Inspection Report
Complaint Investigation
Capacity: 20
Deficiencies: 1
Mar 7, 2025
Visit Reason
The investigation was initiated due to a complaint alleging that staff member Jaqaues Burt was physically aggressive towards Resident A on 12/22/2024.
Findings
The investigation substantiated that staff Jaqaues Burt was physically aggressive towards Resident A, causing bruises on the resident's wrists. The facility suspended and subsequently terminated Ms. Burt's employment.
Complaint Details
The complaint alleged that on 12/22/2024, staff Jaqaues Burt was physically rough with Resident A, pinning his arms down and throwing him around while providing care. APS substantiated the abuse after interviewing Resident A and reviewing photographs of bruises on his wrists.
Deficiencies (1)
| Description |
|---|
| Staff Jaqaues Burt became physically aggressive towards Resident A. |
Report Facts
Capacity: 20
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Jaqaues Burt | Staff | Named in physical abuse finding towards Resident A |
| Mistee Hondorp | Administrator | Interviewed during onsite inspection regarding the abuse allegation |
| Stephen Levy | Licensee Designee | Participated in exit conference and informed of investigation findings |
Inspection Report
Renewal
Capacity: 20
Deficiencies: 0
Feb 8, 2024
Visit Reason
The inspection was conducted as a renewal inspection to determine compliance with applicable licensing statutes and rules for license renewal of the facility.
Findings
The onsite inspection found the facility in compliance with all applicable rules and statutes. The licensing consultant recommended issuance of a regular license to this AFC adult large group home.
Report Facts
Capacity: 20
Number of staff interviewed: 3
Number of residents interviewed: 7
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Stephen Levy | Licensee/Licensee Designee | Named as licensee/licensee designee |
| Mistee Hondorp | Administrator | Named as facility administrator |
| Megan Aukerman | Licensing Consultant | Conducted inspection and signed report |
Inspection Report
Original Licensing
Capacity: 20
Deficiencies: 0
Sep 19, 2014
Visit Reason
The document is an addendum to the Original Licensing Study Report for LakeSide Vista Rotterdam Haus, reflecting a change in controlling interest of Leisure Living Management, LLC.
Findings
The controlling interest in Leisure Living Management of Holland LLC was acquired by WP-LH Holdings, LLC, and ownership of the real estate property was transferred to ARHC LVHLDMIO1O, LLC. A management agreement was entered with Meridian Senior Living Services, LLC for day-to-day management. The licensee designee and administrator remain the same.
Report Facts
Facility capacity: 20
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Teresa Fowler | Licensee Designee | Named as licensee designee in the report |
| Curtis Avison | Administrator | Named as administrator in the report |
Inspection Report
Original Licensing
Capacity: 20
Deficiencies: 0
Jan 25, 2005
Visit Reason
The visit was conducted to respond to a request for a change in the controlling ownership interest of the original corporation or Limited Liability Company to Leisure Living Holdings, Inc., and eventually to LifeHouse Retirement Properties.
Findings
LifeHouse Retirement Properties, Inc. submitted all required documentation for the change in controlling ownership interest involving twenty facilities, including Fountain View Retirement Village # 2. Compliance with all requirements was achieved by 3/1/05.
Report Facts
Facility capacity: 20
Number of facilities involved: 20
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Louis Andriotti | Designee | Administrator/Licensee Designee and participant in meetings |
| Lou J. Andriotti | President & CEO | Meeting participant representing Leisure Living Holdings |
| Mark H. Soth | Director of Human Resources | Meeting participant representing Leisure Living Holdings |
| Donna Konopka | Licensing Consultant | Author of the report and licensing consultant |
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