Inspection Reports for Celebration Villa of Teays Valley

Review of the Licensee's plans of correction and credible evidence was conducted to verify correction of previous deficiencies.

The credible evidence was accepted in lieu of an onsite revisit, and all outstanding citations were corrected.

The inspection was conducted as an annual survey of the assisted living and memory care facility to assess compliance with regulatory requirements.

Deficiencies were cited related to failure to ensure interdisciplinary team participation in quarterly resident assessments, inadequate documentation of social and recreational activities, improper storage of housekeeping chemicals with food, and housekeeping and maintenance issues including damaged carpets and missing bathroom fixtures.

The inspection was conducted as an annual survey to assess the facility's compliance with licensing requirements.

The facility was found to be in substantial compliance with the licensing rule based on record review, observation, and staff interview at the conclusion of the annual survey.

Follow-up to Complaint #37577 to verify correction of previously identified deficiency.

The deficiency related to safety and supervision was corrected as of the follow-up visit on 06/04/25.

Complaint #37577 triggered the follow-up visit; the deficiency was corrected.

Investigation of Complaint #37577 conducted from 03/24/25 to 03/26/25 regarding failure to enter into a written contract with residents specifying full disclosure of all costs and changes in care needs affecting costs.

The Licensee failed to provide residents with a written contract that fully disclosed all costs and explained what changes in care needs would result in cost modifications. Interviews with residents and families confirmed lack of understanding and documentation. The complaint was substantiated and a deficiency was cited.

Complaint #37577 was substantiated. The complaint involved failure to provide full disclosure of costs and changes in care needs in resident contracts. Census at time of complaint was Assisted Living-40, Memory Care-20.

The inspection was conducted as an annual survey of Celebration Villa of Teays Valley, including Assisted Living and Memory Care units.

No deficiencies were cited during the annual survey conducted from May 6 to May 8, 2024. The census included 47 residents in Assisted Living and 21 in Memory Care.

The inspection was conducted as a license renewal survey to determine if the residence complies with state requirements.

The facility was found to be in substantial compliance with the licensing rule based on review of documentation, staff interviews, observations, and performance testing. No deficiencies were cited during this inspection.

The visit was conducted as an annual survey of the assisted living facility.

The inspection found no deficiencies during the annual survey conducted from July 10 to July 13, 2023.

Annual Environmental inspection of an Assisted Living facility.

The inspection found no deficiencies cited during the annual environmental survey.

The inspection was conducted in response to a complaint identified as Complaint ID: 28722, to investigate the allegations at Celebration Villa of Teays Valley.

The complaint investigation was unsubstantiated. The report does not list any deficiencies or violations related to the complaint during the visit on 07/12/2023.

Complaint ID: 28722 was investigated from 07/12/23 8:30 AM to 10:00 AM. The complaint was found to be unsubstantiated.

Follow-up visit to verify correction of previous deficiencies at Celebration Villa of Teays Valley.

The follow-up inspection found that previous citations were cleared, indicating compliance with required corrections.

The inspection was conducted in response to a complaint identified by Complaint ID 27238 to assess compliance and verify correction of deficiencies.

All deficiencies identified during the complaint investigation have been corrected, and no current deficiencies were found at the time of the inspection.

Complaint ID 27238 was investigated and found to have all deficiencies corrected with no current deficiencies noted.

Follow-up visit to the annual survey to verify correction of previously cited deficiencies.

All deficiencies identified in the prior annual survey were corrected as of the follow-up visit on 11/09/22.

Investigation of a complaint regarding medication administration and staffing issues at Celebration Villa of Teays Valley, an assisted living and memory care facility.

The facility failed to follow physician medication orders for two residents, had inadequate staffing leading to missed medication administrations, and failed to maintain accurate medication administration records. Additionally, housekeeping and maintenance deficiencies were observed in the adolescent consumer residence.

Complaint #27321 investigated from 09/19/22 to 09/20/22 regarding medication administration errors and staffing shortages impacting residents #11, #38, #60, and Closed Record #5. Family of CR #5 reported medication documentation errors and missed doses. Facility acknowledged issues and implemented corrective actions.

The inspection was conducted as a complaint investigation with two substantiated allegations regarding staffing and documentation deficiencies.

The facility failed to document residents' conditions every 8 hours following incidents, and staffing levels were inadequate on multiple evening shifts to meet the required number of direct care staff for residents with special care needs. Additional housekeeping and maintenance deficiencies were also noted.

Complaint #27238 with 2 allegations substantiated.

The inspection was conducted in response to Complaint #27183 concerning the assisted living and memory care units at Celebration Villa of Teays Valley.

The allegation was unsubstantiated and no deficiencies were cited during the inspection conducted from August 15 to August 17, 2022.

Complaint #27183 was investigated and found to be unsubstantiated with no deficiencies cited.

Annual survey conducted to assess compliance with regulatory requirements for Celebration Villa of Teays Valley assisted living and memory care facility.

The inspection identified multiple deficiencies including failure to maintain accurate resident admission and discharge records, inadequate housekeeping and maintenance, failure to document release of resident belongings upon death, improper medication administration, lack of resident access to policies and procedures, incomplete employee training on specialty care topics, absence of liability insurance information in admission contracts, unlocked laundry room with hazardous chemicals accessible, and failure to specify CPR procedures in contracts.

The inspection was an Environmental-Annual survey conducted to assess compliance with health, safety, housekeeping, laundry, maintenance, and physical facility standards at Celebration Villa of Teays Valley.

The facility was found to have multiple deficiencies including improper storage of soiled laundry, failure to document resident evacuation training within 24 hours of admission, medication carts blocking emergency exits, and dust accumulation on vents and walls. Several maintenance and housekeeping issues were noted such as damaged carpets, missing bathroom fixtures, and unclean sinks.

