Inspection Reports for
Woodbridge Place

The facility was found to have fully implemented the submitted plan of correction. Deficiencies related to staff training, resident bedroom lighting, and medication administration documentation were addressed with corrective actions and ongoing monitoring plans.

The facility had multiple deficiencies including expired boiler certification, resident-to-resident abuse incidents, missing staff training topics, unsafe resident equipment, inadequate emergency water supply, medication storage and administration errors, incomplete resident assessments, and documentation issues. Plans of correction were accepted and implemented with ongoing audits and staff retraining.

The inspection found multiple deficiencies including issues with resident record confidentiality, criminal background checks, staff training, furniture and equipment maintenance, medication storage and administration, support plan documentation, and staff training in dementia care. All deficiencies had plans of correction submitted and were noted as implemented or in progress.

The complaint investigation was substantiated with findings of verbal abuse, financial exploitation, failure to report abuse, failure to supervise or suspend implicated staff, medication management deficiencies, and incomplete resident documentation and training.

Multiple violations were found including failure to report suspected resident abuse, failure to suspend or supervise staff involved in abuse allegations, improper medication storage and documentation, incomplete resident assessments and support plans, and inadequate staff training. Plans of correction were directed and implemented with ongoing audits and training scheduled.

The inspection was triggered by a complaint, as stated under Inspection Information on page 2.

The facility was found to have multiple deficiencies including an administrator lacking required orientation training, unsecured poisonous materials, obstructed egress routes, incomplete resident medical evaluations, medication records missing diagnosis or purpose, untimely preadmission screening and assessments, and unsigned support plans. Plans of correction were submitted and implemented by early June 2025.

The visit was complaint-related due to an allegation that staff person A forcibly woke a resident and forced them into a shower against their will, which was not reported timely to the Department or Older Adult Protective Services. The complaint was substantiated with multiple violations found.

The inspection found multiple violations related to resident abuse reporting, supervision of staff involved in abuse allegations, timely incident reporting to the Department, unsigned resident contracts, improper treatment of residents, and incomplete preadmission cognitive screening. The facility submitted a plan of correction which was determined to be fully implemented as of the inspection date.

The inspection identified multiple deficiencies including unsecured poisonous materials accessible to residents, lack of operable ventilation in bathrooms, absence of operable bedside lighting for a resident, incomplete posting of weekly menus, presence of discontinued medications in medication carts, inaccurate medication administration documentation, missing signatures on controlled substance administration, unavailable prescribed medication, and incomplete support plans addressing resident needs.

Multiple deficiencies were identified including privacy violations, lack of a staff training plan, physical accommodation issues, sanitary conditions, emergency procedure deficiencies, medication administration errors, incomplete medical evaluations, and missing policies. Many corrective actions were proposed but not fully implemented as of February 27, 2025.

The complaint involved alleged abuse by care staff A towards resident #1, including physical mistreatment. The complaint was substantiated, resulting in suspension and termination of the staff member.

The investigation found that a care staff member allegedly abused a resident by slapping their hand during care, causing the resident to yell and appear scared. The staff member was suspended and later terminated following the Department of Human Services investigation. The facility submitted a plan of correction which was accepted and fully implemented.

The facility was found to be in compliance with 55 Pa. Code Chapter 2600, with a submitted plan of correction fully implemented. Several deficiencies were identified related to resident funds refund, locking poisonous materials, maintenance of surfaces, emergency food and water supply, medication storage and labeling, and medication administration documentation, all of which had corrective actions accepted and implemented.

This visit was a result of a self-reported incident by the community staff member on July 10, 2023, regarding staff member A's failure to provide care and dignity to residents.

The inspection found multiple deficiencies including failure to assist resident #1 with toileting and bowel/bladder management, disrespectful treatment of resident #2, denial of access to bedrooms by locking doors, and improper medication storage. Staff member A was suspended and terminated following investigations. Corrective actions and staff re-education were implemented.

The submitted plan of correction was determined to be fully implemented, with corrective actions taken regarding medication storage and availability, including recalibration of glucometers and ensuring medication orders are reviewed weekly.

The visit was complaint-related as indicated by the inspection information section stating 'Reason: Complaint'.

The inspection identified deficiencies related to failure to provide assistance with activities of daily living (ADLs) as required by resident support plans, unattended hazardous equipment in the memory care unit, and incomplete support plan revisions. Plans of correction were accepted and implemented.

The inspection found that the facility had delayed reporting a resident abuse incident involving an altercation between two residents. The Executive Director submitted a plan of correction and retrained staff on abuse reporting timelines and procedures, which was accepted and implemented.

The complaint investigation substantiated abuse allegations against staff member C involving physical and mental abuse of residents in the secured dementia care unit. The abuse was confirmed through face-to-face interviews and written statements from staff and residents.

