Deficiencies per Year
4
3
2
1
0
Unclassified
Census Over Time
Inspection Report
Complaint Investigation
Census: 15
Deficiencies: 0
Sep 19, 2023
Visit Reason
Surveyor completed a complaint survey at Azura Memory Care of Kenosha.
Findings
The complaint was unsubstantiated and no deficiencies were identified during the survey.
Complaint Details
Complaint was unsubstantiated.
Inspection Report
Complaint Investigation
Deficiencies: 0
Jul 21, 2023
Visit Reason
A verification visit, self-report, and complaint survey were conducted on July 21, 2023, to determine if Azura Memory Care of Kenosha North was in substantial compliance with Wisconsin statutes and administrative codes governing community-based residential facilities.
Findings
The Department issued a Statement of Deficiency (SOD #QHZJ12) for violations of Wis. Stat. ch. 50 and Wis. Admin. Code ch. DHS 83. A forfeiture of $400 was imposed for these violations, and a $200 inspection fee was assessed for a revisit to verify correction of prior deficiencies.
Complaint Details
The visit was complaint-related, involving a verification visit, self-report, and complaint survey to assess compliance. The report does not explicitly state the substantiation status of the complaint.
Report Facts
Forfeiture amount: 400
Reduced forfeiture amount: 260
Revisit inspection fee: 200
Compliance timeframe: 45
Payment timeframe: 10
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| MaryBeth Hoffman | Assisted Living Regional Director | Contact person for questions about the letter |
| Kenneth Brotheridge | Assisted Living Director | Signed the Notice and Order letter |
Inspection Report
Complaint Investigation
Census: 15
Deficiencies: 4
Jul 21, 2023
Visit Reason
Surveyors completed a verification visit, self-report, and complaint survey triggered by a complaint alleging a resident's diet was not being followed. The visit included investigation of food safety, individual service plan implementation, water temperature, and door safety.
Findings
Four deficiencies were identified, including a repeat violation related to failure to implement and follow a resident's individualized service plan diet. Food safety violations included improper food temperature control and unlabeled frozen foods. Hot water temperatures exceeded regulatory limits in resident bathrooms. One exterior door required a key to open from the inside, violating door operation requirements.
Complaint Details
One of one complaint was substantiated regarding failure to follow a resident's diet as ordered.
Deficiencies (4)
| Description |
|---|
| Staff did not implement and follow Resident 1's individualized service plan; resident was served food outside of ordered pureed diet. |
| Food safety violations: cold foods not held at or below 40°F, hot foods not held at or above 140°F, and frozen foods not labeled and dated. |
| Hot water temperature at bathroom sinks for 3 residents exceeded 115°F, measuring 130°F, 126°F, and 118°F respectively. |
| One of six exterior doors (front sunroom exit door) required a key to unlock from the inside, not permitting one-hand, one-motion operation. |
Report Facts
Deficiencies identified: 4
Revisit fee: 200
Residents present: 15
Hot water temperatures: 130
Hot water temperatures: 126
Hot water temperatures: 118
Cold food temperatures: 72
Cold food temperatures: 67
Cold food temperatures: 66
Cold food temperatures: 57
Hot food temperature: 127.4
Hot food temperature: 75
Unlabeled frozen food items: 8
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Administrator A | Administrator | Interviewed regarding food service, door lock, and hot water temperature issues. |
| Caregiver H | Caregiver | Interviewed regarding food preparation, diet implementation, and freezer labeling. |
| Caregiver I | Caregiver | Interviewed regarding food preparation and diet implementation. |
| Regional Director of Operations G | Regional Director of Operations and Quality Assurance | Interviewed regarding food service and diet implementation. |
| Regional Director of Clinical Services K | Regional Director of Clinical Services | Interviewed regarding food service and diet implementation. |
| Maintenance Person J | Maintenance Person | Interviewed regarding hot water temperature monitoring and adjustments. |
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