The inspection was conducted in response to a complaint (#26482) received regarding Celebration Villa of Teays Valley.

The investigation found three allegations, none of which were substantiated. The census at the time was 43 assisted living residents and 20 memory care residents.

Complaint #26482 was investigated from 02/09/22 at 11:00 PM to 02/10/22 at 11:00 AM. There were 3 allegations reviewed and 0 were substantiated.

Follow-up to the annual inspection to verify correction of previously identified deficiencies.

All deficiencies identified in the prior annual inspection have been corrected. The census included 44 assisted living residents with 2 out-of-facility and 21 Alzheimer's residents with 1 out-of-facility.

Annual survey conducted to assess compliance with state regulations for assisted living and Alzheimer's care units.

The facility had multiple deficiencies including incomplete staff training, inadequate housekeeping and maintenance, incomplete resident assessments and care plans, missing resident demographic and physician information, failure to report significant weight changes, and improper infection control practices.

The inspection was conducted as an Infection Control Survey to assess compliance with infection prevention and control standards.

The survey found no deficiencies or tags cited. Both staff and residents were offered the vaccine during the visit.

The inspection was conducted as an Initial Licensure Survey with an Annual Environmental review on July 7, 2020.

The inspection found no deficiencies cited during the Initial Licensure Survey and Annual Environmental review.

The document is a plan of correction following a behavioral health survey conducted to address deficiencies related to the safety and appropriateness of the environment for adolescent consumers.

The survey found that the facility did not provide a safe environment, noting that adolescent girls' bedrooms had outside doors without alarms and staff were not awake on weekend nights to monitor consumers. The plan of correction indicated that awake-night supervision would be implemented on weekends by July 1, 2004.

The inspection was conducted as a complaint survey related to concerns about the facility's handling of resident transfers and discharge documentation.

The facility failed to prepare and provide proper transfer/discharge summaries for a resident, including medical history, physician's orders, and progress notes. Additionally, housekeeping and maintenance deficiencies were observed, such as damaged carpet, missing bathroom fixtures, and unclean areas.

Complaint ID# WV00023357 was unsubstantiated. The complaint related to transfer/discharge documentation and was found to be an unrelated deficiency.

Change of ownership revisit survey completed with credible evidence to verify correction of previous deficiencies.

All deficiencies identified in prior surveys were corrected as of the revisit date 11/19/2019.

This was a re-visit inspection following an Environmental CHOW survey conducted on September 3, 2019, to verify correction of previously cited deficiencies.

The re-visit inspection found that all previously cited deficiencies (0441, 0452, and 0496) were corrected.

The inspection was conducted as a routine environmental and physical facility survey to assess compliance with health, safety, housekeeping, maintenance, and emergency preparedness regulations.

The facility was found to have deficiencies related to improper storage of soiled and clean laundry, inadequate maintenance and housekeeping including damaged physical environment elements, and lack of an emergency alternate shelter agreement in the disaster preparedness plan.

Routine inspection survey conducted to assess compliance with health and safety regulations, care planning, resident rights, physical environment, and record keeping at Celebration Villa of Teays Valley.

The facility was found deficient in multiple areas including failure to develop timely assessments and care plans for residents, inadequate housekeeping and maintenance, lack of secure storage for resident records, absence of call system in memory care unit, improper resident contract provisions regarding release of belongings upon death, and failure to provide residents with rights to pharmacy choice and free copies of records.

The visit was a complaint follow-up inspection to verify correction of previously identified deficiencies related to a complaint with ID WV00022337.

The deficiencies identified in the prior complaint investigation were corrected as of the follow-up visit on July 22, 2019.

Complaint ID WV00022337; deficiencies were corrected as confirmed during the follow-up visit.

The inspection was conducted as a complaint investigation based on complaint WV00022524 with visits on May 22, 2019 and June 19, 2019.

No deficiencies were cited during the complaint investigation conducted at Celebration Villa of Teays Valley.

Complaint WV00022524 was investigated on May 22, 2019 and June 19, 2019 with no deficiencies cited.

Complaint investigation conducted from April 29 to May 2, 2019, triggered by allegations of neglect and abuse at Celebration Villa of Teays Valley assisted living and memory care units.

The facility failed to develop and adopt consistent written policies for abuse reporting, failed to ensure adequate staffing levels on the memory care unit, and failed to report neglect and abuse allegations timely to Adult Protective Services (APS) and the licensing agency. Investigations of abuse allegations were incomplete and not thoroughly documented, and measures to prevent further abuse during investigations were not implemented. Housekeeping and maintenance deficiencies were also noted.

Complaint ID WV00022337 investigated from April 29 to May 2, 2019. Census at time was 53 assisted living and 23 memory care residents with 1 out of facility. Allegations included neglect and abuse by Employee #T1, including failure to assist a resident after a fall, abandonment of shift, and failure to report incidents to APS. Investigation and reporting deficiencies were confirmed.

The inspection was conducted as a complaint investigation based on Complaint ID WV00022056 during February 27-28, 2019.

No deficiencies were cited during the complaint investigation.

Complaint ID WV00022056 was investigated and found to have no deficiencies cited.

The inspection was conducted as a complaint investigation based on Complaint ID WV0021918.

No deficiencies were cited during the complaint investigation.

Complaint ID WV0021918 was investigated and found to have no deficiencies cited.

The document reports on the annual licensure survey and annual environmental inspection conducted at Celebration Villa of Teays Valley.

The inspection found no deficiencies cited during the annual licensure and environmental survey.

Annual licensure survey conducted from October 29 to November 1, 2018 to assess compliance with regulatory requirements.