The investigation found that staff member C engaged in abusive behavior towards residents in the secured dementia care unit, including forcibly dragging residents to their rooms, locking a resident out of their room, and causing mental anguish. The abuse was not reported immediately as required. Staff member C was suspended and subsequently terminated. Training on abuse and resident rights was conducted for staff.

The inspection was triggered by a complaint and incident as stated under Inspection Information with reason 'Complaint, Incident'.

The facility was found to have deficiencies including a direct care staff member providing unsupervised ADL services without completing required training and competency testing, and a resident's bed equipped with an uncovered enabler bar. The submitted plan of correction was accepted and fully implemented by 04/18/2023.

The submitted plan of correction was determined to be fully implemented. Deficiencies related to assistance with activities of daily living, resident privacy, staffing levels, and staff orientation and training were addressed with corrective actions and training completed by the specified dates.

The inspection was complaint-related, involving allegations of abuse and other regulatory violations. The abuse allegations were substantiated with specific incidents described involving staff members and residents.

Multiple violations were found including abuse incidents, failure to provide fire safety orientation to new staff, sanitary condition issues, medication administration errors, improper food storage, and incomplete medication records. Plans of correction were proposed but many were not implemented as of the last follow-up.

The inspection was complaint-related with substantiated findings of abuse and neglect, medication errors, and failure to follow regulatory requirements.

Multiple violations were found related to resident care, medication administration, staff training, abuse incidents, sanitary conditions, and regulatory compliance. The facility was issued a second provisional license with required plans of correction and follow-up inspections.

The inspection was complaint and incident related; no deficiencies or substantiation status were reported.

No regulatory citations or deficiencies were identified as a result of this inspection.

The facility was found to have fully implemented the plan of correction regarding a violation where a staff member took and published a photograph of a resident without consent, violating resident dignity and privacy. The employee resigned and staff retraining on social media policy and resident rights was directed and completed.

The facility was found to have fully implemented the submitted plan of correction related to medication administration, following prescriber's orders, and preadmission screening for the secured dementia care unit. Various corrective actions were taken including removal of responsible staff from medication duties, audits, and implementation of new processes to ensure compliance.

No regulatory citations or deficiencies were identified as a result of this inspection.

The inspection was complaint-related and incident-driven, with no deficiencies found and no follow-up required.

No regulatory citations or deficiencies were identified during the inspection period.

Multiple medication management deficiencies were identified, including issues with prescription currency, medication storage, labeling, refusal documentation, and medication error reporting. Additional findings included incomplete resident assessments. The facility submitted plans of correction for all deficiencies, with some plans implemented and others pending.

The inspection was complaint-driven, triggered by allegations that led to an unannounced partial inspection on November 9, 2021. The exit conference was held the same day. Follow-up submissions and reviews occurred through January 2022.

Multiple violations were found related to abuse, medication administration, sanitary conditions, medical evaluations, medication storage, refusal of medication documentation, following prescriber's orders, training records, preadmission screening, additional assessments, and support plan signatures. The facility was issued a first provisional license due to these violations and required to submit plans of correction.

The inspection identified multiple violations including failure to post required notices, staffing shortages, unsafe storage of poisonous materials, sanitary issues, missing emergency phone numbers, incomplete medical evaluations, medication management deficiencies, and lack of documentation for secured dementia care unit admissions. Plans of correction were accepted for all violations with specified completion dates.

Multiple violations of 55 Pa. Code Chapter 2600 were found during the inspections, resulting in revocation of the prior certificate of compliance and issuance of a first provisional license. The Department intends to assess fines for several violations unless corrected by specified deadlines.

The visit was complaint-related. The deficiency involved incomplete documentation in the Resident Assessment Support Plan for resident #1. The plan of correction was accepted and implemented, with resident #1 having passed away on hospice services, preventing correction of the original RASP.

The inspection found a deficiency related to the Resident Assessment Support Plan (RASP) for resident #1, which did not include the personal care need and degree level needed for writing correspondence. The plan of correction was accepted and fully implemented.

The submitted plan of correction was determined to be fully implemented as of the 05/04/2021 review. The facility corrected the deficiency regarding the lack of documentation for a criminal background check for a staff member.

The inspection was triggered by complaints regarding wound care, choking incident, medication administration, dietary compliance, and record keeping deficiencies at the facility.

The inspection found multiple deficiencies including failure to follow wound care orders, medication refusal documentation, dietary needs not met, inadequate choking response, incomplete resident records, and missing preadmission screenings and support plans. Plans of correction were accepted with retraining, audits, and implementation of new electronic health records.

The submitted plan of correction was determined to be fully implemented with no new issues identified. The facility demonstrated compliance with medication storage, administration, and documentation procedures, as well as preadmission screening requirements.

The inspection was complaint-related and the follow-up type was noted as not required. No substantiation status was provided.

No regulatory citations or deficiencies were identified during the inspection.

