Inspection Reports for
CENTRAL BAPTIST VILLAGE (Assisted Living)
4747 N Canfield Ave, Norridge, IL, 60706
Back to Facility ProfileDeficiencies (last 3 years)
Deficiencies (over 3 years)
7.3 deficiencies/year
Deficiencies are regulatory violations found during state inspections.
109% worse than Illinois average
Illinois average: 3.5 deficiencies/yearDeficiencies per year
12
9
6
3
0
Inspection Report
Routine
Deficiencies: 7
Date: Aug 8, 2025
Visit Reason
The inspection was a routine survey to assess compliance with regulatory requirements related to resident care, dignity, activities of daily living, range of motion, catheter care, feeding tube care, medication administration, and infection control.
Findings
The facility was found deficient in multiple areas including failure to assist residents with feeding in a dignified manner, inadequate assistance with activities of daily living, failure to apply prescribed palm protectors, improper catheter care leading to infection risk, failure to check gastrostomy tube placement correctly, medication administration errors, and poor adherence to infection prevention and control protocols including hand hygiene and barrier precautions.
Deficiencies (7)
F 0557: The facility failed to assist residents with feeding in a dignified manner by mixing pureed foods together and standing over residents during feeding.
F 0677: The facility failed to provide adequate assistance with activities of daily living for residents requiring help with hygiene, toileting, and grooming.
F 0688: The facility failed to apply left and right palm protectors as ordered by the physician for a resident, risking worsening contractures.
F 0690: The facility failed to provide catheter care in a manner to prevent urinary tract infections, including failure to clean catheter tubing and use clean privacy bags.
F 0693: The facility failed to aspirate gastric contents to check placement of a resident's gastrostomy tube as ordered, relying instead on auscultation of air.
F 0759: The facility failed to administer medications as ordered, resulting in a 10% medication error rate during observed medication pass.
F 0880: The facility failed to perform hand hygiene and adhere to enhanced barrier precautions, including improper glove use and failure to wear gowns during catheter care.
Report Facts
Medication error rate: 10
Residents reviewed: 25
Residents affected: 3
Residents affected: 2
Residents affected: 1
Residents affected: 1
Residents affected: 1
Residents affected: 1
Residents affected: 6
Employees mentioned
| Name | Title | Context |
|---|---|---|
| V2 | Director of Nursing | Named in multiple findings including ADL care, medication administration, catheter care, and infection control |
| V4 | Assistant Director of Nursing | Named in medication administration and infection control findings |
| V7 | Registered Nurse | Named in feeding dignity and palm protector findings |
| V10 | Registered Nurse | Named in gastrostomy tube care and medication administration findings |
| V13 | Certified Nurse Assistant | Named in catheter care and infection control findings |
| V14 | Certified Nurse Assistant | Named in infection control findings |
| V15 | Wound Care Nurse | Named in infection control findings |
| V17 | Registered Nurse | Named in gastrostomy tube care and infection control findings |
Inspection Report
Complaint Investigation
Deficiencies: 1
Date: Feb 18, 2025
Visit Reason
The inspection was conducted as a complaint investigation regarding the facility's failure to notify a physician about a resident's concern of redness and pain on the buttock to ensure adequate assessment and treatment.
Complaint Details
Complaint IL185243/2590716 was substantiated with citation 295.4000 related to failure to notify physician of resident's concern of redness and pain.
Findings
The facility failed to notify the physician of one resident's concern of redness and pain on the buttock, despite documentation of the resident's complaints and observations of redness. Staff stated that since the resident self-administers medication, physician notification was not made, but the Power of Attorney and physician should have been notified. Staff will be in-serviced on this requirement.
Deficiencies (1)
Failed to notify physician of one resident's concern of redness and pain on the buttock to ensure adequate assessment and appropriate treatment.
Report Facts
Residents reviewed: 3
Resident age: 97
Dates of documented observations: 5
Date of survey completion: Feb 18, 2025
Employees mentioned
| Name | Title | Context |
|---|---|---|
| E2 | Director of Resident Services | Provided documentation and interview regarding resident care and notification procedures |
| E4 | Registered Nurse | Entered progress notes and interview regarding resident's complaint and physician notification |
Inspection Report
Plan of Correction
Deficiencies: 1
Date: Feb 18, 2025
Visit Reason
Complaint investigation regarding failure to notify a physician of a resident's concern of redness and pain on the buttock to ensure adequate assessment and treatment.