No deficiencies were cited during the annual licensure survey for the facility.

The inspection was conducted as a complaint investigation based on Complaint ID WV00019891.

No deficiencies were cited during the complaint investigation conducted on March 12-13, 2018.

Complaint ID WV00019891 was investigated with no deficiencies cited.

The inspection was conducted as an annual licensure survey of Celebration Villa of Teays Valley to assess compliance with state regulations.

No deficiencies were cited during the annual licensure survey conducted from November 27-30, 2017.

The document is an annual licensure survey conducted to assess environmental compliance at the facility.

No deficiencies were cited during the environmental annual licensure survey conducted on November 27, 2017.

The visit was a follow-up survey conducted to verify corrections after the annual licensure survey and to assess compliance in assisted living and memory care units.

The report summarizes the annual licensure survey conducted in December 2016 and the follow-up survey in February 2017, noting census counts for assisted living and Alzheimer's/memory care units. Specific deficiencies cited in the annual survey are not detailed here.

Annual licensure survey conducted to assess compliance with health and safety regulations, staff training, care planning, behavioral management, medication administration, incident reporting, and dietary services.

The facility was found deficient in multiple areas including staff training on Alzheimer's care, timely development and review of care plans, behavioral health evaluations, medication monitoring and physician notification, incident reporting, tuberculosis screening, and dietary services compliance. Physical environment issues such as housekeeping and maintenance were also noted.

The inspection was conducted as an annual licensure survey focusing on environmental conditions at the facility.

No deficiencies were cited during this annual licensure survey.

The visit was a follow-up survey conducted to verify correction of deficiencies identified during the annual licensure survey conducted November 9-11, 2015.

The report summarizes the annual licensure survey and the subsequent follow-up survey. The census was 44 residents during both visits. No specific deficiencies or severity levels are detailed in the provided text.

The inspection was conducted as an annual licensure survey and environmental review of the assisted living program at Celebration Villa of Teays Valley.

No deficiencies were cited during this annual licensure survey and environmental inspection.

The inspection was conducted as an annual licensure survey of the assisted living facility to assess compliance with state regulations including employee training, management of resident funds, and release of resident belongings upon death.

The facility was found deficient in maintaining annual in-service training records for all staff on required topics, managing resident funds with proper consent documentation, and ensuring proper release of resident belongings and funds to estate administrators or executors upon resident death. Additionally, housekeeping and maintenance issues were noted in a prior behavioral health survey.

The visit was conducted as an annual licensure survey including an annual environmental inspection.

No deficiencies were cited during the environmental survey completed on 01/07/2015.

Annual licensure survey conducted from October 20-23, 2014 to assess compliance with state regulations for Celebration Villa of Teays Valley.

The facility was found deficient in multiple areas including failure to maintain accurate resident transfer registers, inadequate housekeeping and maintenance, incomplete and outdated resident assessment and service plans, medication administration errors, lack of physician orders for medications, failure to determine resident capability for self-administration of medications, insufficient staff training on resident conditions, improper release of resident belongings upon death, and failure to prepare therapeutic diets according to physician or dietitian instructions.

The inspection was conducted as a complaint investigation on June 12-13, 2014 at Celebration Villa of Teays Valley.

The report does not provide specific findings or deficiencies related to the complaint investigation; the summary statement of deficiencies section is blank.

Complaint investigation conducted on June 12-13, 2014 with a census of 51 residents.

Annual inspection conducted to assess compliance with health and safety regulations at Celebration Villa of Teays Valley.

The report includes initial comments noting the census of 73 residents on the inspection date. Specific deficiencies or detailed findings are not provided in the available page.

The inspection was conducted as a complaint investigation at Celebration Villa of Teays Valley.

The report does not provide specific findings or deficiencies related to the complaint investigation.

Complaint investigation conducted on October 9, 2013, with a census of 47 residents. No substantiation status or detailed complaint findings are provided.

The visit was conducted as an annual licensure survey of the facility.

No deficiencies were cited during the inspection, but technical assistance was provided.

The visit was a follow-up survey conducted from September 30, 2013 to October 2, 2013, to verify correction of previously identified deficiencies and compliance with licensing standards at Celebration Villa of Teays Valley (ALR/ALZ).

The survey found multiple deficiencies including inadequate housekeeping and maintenance, failure to provide required employee training, incomplete and outdated resident service plans, medication administration issues, lack of weekly nursing assessments for residents with nursing needs, and failure to document resident weights upon admission and monthly thereafter.

The inspection was conducted as a complaint investigation at Celebration Villa of Teays Valley.

The report does not provide specific findings or deficiencies related to the complaint investigation.

Complaint investigation WV00008762 conducted on September 10-11, 2013 with a census of 23.

The inspection was conducted as a complaint investigation at Celebration Villa of Teays Valley from July 11-15, 2013.

The complaint investigation was partially substantiated, but no deficiencies were cited during the inspection.

Partially substantiated complaint with no deficiencies cited.

The inspection was conducted as a complaint investigation at Celebration Villa of Teays Valley.

The complaint investigation was unsubstantiated with no deficiencies cited.

Complaint investigation WV00008033 conducted April 24-25, 2013; found to be unsubstantiated.

The document reports on the annual licensure survey and subsequent follow-up surveys conducted to assess compliance and environmental conditions at the facility.

The report summarizes the annual licensure survey conducted on October 29, 2012, and follow-up surveys on February 6, 2013, and March 26, 2013, with census counts noted. Deficiencies identified in earlier surveys were corrected by January 4, 2013.

The visit was a follow-up survey to verify correction of deficiencies identified in a prior annual licensure survey conducted on October 29, 2012.

