Inspection Reports for Alizah Family Services
20752 Gemini Trail, Lakeville, MN 55044, MN, 55044
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Inspection Report
Routine
Census: 4
Deficiencies: 9
Oct 22, 2024
Visit Reason
The Minnesota Department of Health conducted a full survey to evaluate and assess compliance with state licensing statutes for Alizah Family Services.
Findings
The survey identified multiple deficiencies including failure to prepare and serve food according to Minnesota Food Code, lack of a comprehensive emergency preparedness plan, incomplete and unauthenticated resident records, incomplete service plans and medication management plans, and missing required signage for electronic monitoring devices.
Severity Breakdown
Level 1: 1
Level 2: 8
Deficiencies (9)
| Description | Severity |
|---|---|
| Food was not prepared and served according to the Minnesota Food Code, including raw shell eggs stored over ready-to-eat foods. | Level 2 |
| Emergency preparedness plan lacked required content including tracking of staff and residents, communication plans, and training. | Level 2 |
| Resident records lacked authenticated entries by name and title of person making the entry. | Level 2 |
| Resident records lacked documentation of all services provided as identified in the service plan. | Level 2 |
| Service plan was not revised to reflect current services provided and lacked fees for services. | Level 2 |
| Individualized medication management plan did not include all required content, such as delegation of inhaler administration to unlicensed personnel. | Level 2 |
| Individualized treatment or therapy management plan did not include all required content, such as incentive spirometry and passive range of motion services. | Level 2 |
| Facility failed to post required notice at main entrance disclosing electronic monitoring devices. | Level 1 |
| Handwashing sink was used improperly for silverware and straw storage instead of handwashing only. | Level 2 |
Report Facts
Residents present: 4
Deficiencies cited: 9
Compliance timeframes: 21
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Jodi Johnson | Supervisor, State Evaluation Team | Named as contact for questions regarding the survey. |
| CNS-B | Clinical Nurse Supervisor | Provided statements about deficiencies in resident records, service plans, medication and treatment plans. |
| ULP-C | Unlicensed Personnel | Observed administering medications and treatments to resident R1. |
| Gabriella A. Nowrang | Certified Food Protection Manager | Named on Food and Beverage Establishment Inspection report. |
| Paul Ramcharit | Owner | Signed acknowledgement of Food and Beverage Inspection report. |
| Blia Lor | Public Health Sanitarian I | Conducted Food and Beverage Establishment inspection. |
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