisions: the facility failed to notify the department within 5 days of the administrator change.
R 325.1922 Admissions and retention of residents: Resident A’s and Resident B’s service plans were not updated to reflect current care needs and behavior changes.
R 325.1921 Governing bodies, administrators, and supervisors: the facility did not assure monitoring and documentation of bed rails on Resident A’s bed as required.
Report Facts
Corrective action plan due: 15
Inspection Report — Aug 6, 2024
Complaint Investigation
Date: Aug 6, 2024
Visit Reason
Investigation of a complaint received on 2024-07-30 about the Resident of Concern not receiving appropriate care.
Complaint Details
The Resident of Concern does not receive appropriate care: not established. Additional findings: failure to have a service plan for the Resident of Concern — established.
Findings
One violation was established for failure to have a service plan for the Resident of Concern. The allegation that the Resident of Concern did not receive appropriate care was not established.
Deficiencies (1)
R 325.1922 Admission and retention of residents: the facility did not have a service plan for the Resident of Concern.
Report Facts
Corrective action plan due: 15
Inspection Report — Jan 18, 2023
Original Licensing
Date: Jan 18, 2023
Visit Reason
Original license application for a home for the aged with programs for aged and Alzheimer's disease or related condition care.
Findings
The study determined substantial compliance with applicable licensing statutes and administrative rules after the on-site inspection and subsequent documentation submission.
Report Facts
License length: 6
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