The facility was found to have multiple deficiencies related to fire safety, physical facilities maintenance, housekeeping, and preventive maintenance. The follow-up survey noted improvements such as removal of door props on fire-rated doors, cleaning and organizing of kitchen and maintenance areas, establishment of a preventive maintenance program, and proper storage of food and laundry supplies. However, ongoing renovation work was noted with concerns about cross contamination, and some physical environment issues required continued monitoring.

The inspection was conducted as an annual licensure survey and a follow-up survey to assess environmental conditions and compliance with physical facility requirements.

The facility failed to maintain the interior and exterior in a clean, safe, and good repair condition, including issues such as unlit light bulbs, damaged countertops, and improper storage of food items. The facility had repeat deficiencies related to physical maintenance and housekeeping.

The visit was conducted as an annual licensure survey of Celebration Villa of Teays Valley to assess compliance with health care standards and facility regulations.

The inspection found deficiencies related to medication administration, including failure to obtain physician's orders for self-administered medications and discontinuations, and failure to properly assess residents' capability to self-administer medications. Additionally, housekeeping and maintenance issues were noted, such as damaged carpet, missing bathroom fixtures, and unclean areas.

The visit was conducted as an annual licensure survey to assess compliance with regulatory requirements for the facility.

The report documents the annual licensure survey conducted November 12-14, 2012, with a census of 42 residents. A follow-up survey on January 3, 2013, with a census of 47, noted that deficiencies were corrected and technical assistance was given.

The inspection was conducted as an annual licensure survey to assess environmental and physical facility conditions at Celebration Villa of Teays Valley, including compliance with health and safety regulations.

The facility was found to have deficiencies related to cleanliness and maintenance, including dusty ceiling vent covers, damaged countertops, unlit light bulbs, improper food storage, and lack of current vaccination documentation for resident and facility cats.

The inspection was conducted as a complaint investigation at Celebration Villa of Teays Valley, an assisted living facility with memory care units.

The complaint investigation was unsubstantiated, and technical assistance was provided during the visit.

Complaint investigation #WV00006951 was unsubstantiated. Technical assistance was given.

The inspection was conducted as a complaint investigation from November 29 to December 9, 2011, at Celebration Villa of Teays Valley, an assisted living and Alzheimer's unit combined facility.

The report documents deficiencies found during the complaint investigation and notes a follow-up complaint visit on January 25, 2012, where deficiencies were corrected.

Complaint investigation conducted November 29 - December 9, 2011, with a follow-up on January 25, 2012. Deficiencies identified during the initial investigation were corrected by the follow-up visit.

The inspection was conducted as a complaint investigation from November 29 through December 9, 2011, to assess staffing adequacy and care quality at Celebration Villa of Teays Valley.

The investigation found inadequate staffing levels that did not meet regulatory requirements based on residents' care needs, resulting in insufficient assistance to residents and poor housekeeping and maintenance conditions. Multiple resident and family complaints highlighted issues with care, staffing shortages, and facility cleanliness.

Complaint investigation conducted November 29 - December 9, 2011, with census of 70 residents (ALR and Alzheimer’s unit combined). Multiple resident and family complaints about inadequate staffing, poor care, and facility conditions were documented. Staffing levels were verified to be below regulatory requirements.

The document is an annual licensure survey conducted to assess the facility's compliance with regulatory requirements.

The survey found that deficiency E242 related to the sprinkler system was deleted after confirmation that the system is a type 13 and the facility is in compliance. No other deficiencies are explicitly stated.

The visit was an annual licensure survey conducted from November 28 to December 1, 2011, to assess compliance with healthcare standards and medication administration practices.

The inspection found significant deficiencies in medication administration, including failure to obtain proper prescriptions before changing medication orders for 40 of 70 residents, failure to document medication administration properly, and administration of medications not ordered by a physician. Additionally, housekeeping and maintenance issues were noted in a behavioral health facility from a prior survey.

The inspection was conducted as an annual licensure survey of the facility.

The report documents the annual licensure survey conducted from November 28 to December 1, 2011, with a census of 70 residents. A follow-up survey was conducted on February 7, 2012, with a census of 47, during which deficiencies were corrected.

The inspection was conducted as a complaint investigation at Celebration Villa of Teays Valley.

The complaint investigation was unsubstantiated with no deficiencies cited.

The complaint investigation conducted from August 15-17, 2011 was unsubstantiated.

The visit was conducted as an annual licensure survey to assess environmental and physical facility conditions at Celebration Villa of Teays Valley.

The survey found deficiencies related to maintenance and housekeeping, including excessive combustible materials in a resident's room, unsecured hazardous cleaning agents, damaged walls and floors, mold/mildew, grease buildup, and a damaged ice machine gasket.

The inspection was conducted as an annual licensure survey to assess environmental compliance and overall facility conditions.

The report documents an environmental survey conducted by the state surveyor, with a follow-up survey noting that deficiencies were corrected. No specific deficiencies or severity levels are detailed in the provided text.

The inspection was conducted as an annual licensure survey of Celebration Villa of Teays Valley to assess compliance with state regulations and standards.

The survey identified deficiencies including failure to obtain a required surety bond for resident funds, inadequate adherence to diabetic management policies and physician orders, and housekeeping and maintenance issues such as damaged carpet and missing bathroom fixtures.

The inspection was conducted as an annual licensure survey of the facility.

The report documents the annual licensure survey conducted November 9-11, 2010, with a follow-up survey on January 4, 2011, confirming that deficiencies identified were corrected.

The inspection was conducted as a complaint investigation at Celebration Villa of Teays Valley.

The complaint investigation was unsubstantiated with no deficiencies cited.