Complaint Details
Complaint Investigation IL185243/2590716 - Substantiated, 295.4000 cited.
Findings
The facility failed to notify the physician of one resident's concern of redness and pain on the buttock, despite the resident self-administering medication. This was substantiated as a Type 3 violation of Section 295.4000 Physician's Assessment.
Deficiencies (1)
Failure to notify physician of resident's concern of redness and pain on the buttock to ensure adequate assessment and treatment.
Report Facts
Deficiency count: 1
Resident age: 97
Date of survey: Feb 18, 2025
Date of completion: Feb 28, 2025
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Jolanta Jerzyk | Presenter of the in-service training on notification of physician and POA. | |
| E2 | Director of Resident Services | Monitors documentation and compliance with physician notification. |
| E4 | Registered Nurse | Assessed resident and noted unsteady condition; advised resident to call physician. |
Inspection Report
Complaint Investigation
Deficiencies: 1
Date: Jan 2, 2025
Visit Reason
The inspection was conducted due to complaints regarding inadequate staff assistance and supervision leading to resident falls and injuries.
Complaint Details
The investigation was complaint-driven, focusing on falls involving residents R1 and R2. The complaints were substantiated with findings of inadequate staff assistance and supervision. Resident R1 fell during care by an orienting CNA working alone, and resident R2 fell in an unsupervised activity room causing a laceration requiring stitches.
Findings
The facility failed to provide required staff assistance for bed mobility and ambulation for dependent residents, resulting in falls for two residents. There was inadequate supervision in the activity room, contributing to a resident fall causing injury.
Deficiencies (1)
F 0689: The facility failed to ensure adequate staff assistance for bed mobility and ambulation as per MDS assessments, leading to falls for two residents. Staff orientation and supervision practices were insufficient to prevent these incidents.
Report Facts
Residents affected: 2
Stitches required: 3
Employees mentioned
| Name | Title | Context |
|---|---|---|
| V3 | Certified Nursing Assistant (CNA) | Named in fall incident involving resident R1 during orientation period. |
| V7 | Certified Nursing Assistant (CNA) | Mentor CNA who was absent during R1's fall incident. |
| V2 | Director of Nursing (DON) | Provided statements regarding staff orientation and supervision failures. |
| V5 | Social Service Personnel | Witnessed resident R2's fall and noted lack of supervision in activity room. |
| V8 | Restorative Nurse (RN) | Commented on required two-person assistance for bed mobility for resident R1. |
Inspection Report
Annual Inspection
Census: 102
Deficiencies: 5
Date: Aug 15, 2024
Visit Reason
The inspection was conducted as an annual survey to assess compliance with healthcare regulations and facility policies at Central Baptist Village.
Findings
The facility was found deficient in multiple areas including pressure ulcer care, medication administration, food portioning and substitutions, and infection prevention and control during a COVID-19 outbreak. Deficiencies involved failure to follow care plans, medication errors, inadequate food portions, improper food substitutions, and lack of proper COVID testing documentation for staff.
Deficiencies (5)
F 0686: The facility failed to provide appropriate pressure ulcer care and prevent new ulcers from developing for a resident at high risk. The resident did not have a low air loss pressure relieving mattress as required by care plan.
F 0759: The facility failed to follow medication administration policies resulting in a 9.09% medication error rate with 3 errors out of 33 opportunities for 2 residents.
F 0803: The facility failed to serve proper portion sizes of Garlic Herb Roasted Pork Tenderloin to residents on mechanically altered diets, serving 3 ounces instead of the planned 4 ounces.
F 0806: The facility failed to provide food substitutions equivalent in nutritive value to the originally planned menu items for 4 residents, serving half sandwiches with less protein than required.
F 0880: The facility failed to document and track COVID-19 testing results for healthcare providers during a COVID outbreak affecting 102 residents, not following their own testing and mitigation policy.
