7 Reports
Inspection Report — Mar 23, 2026
Renewal
Date: Mar 23, 2026
Visit Reason
Renewal inspection of the home for the aged license.
Findings
The home was found in non-compliance with 10 rules; a written corrective action plan was required before the license is renewed.
Deficiencies (9)
R 325.1921 Governing bodies, administrators, and supervisors: the home did not have an organized program to ensure the protection and safety of residents using bedside assist devices as required by the home's standard operating procedure and physician orders.
R 325.1922 Admission and retention of residents: Residents A and F did not have tuberculosis screenings completed within 12 months prior to admission.
R 325.1923 Employee's health: Employees #4 and #6 did not have tuberculosis screenings completed within 10 days of hire and prior to occupational exposure.
R 325.1931 Employees; general provisions: the staffing schedule did not identify a shift supervisor on duty from March 15 through March 28, 2026.
R 325.1931 Employees; general provisions: Employees #2, #4, and #6 lacked required training in areas including reporting, resident rights, safety, infectious disease precautions, and dementia care.
R 325.1932 Resident’s medications: Medication Administration Records for Residents A, B, C, and E lacked staff initials on multiple dates and some PRN medication orders lacked specific administration instructions or documented reasons.
R 325.1953 Menus: a weekly menu was not posted for residents prescribed therapeutic or special diets such as pureed diets.
R 325.1970 Water supply systems: the hot water temperature in room 231 was 126 degrees Fahrenheit, exceeding the allowed range of 105 to 120 degrees.
R 325.1976 Kitchen and dietary: the March 2026 Daily Sanitizing Heat Dish Machine temperature log was incomplete and did not indicate minimum required temperatures for wash or rinse cycles.
Report Facts
Corrective action plan due: 15
Inspection Report — Feb 16, 2026
Complaint Investigation
Date: Feb 16, 2026
Visit Reason
Investigation of a complaint received on 2026-02-11 about medication administration.
Complaint Details
The home is not administering medications, as ordered, to Resident A: established. Additional findings: no violation established.
Findings
One rule violation was established regarding medication administration for Resident A.
Deficiencies (1)
R 325.1932 Resident medications: the home did not administer Carbidopa-Levodopa to Resident A as ordered, with multiple doses given outside the 15-minute scheduled time window and some doses given late or early.
Report Facts
Corrective action plan due: 15
Inspection Report — Jun 12, 2025
Complaint Investigation
Date: Jun 12, 2025
Visit Reason
Investigation of a complaint received on 2025-06-09 about staffing, resident protection, food quality, personal care, and laundry.
Complaint Details
The home was short staffed: established. Resident C lacked protection: not established. The food was unhealthy: not established. Residents were not being showered: not established. Residents’ laundry was not completed: not established. Additional findings: shift supervisor designation violations established.
Findings
Two rule violations were established related to staffing levels and shift supervisor designation. Other allegations including resident protection, food quality, personal care, and laundry were not substantiated.
Deficiencies (2)
R 325.1931 Employees; general provisions: the home did not have adequate and sufficient staff on duty at all times to meet residents' needs, as schedules showed only two staff on duty for residents requiring two-person assistance and/or Hoyer lifts, and no staff assigned to memory care on some days.
R 325.1931 Employees; general provisions: the home failed to designate one fully dressed, awake supervisor of resident care on each shift, with multiple instances of no supervisor designated or supervisors not covering entire shifts without alternates.
Report Facts
Corrective action plan due: 15
Inspection Report — Jul 23, 2024
Renewal
Date: Jul 23, 2024
Visit Reason
License renewal notice; no inspection report attached. Administrative review without an on-site visit.
Findings
The facility was found in substantial compliance with the public health code and administrative rules regulating home for the aged facilities; the license has been renewed.
Report Facts
License length: 12
Inspection Report — Sep 25, 2023
Complaint Investigation
Date: Sep 25, 2023
Visit Reason
Investigation of a complaint received on 2023-09-21 about misadministration of medication and lack of adequate action to protect Resident A.
Complaint Details
Misadministration of Resident A’s medication and lack of adequate action taken to protect Resident A: established. Additional findings: established.
Findings
Two violations were established related to medication misadministration and failure to maintain proper medication logs, placing Resident A at risk of harm.
Deficiencies (2)
R 325.1932 Resident’s medications: staff continually administered Resident A’s medications outside of the clear instructions provided within the physician's orders, leading to harm including a fall and health decline.
R 325.1932 Resident medications: staff failed to complete individual medication logs with initials at the time medication was given on several dates.
Report Facts
Corrective action plan due: 15
Inspection Report — Aug 29, 2023
Renewal
Date: Aug 29, 2023
Visit Reason
Renewal inspection of the adult foster care family home license.
Findings
The home was found in non-compliance with 8 rules; a written corrective action plan was required before the license is renewed.
Deficiencies (7)
R 325.1923 Employee's health: employee tuberculosis screenings were not completed within 10 days of hire and before occupational exposure, and the facility lacked an annual TB risk assessment until 8/30/2023.
R 325.1931 Employees; general provisions: the August 2023 staffing schedule lacked designation of one supervisor of resident care for each shift.
R 325.1931 Employees; general provisions: several employees lacked required training records including reporting, personal care, resident rights, safety, and infection control; one employee did not know disaster plan location or procedures.
R 325.1932 Resident medications: medication administration records were incomplete or missing on multiple dates, as needed medications lacked specific instructions, and medications were not always administered per licensed health care professional orders.
R 325.1954 Meal and food records: the home lacked meal census records for the preceding three-month period.
R 325.1976 Kitchen and dietary: the July and August 2023 daily sanitizing checklist records were incomplete with missing final rinse temperatures.
R 325.1976 Kitchen and dietary: food and drink in the facility kitchen refrigerator and memory care kitchenette refrigerator and freezer were not dated.
Report Facts
Corrective action plan due: 15
Inspection Report — Oct 12, 2022
Original Licensing
Date: Oct 12, 2022
Visit Reason
Original license application for a home for the aged.
Findings
The study determined substantial compliance with applicable licensing statutes and administrative rules.
Report Facts
License length: 6
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