Complaint investigation #WV00005988 was unsubstantiated.

The inspection was conducted as a complaint investigation at Celebration Villa of Teays Valley.

The complaint investigation was unsubstantiated with no deficiencies cited.

The complaint investigation was unsubstantiated as stated in the report.

The visit was a follow-up survey conducted to verify correction of deficiencies identified during the annual licensure survey conducted December 1-3, 2009.

Deficiencies identified in the prior annual licensure survey were corrected, and technical assistance was provided during the follow-up visit.

Annual licensure survey conducted December 1-3, 2009 to assess compliance with state regulations for Celebration Villa of Teays Valley.

The facility was found deficient in multiple areas including failure to complete required abuse registry screenings prior to hire, inadequate housekeeping and maintenance, incomplete admission agreements, improper management of resident funds, failure to promptly resolve and document complaints, outdated or incomplete service plans, insufficient monitoring following incidents, and failure to document resident weights and notify physicians of significant weight changes.

The facility failed to document or resolve nine complaints reported by residents or their representatives during October and November 2009. No written notifications of complaint outcomes were provided to complainants within the required four-day timeframe.

Annual licensure survey conducted to assess the environment and compliance of the facility.

No deficiencies were found during the survey; only technical assistance was provided.

The inspection was conducted as a complaint investigation (#WV00004944) with follow-up visits to verify correction of deficiencies and understanding of the complaint.

The report documents deficiencies related to safety and housekeeping in the facility, including inadequate supervision during weekend nights, unsecured doors, and maintenance issues such as carpet damage and missing bathroom fixtures. Plans of correction were outlined to address these issues.

Complaint investigation #WV00004944 conducted May 13-14, 2009 with follow-up visits on September 16, 2009 and October 27-28, 2009. Census ranged from 43 to 57 during visits. Deficiencies were corrected and technical assistance was given.

The inspection was conducted as a complaint investigation for CI #WV00005035 and CI #WV00005054 during June 24-30, 2009, with follow-up visits in August and October 2009 to verify correction of deficiencies.

The report documents deficiencies related to safety and housekeeping, including inadequate supervision during weekend nights, unsecured outside doors, and maintenance issues such as carpet damage and missing bathroom fixtures. Corrective actions and plans for improvement were outlined.

Complaint Investigation CI #WV00005035 and CI #WV00005054 conducted June 24-30, 2009 with census 56. Follow-up visits on August 3-5, 2009 (census 44) and October 27-28, 2009 (census 45) to verify corrections. Deficiencies were corrected with technical assistance only.

The inspection was conducted as a complaint investigation for complaint #WV00005282 on October 27-28, 2009.

The complaint investigation was unsubstantiated, and technical assistance was provided to the facility.

Complaint #WV00005282 was investigated and found to be unsubstantiated.

Complaint investigation conducted May 13-14, 2009, with follow-up on September 16, 2009, related to medication administration, employee training, personnel records, housekeeping, and infection control.

The facility failed to ensure protection of residents' physical and mental well-being, proper supervision and training of new nurses, accurate medication administration records, adequate housekeeping and maintenance, and compliance with infection control standards. Personnel files were incomplete or missing for agency staff, and medication errors and documentation deficiencies were noted.

Complaint investigation #WV00004944 conducted May 13-14, 2009, with follow-up on September 16, 2009. Census at time of complaint was 47 residents. Surveyors Donna Williamson, RN, HFNS I and Pam Martin, RN, HFNS I conducted the investigation.

The inspection was conducted due to complaints received regarding housekeeping deficiencies and medication administration concerns at Celebration Villa of Teays Valley.

The facility failed to ensure sufficient housekeeping staff to meet cleaning needs, resulting in debris and soiled areas in multiple resident rooms and common areas. Complaints about medication administration and housekeeping were not thoroughly investigated or properly addressed in written responses. The administrator failed to respond to complaints within the required timeframe and did not maintain adequate documentation of investigations.

The complaint investigation (CI #WV00005035 and CI #WV00005054) was conducted from June 24-30, 2009 and June 24-29, 2009 respectively. Complaints included concerns about medication administration errors, prescriptions not being refilled, and inadequate housekeeping. The administrator failed to ensure sufficient housekeeping staff and failed to respond adequately and timely to complaints. Family members and residents reported ongoing issues with cleanliness and medication administration. The census at the time was 56.

The inspection was conducted as a complaint investigation based on concerns raised by residents' family members and others regarding housekeeping, resident care, medication administration, and safety issues at Celebration Villa of Teays Valley.

The facility was found deficient in multiple areas including insufficient housekeeping staff leading to unsanitary conditions, failure to follow resident care plans especially regarding incontinence care, inadequate updating and monitoring of residents' functional needs and service plans after significant events such as elopement, failure to promptly notify physicians and responsible parties of major incidents or changes in condition, and unsafe storage of toxic cleaning supplies accessible to confused residents.

The complaint investigation was based on multiple complaints received between June 24-30, 2009, including concerns about housekeeping inadequacies, medication errors, resident safety, and failure to respond to complaints in a timely manner. The investigation included interviews with family members, residents, and staff, and review of resident records.

The inspection was conducted as a complaint follow-up investigation regarding concerns about resident care, including failure to update assessments and service plans after an elopement, inadequate monitoring following a significant change in condition, and failure to notify the physician and responsible party promptly after major incidents.

The facility failed to update a resident's functional needs assessment and service plan after an elopement, did not monitor and document the resident's condition at least every eight hours following a significant change and elopement, and failed to promptly notify the resident's physician and responsible party after major incidents. Additionally, the report references prior deficiencies related to inadequate housekeeping and maintenance from 2004.