Report Facts
Medication administration errors: 3
Residents affected by pressure ulcer deficiency: 1
Residents affected by medication error deficiency: 2
Residents affected by food portion size deficiency: 5
Residents affected by food substitution deficiency: 4
Facility census: 102
COVID positive residents: 21
Employees mentioned
| Name | Title | Context |
|---|---|---|
| V2 | Director of Nursing | Named in pressure ulcer and medication administration findings |
| V14 | MDS/Minimum Data Set Coordinator | Named in medication administration errors |
| V20 | Registered Nurse / Wound Care | Named in pressure ulcer care findings |
| V17 | Food Service Worker | Named in food portion size and substitution deficiencies |
| V18 | Assistant Food Service Manager | Named in food portion size and substitution deficiencies |
| V19 | Dietitian | Named in food portion size and substitution deficiencies |
| V16 | Executive Chef | Named in food portion size and substitution deficiencies |
| V3 | Infection Preventionist | Named in infection prevention and COVID testing deficiencies |
| V25 | Nurse Educator | Named in COVID outbreak and infection control deficiencies |
| V26 | Rehab/Restorative Nurse | Named in COVID outbreak and infection control deficiencies |
| V27 | Social Services Staff | Named in COVID outbreak and infection control deficiencies |
| V28 | Social Services Staff | Named in COVID outbreak and infection control deficiencies |
Inspection Report
Annual Inspection
Deficiencies: 7
Date: Sep 7, 2023
Visit Reason
The inspection was conducted as the facility's annual survey to assess compliance with regulatory requirements and resident care standards.
Findings
The facility was found deficient in multiple areas including failure to ensure resident privacy during care, delayed development of care plans for pressure injuries, unsafe resident transfers without gait belt use, improper catheter care, failure to obtain weekly weights for a resident at nutritional risk, improper food handling leading to cross-contamination risk, and inadequate infection control practices related to glove use during incontinence care.
Deficiencies (7)
F 0550: The facility failed to ensure privacy was provided for a resident during care when bathroom and bedroom doors were left open while the resident was toileted.
F 0656: The facility failed to develop and implement a timely care plan to address a pressure injury for a resident, initiating the care plan only after the annual survey began.
F 0689: The facility failed to provide a safe transfer for a resident by not using a gait belt during transfers despite the resident being at high fall risk.
F 0690: The facility failed to ensure an indwelling urinary catheter drainage bag was kept off the floor to prevent contamination and infection.
F 0692: The facility failed to ensure weekly weights were obtained for a resident at nutritional risk, with documented gaps in weight monitoring over several weeks.
F 0812: The facility failed to prevent cross-contamination during food preparation when a cook allowed chicken breasts to contact a visibly soiled apron and used gloved hands improperly.
F 0880: The facility failed to prevent cross contamination of resident contact surfaces by not removing gloves and washing hands after providing incontinence care for multiple residents.
Report Facts
Residents reviewed: 21
Weight loss: 13.4
Chicken breasts: 14
Pressure injury measurement: 3.1
Pressure injury measurement: 4.6
Inspection Report
Plan of Correction
Deficiencies: 3
Date: 6021978 View POC 003 Combined SOC's
Visit Reason
The document is a Plan of Correction submitted by Central Baptist Village in response to alleged deficiencies related to employee health records and tuberculosis (TB) testing compliance.
Findings
The Plan of Correction addresses deficiencies including incomplete TB testing and physical examinations for employees, with corrective actions and quality assurance plans to ensure compliance with state regulations.
Deficiencies (3)
Employee E4 had a positive Quantiferon TB Gold Plus Test but the x-ray evidence was not accepted due to incomplete documentation.
Employee E8 did not have a physical examination completed until after the required timeframe.
Resident R5 admitted without an initial TB test completed; test was completed during survey with negative result.
Report Facts
Date of Completion: 2025.07
Employee hire date: 2025.05
TB Test collection date: 2025.01
Employee hire date: 2025.03
Physical exam completion date: 2025.06
Resident admission date: 2024.09
Resident TB test completion date: 2023.08
Resident TB test during survey: 2025.06
Employees mentioned
| Name | Title | Context |
|---|---|---|
| David P Ciaverella | MD | Reading physician for chest x-ray dated 1/13/2025 |
| Pankti Dhruv Reid | Authorizing provider | Authorizing provider for chest x-ray |
| Barbara Czyz | Administered TB test on 06/24/2025 | |
| Jobelle Gramata | Employee medical exam dated 6/18/2025 |
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