No inspection findings are reported in this document. It confirms issuance of a regular license following the renewal application and outlines the requirement for future annual inspections.

The inspection was complaint-driven and included follow-up reviews. The submitted plan of correction was determined to be fully implemented.

The facility was found to have deficiencies related to self-administration of medications, including failure to assess a resident's ability to self-administer medications and improper storage of medications in a resident's room. Plans of correction were accepted and fully implemented.

The visit was complaint-related, triggered by concerns about resident neglect. The complaint was substantiated by findings of maggot infestation in a resident's ear and insufficient staffing during waking hours.

The facility was found to have neglected a resident on hospice whose ear canal was infested with maggots, and staffing hours during waking hours were below the required 75%. Plans of correction were accepted and implemented to address abuse and staffing deficiencies.

No regulatory citations were identified as a result of this inspection.

The investigation was triggered by an incident involving resident altercations and an elopement from the secured dementia care unit. The plan of correction was approved and fully implemented as of August 12, 2020.

The submitted plan of correction was fully implemented and compliance was maintained. The investigation involved multiple incidents including resident altercations and an elopement from the secured dementia care unit.

The Pennsylvania Department of Human Services determined that the submitted plan of correction was fully implemented and that continued compliance must be maintained.

No regulatory citations or deficiencies were identified as a result of this inspection.

The investigation was initiated due to an incident involving medication errors and unsafe medication handling practices. The complaint was substantiated with multiple violations found.

Multiple violations were identified including medication errors, unsecured narcotic medication, lack of dual signatures on controlled substance records, and inadequate staff training on managing challenging resident behaviors. Plans of correction were submitted but many were only partially implemented as of the report date.

No regulatory citations were identified as a result of this inspection.

Violations of 55 Pa. Code Chapter 2600 were found during the inspection. The facility was required to correct all citations by specified dates and maintain continued compliance. Multiple plans of correction were submitted addressing issues such as resident agreements, staffing, medication administration, food storage, first aid kits, and documentation for secured dementia care unit admissions.

The inspection was triggered by an incident complaint. The violation regarding the criminal background check was substantiated.

Violations of 55 Pa. Code Chapter 2600 related to Personal Care Homes were found. The home failed to submit a criminal background check request for a staff member within the required timeframe.

The inspection was triggered by a complaint, and the report documents violations related to resident privacy, medication administration, and timely completion of medical evaluations. The complaint was substantiated by the findings.

Violations of the Pennsylvania Personal Care Homes regulations were identified during the inspection. The facility was required to correct all cited violations and maintain ongoing compliance.

Violations related to medication administration and documentation were found, including discrepancies in medication orders and missing medication counts. Plans of correction were partially implemented with adequate progress noted as of March 4, 2020.

The inspection was triggered by a complaint. The report does not explicitly state substantiation status.

Violations of 55 Pa. Code Ch. 2600 were found during the inspection. The report includes deficiencies related to medication administration and documentation, with corrective actions partially implemented as of June 4, 2019.

Multiple violations were found related to medical evaluations, medication administration records, glucometer calibration, insulin administration, and support plan documentation. Plans of correction were partially implemented with inadequate progress as of the report date.

The complaint was substantiated involving a resident elopement and medication administration errors. The resident eloped on 12/11/18 and was found by police. Medication omissions occurred on 12/14/18, 12/15/18, 12/18/18, 12/21/18, and 12/22/18.

The facility was found to have violated regulations related to resident neglect and failure to follow prescriber directions. Specifically, a resident eloped from the facility and medication was not administered as prescribed on multiple occasions.

The inspection was complaint-driven as noted on the violation report page 2. The violations were substantiated as multiple deficiencies were documented.

Multiple violations were found including incomplete criminal background checks, inadequate staffing to meet residents' medication needs, failure to administer prescribed medications, expired medication administration certification, incomplete pre-admission screening, and incomplete initial resident assessments.

The facility was found to have multiple violations including failure to post licensing documents, unsigned resident contracts, missing resident rights acknowledgments, uncovered trash receptacles, incomplete medical evaluations, medication administration record errors, and improper posting of exit door codes. Plans of correction were submitted and partially implemented.

The visit was complaint-related due to an incident involving mistreatment of Resident 1 and failure to follow physician orders. The investigation substantiated violations of dignity and respect and medication/treatment orders.

Violations of 55 Pa. Code Chapter 2600 were found related to resident dignity and respect, and failure to follow physician orders for compression stockings. Staff mistreatment of a resident and inadequate implementation of physician orders were documented.

The facility was found to be in substantial compliance but had multiple violations related to privacy, criminal background checks, fire safety orientation, staff training, sanitary conditions, food safety, medical evaluations, emergency plans, medication records, support plans, and secured dementia care unit requirements.

No inspection findings are reported in this document. It is a license renewal notice confirming the issuance of a regular license based on the renewal application.