This was a complaint follow-up investigation (Complaint #WV00005054) conducted June 24-29, 2009, involving review of one resident's medical record and interviews. The complaint included failure to update care plans after elopement, inadequate monitoring post-incident, and failure to notify physician and family promptly.

The inspection was conducted as a complaint investigation following concerns about inadequate staffing, housekeeping, medication administration, and training at the assisted living residence.

The facility failed to maintain adequate staffing levels, proper housekeeping and maintenance, timely medication administration, complete staffing schedules, and required employee training. Additionally, there were deficiencies in narcotic drug count procedures and documentation.

Complaint investigation #WV00004944 conducted May 13-14, 2009, with census of 47 residents. Family of resident #23 complained about bathroom cleanliness. Staff and family reported insufficient aides and nurses, especially on weekends and holidays.

The inspection was conducted as a complaint investigation regarding medication administration and staffing concerns at Celebration Villa of Teays Valley.

The facility failed to ensure medications were passed to all 47 residents within the required time frame, with observations of medication errors and inadequate nurse supervision. Additionally, housekeeping and maintenance deficiencies were noted from a prior 2004 survey.

The complaint investigation (#WV00004944) revealed that nurses failed to pass medications timely and correctly, with residents and staff reporting medication errors by nurse LPN, TS. Concerns included incorrect medication administration, failure to give noon medications on the Alzheimer's unit, and improper infection control techniques. The administrator was unaware of these issues until June 24, 2009.

The inspection was conducted as a complaint investigation for Celebration Villa of Teays Valley, an assisted living facility with memory care units.

The complaint investigation found no deficiencies and was unsubstantiated. Technical assistance was provided to the facility.

Complaint investigation #WV00004706 conducted on March 4 and 5, 2009. The complaint was unsubstantiated with no deficiencies found.

The visit was conducted as an annual licensure survey to assess the environment and compliance with physical facility regulations.

The administrator failed to maintain a safe environment for residents, including lack of oxygen use signage, unsecured oxygen cylinders in resident room #134, and use of electrical extension cords throughout the facility.

The document reports on the Annual Licensure Survey conducted to assess the facility's compliance with regulatory standards.

The survey included an environmental assessment and a follow-up survey to verify correction of deficiencies. Deficiencies identified in the prior survey were corrected by the follow-up visit.

Annual licensure survey conducted December 8-10, 2008 to assess compliance with assisted living residence licensing regulations.

The facility was found deficient in multiple areas including failure to follow diabetic monitoring and medication administration policies, inadequate housekeeping and maintenance, incomplete personnel licensure documentation, improper medication availability and documentation, failure to properly destroy discontinued controlled substances, and failure to follow physician ordered therapeutic diets including fluid restrictions.

The inspection was conducted as an annual licensure survey of Celebration Villa of Teays Valley to assess compliance with health care standards and facility regulations.

The survey found deficiencies related to failure to provide resident care in accordance with current standards, specifically regarding infection control and diabetic care for six of eight residents with diabetes. Additionally, housekeeping and maintenance issues were noted, including damaged carpets, missing bathroom fixtures, and unclean areas.

The inspection was conducted as an annual licensure survey of the facility.

The report documents the annual licensure survey conducted December 8-10, 2008, with a census of 47 residents. A follow-up survey was conducted in January and March 2009 to verify correction of deficiencies, which were corrected.

Annual licensure survey conducted to assess compliance with state regulations for Celebration Villa of Teays Valley, an assisted living residence.

The facility was found deficient in multiple areas including failure to develop consistent written policies, inadequate housekeeping and maintenance, incomplete pre-employment abuse registry checks, insufficient staff training on specialty care and therapeutic diets, medication administration errors, inadequate resident monitoring and documentation, and failure to update resident service plans to reflect current needs.

The inspection was conducted as an annual licensure survey of the facility.

The report includes findings from the annual licensure survey conducted December 3-6, 2007, with a census of 60 residents. A follow-up survey was conducted February 5-6, 2008, with a census of 46, where deficiencies were corrected and only technical assistance was provided.

The visit was conducted as an annual licensure survey to assess the environment and compliance of the facility.

The survey found no deficiencies and only provided technical assistance (TA) during the inspection.

The inspection was conducted as a complaint investigation following concerns about inadequate staffing, resident care, and housekeeping at Celebration Villa of Teays Valley.

The facility was found to have inadequate staffing levels, especially on the Memory Care Unit, with frequent use of agency staff and staff unable to complete all duties. Housekeeping and maintenance were deficient, with issues such as damaged carpets, missing bathroom fixtures, and unclean areas. Staff training on abuse prevention and reporting was also inadequate.

Complaint # WV00003509 was investigated from July 23 to August 1, 2007, triggered by family concerns about a resident developing a serious bedsore and inadequate room cleanliness after an overnight pass.

The inspection was conducted due to a complaint from the family of resident #27 regarding a developing serious bed sore and unclean room conditions after an overnight pass.

The facility was found deficient in staffing levels, housekeeping, maintenance, physical safety, and storage security. Staffing was insufficient on multiple shifts, with high turnover and inadequate supervision, especially in the Memory Care Unit. Housekeeping and maintenance issues included damaged carpets, missing bathroom fixtures, and rodent infestation. Hazardous materials were not properly secured.

Complaint # WV00003509 from family of resident #27 dated July 17, 2007, alleging a serious bed sore and unclean room after overnight pass. The complaint investigation found multiple deficiencies related to staffing, housekeeping, and safety.

The inspection was conducted as a complaint investigation for Complaint # WV00003509 from July 23 to August 1, 2007.

The report documents a complaint investigation followed by a complaint follow-up visit and notes that deficiencies were corrected as of October 4, 2007.

