Inspection Reports for Affinity Quality Living LLC
1620 Wilking Way, Shakopee, MN 55379, MN, 55379
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Inspection Report
Follow-Up
Census: 1
Deficiencies: 6
May 21, 2024
Visit Reason
Follow-up survey conducted to determine if orders from the April 16, 2024, initial survey were corrected.
Findings
The follow-up survey verified that the facility is in substantial compliance with previous correction orders.
Severity Breakdown
Level 1: 1
Level 2: 5
Deficiencies (6)
| Description | Severity |
|---|---|
| Failed to employ a licensed assisted living director; licensee lacked a licensed assisted living director to manage and supervise assisted living services. | Level 2 |
| Failed to develop and maintain a fire safety and evacuation plan with required content specific to the facility. | Level 2 |
| Failed to include required designation of representative statutory language in the assisted living contract for the resident. | Level 1 |
| Failed to ensure training and competency evaluations were completed as required prior to providing direct care for two unlicensed personnel. | Level 2 |
| Failed to ensure two employees received the required amount of dementia care training within the required timeframe. | Level 2 |
| Failed to ensure the resident's service plan included all required content such as fees for services, monitoring schedules, contingency plans, and emergency contact information. | Level 2 |
Report Facts
Fine amount: 500
Resident census: 1
Dementia care training hours: 7.75
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Jodi Johnson | Supervisor, State Evaluation Team | Signed follow-up survey letter and correspondence. |
| Nagmo Abdikarim | Food Service Manager, Certified Food Protection Manager | Named in food and beverage establishment inspection. |
| Sarah Conboy | Public Health Sanitation Supervisor | Conducted food and beverage establishment inspection. |
| O/ALD-A | Owner/Assisted Living Director | Named in assisted living director licensure deficiency and fire safety plan interview. |
| CNS-B | Clinical Nurse Supervisor | Named in training and competency evaluations and fire safety plan interviews. |
| ULP-C | Unlicensed Personnel | Named in training and competency evaluation deficiency. |
| ULP-D | Unlicensed Personnel | Named in training and competency evaluation deficiency. |
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