Complaint # WV00003509 was investigated from July 23 to August 1, 2007, with a follow-up visit December 3-6, 2007. Deficiencies identified were corrected by October 4, 2007.

The document includes an annual licensure survey, a complaint investigation, and multiple follow-up surveys related to complaint #WV00003081 conducted at Celebration Villa of Teays Valley.

The survey identified deficiencies related to safety and housekeeping, including inadequate supervision during weekend nights, unsecured doors, and maintenance issues such as carpet damage and missing bathroom fixtures. Corrective actions and plans for repairs were documented, and deficiencies were noted as corrected by the final follow-up.

Complaint investigation related to complaint #WV00003081 conducted November 13-16, 2006 with census 50. Follow-up surveys were conducted on January 8-9, 2007 (census 49), January 31, 2007 (census 49), and February 21, 2007 (census 63).

The inspection was conducted as an Annual Licensure Survey with a complaint investigation and multiple follow-up visits related to complaint #WV00003081.

The facility was found deficient in ensuring adequate housekeeping and maintenance, as well as in medication administration practices, particularly regarding insulin administration and physician order compliance. Multiple repeat deficiencies were noted related to failure to administer medications as ordered and failure to notify physicians of critical blood sugar readings.

Complaint investigation #WV00003081 was conducted November 13-16, 2006, with follow-up visits on January 8-9, 2007 and January 31, 2007. The complaint involved failure to administer medications as ordered and failure to notify physicians as required. The deficiencies were substantiated and repeated in follow-up surveys.

Annual licensure survey and complaint investigation follow-up to assess compliance with health and safety regulations, medication administration, and resident care standards.

The facility failed to ensure proper medication administration, specifically insulin management for diabetic residents, including failure to notify physicians of elevated blood sugars or insulin refusals. Housekeeping and maintenance deficiencies were also noted, such as damaged carpets and missing bathroom fixtures. A new policy for insulin-dependent diabetic residents was implemented to address blood glucose monitoring and physician notification.

Complaint Investigation #WV00003081 conducted November 13-16, 2006 with census 50. Follow-up surveys conducted January 8-9, 2007 and January 31, 2007 with census 49.

The visit was a complaint investigation and follow-up related to staffing levels and medication administration at Celebration Villa of Teays Valley.

The facility failed to maintain adequate staffing levels to meet resident care needs, including monitoring a high elopement risk resident. There were also deficiencies in housekeeping and maintenance, and failures to administer medications and follow physician orders accurately, particularly related to insulin administration and blood pressure monitoring.

Complaint investigation #WV00003081 conducted November 13-16, 2006, with follow-up survey January 8-9, 2007. The complaint involved inadequate staffing and medication administration errors.

Complaint investigation conducted from November 13-16, 2006, focusing on resident care, safety, staffing, and complaint handling at Celebration Villa of Teays Valley.

The facility failed to maintain adequate housekeeping and maintenance, ensure safety measures such as door alarms, maintain sufficient staffing levels, properly address resident complaints, update resident service plans, administer medications as ordered, and prepare therapeutic diets according to physician or dietitian instructions.

Complaint investigation #WV00003081 conducted November 13-16, 2006. Census was 50. Complaints included resident care issues, food dissatisfaction, delayed staff response, and safety concerns. Complaint file contained only four written complaints related to billing, with no documentation of other complaints or timely written responses.

The inspection was conducted as an annual licensure survey to assess the environment and compliance with health and safety regulations at Celebration Villa of Teays Valley.

The survey identified deficiencies related to physical facilities, including lack of alarm systems on exit doors to prevent resident wandering, and environmental maintenance issues such as damaged carpet, missing bathroom fixtures, and cleanliness concerns. Plans of correction were directed to address these issues.

Annual licensure survey conducted to assess the environment and compliance of Celebration Villa of Teays Valley.

The survey included an environmental assessment with no specific deficiencies noted in the summary. A follow-up survey was conducted to verify correction of prior deficiencies, which were confirmed corrected.

The inspection was conducted as an annual licensure survey and follow-up to verify correction of previous deficiencies.

The facility was found deficient in multiple areas including inadequate housekeeping and maintenance, failure to ensure proper employee background checks and training, incomplete resident assessments and service plans, lack of physician orders for medications, improper medication storage, inadequate dietary management, and insufficient security measures to prevent resident elopement.

Annual licensure survey conducted November 28-29, 2005 to assess compliance with state regulations for Celebration Villa of Teays Valley.

The facility was found deficient in multiple areas including failure to ensure timely criminal background checks for new hires, inadequate reporting of major incidents, incomplete employee training, missing tuberculosis screenings, incomplete or outdated resident health assessments and service plans, lack of physician orders for medications, improper medication storage, failure to notify physicians of significant weight changes, and inadequate security measures to prevent resident elopement.

The inspection was conducted as an annual licensure survey of the facility, including a follow-up survey to verify correction of previous deficiencies.

The report indicates that deficiencies were identified during the annual licensure survey and that these deficiencies were corrected by the time of the follow-up survey. Technical assistance was also provided.

The inspection was conducted as an annual licensure survey to assess compliance with environmental and physical facility standards at Celebration Villa of Teays Valley.

The survey found deficiencies related to maintenance and housekeeping, including unsanitary conditions in the food preparation area such as old dried food splatter on equipment and debris under the stove, as well as physical damages like carpet burns and missing bathroom fixtures.

Annual licensure survey conducted to assess environmental conditions and compliance of the facility.

The survey identified environmental conditions during the annual inspection. A follow-up survey was conducted to verify correction of deficiencies, which were found to be corrected.

The document is a follow-up to a re-licensure survey for the Alzheimer's Unit and Assisted Living facility, conducted to verify correction of deficiencies and compliance with licensing requirements.

The report indicates that deficiencies identified in previous surveys were corrected by the time of the follow-up inspection on January 4, 2005. The census increased from 14 to 60 over the course of the surveys and follow-ups.

This is a first follow-up visit to a re-licensure survey conducted on September 22-23, 2004, for the Alzheimer's Unit and Assisted Living facility to verify correction of previously cited deficiencies.

The facility was found to have corrected the use of full length bed rails by removing those from the foot of beds, leaving only half length rails at the head of beds, bringing the community into compliance. The Director of Wellness will continue to monitor compliance. Other housekeeping and maintenance issues from an earlier behavioral health survey remain addressed through ongoing monitoring and work orders.

The inspection was conducted in response to Complaint #WV00001668 on October 7, 2004.

No deficiencies were issued during this complaint investigation inspection.

Complaint #WV00001668 was investigated and found to have no deficiencies.

Re-licensure survey conducted on September 22-23, 2004, to assess compliance with state regulations for the Alzheimer's Unit and Assisted Living facility.

The facility was found deficient in multiple areas including failure to monitor side effects of behavior modifying medications, inadequate housekeeping and maintenance, incomplete employee screening and training, incomplete resident health assessments and service plan reviews, use of full length bed rails contrary to regulations, failure to provide updated admission contracts to residents, and lack of documentation of emergency evacuation orientation for residents.

The inspection was an environmental survey conducted to assess the facility's compliance with health and safety regulations.

The environmental survey found no deficiencies at the facility during the inspection.

The inspection was conducted as a complaint investigation identified as #WV00001562.

The complaint investigation was unsubstantiated and no deficiencies were found during the inspection.

Complaint Investigation #WV00001562 was unsubstantiated with no deficiencies identified.

The visit was a 1st follow-up complaint investigation related to Complaint Investigation #WV00001380 dated June 23, 2004.

The inspection identified deficiencies related to safety and supervision, including lack of awake night staff on weekends and unsecured outside doors in the adolescent girls' residence.

Complaint Investigation #WV00001380 dated June 23, 2004, with follow-up on July 27, 2004.

The inspection was conducted due to concerns about staffing adequacy and safety in the Alzheimer's/dementia special care unit, including incidents of aggressive behavior between residents and inadequate supervision.

The facility failed to provide sufficient direct care staff to meet residents' physical and psychosocial needs, resulting in unwitnessed altercations between residents. Additionally, the environment was found unsafe and inadequately maintained, with issues such as unsecured doors, damaged furnishings, and poor housekeeping.

The complaint investigation revealed substantiated issues with insufficient staffing to monitor residents, resulting in aggressive incidents between residents #11 and F-1, including physical altercations causing injury. The resident F-1 was later found to have a sternal fracture of uncertain age.

Follow-up visit to verify correction of deficiencies identified during the annual inspection.

The follow-up inspection found that previously identified deficiencies related to safety and supervision in the adolescent residence were corrected. Plans were made to provide awake-night supervision during weekend shifts by July 1, 2004.

Follow-up visit to verify correction of deficiencies identified in a previous complaint investigation (CI WV00001022) conducted on February 11, 2003.

Deficiencies previously identified related to safety and supervision were corrected as of this follow-up visit. The report notes that staff deployment changes will be implemented by July 1, 2004 to ensure awake-night supervision on weekends.

Follow up to complaint investigation WV00001022; deficiencies corrected.

Annual survey conducted to assess compliance with health, safety, employee training, housekeeping, and dietary service regulations at Celebration Villa of Teays Valley.

The inspection identified multiple deficiencies including inadequate employee orientation and annual training, failure to maintain a safe and appropriate environment, poor housekeeping and maintenance, and failure to obtain and document monthly resident weights and notify physicians of significant weight changes.

The inspection was conducted as a complaint investigation related to failure to respond in writing to resident complaints at Broadmore Assisted Living @ Teays Valley.

The facility failed to respond in writing to multiple resident complaints within the required timeframe. Additionally, deficiencies were found related to inadequate housekeeping, maintenance, and safety concerns such as unsecured doors and lack of awake staff on weekend nights.

Complaint investigation #1022 was conducted at Broadmore Assisted Living @ Teays Valley on December 9, 2003. The administrator failed to respond in writing to complaints from residents and families regarding insurance communication, cleaning requests, and service issues such as refusal to serve breakfast for late arrival.

Annual survey conducted at Broadmore Assisted Living at Teays Valley on September 29-30, 2003 to assess compliance with regulatory requirements including staff training, resident care, behavior management, housekeeping, maintenance, and reporting obligations.

The facility was found deficient in multiple areas including failure to ensure all staff received mandatory training, inadequate behavior management documentation, failure to report suspected abuse and neglect, inadequate housekeeping and maintenance, failure to obtain monthly resident weights, and failure to administer medications as ordered.

Complaint investigation #WV00000766 was conducted at Broadmore Assisted Living on August 14, 2003, to assess freedom of movement for residents in the Memory Care Unit and compliance with physical environment regulations.

The administrator failed to ensure that all residents brought to the Memory Care Unit had freedom of movement to their personal spaces, including access to a bed and designated bathroom. The unit had 14 residents but only 13 beds. Documentation was lacking regarding residents' time and duration in the Memory Care Unit. Observations and interviews revealed residents wandering into others' rooms and restricted access due to locked unit doors requiring staff escort.

Complaint investigation #WV00000766 focused on freedom of movement issues in the Memory Care Unit. The complaint was substantiated by observations, interviews, and record reviews showing residents locked in the unit, wandering into other rooms, and insufficient beds for the number of residents.