Inspection Reports for Creekside Village
1500 E Bradley Ave, Ponca City, OK 74604, United States, OK
Back to Facility ProfileDeficiencies per Year
12
9
6
3
0
Moderate
Census Over Time
Inspection Report
Renewal
Capacity: 39
Deficiencies: 0
May 20, 2025
Visit Reason
This document serves as a license renewal for the assisted living center Creekside Village, certifying the facility to continue operation under state regulations.
Findings
The license renewal certifies that the facility meets the provisions of the Oklahoma Statutes and State Board of Health regulations for assisted living centers.
Report Facts
Licensed capacity: 39
Inspection Report
Renewal
Census: 32
Deficiencies: 1
Mar 4, 2025
Visit Reason
A relicensure survey with complaint investigations was conducted at Creekside Village to assess compliance with regulatory standards and investigate specific allegations of abuse, medication administration, and staffing adequacy.
Findings
The survey identified deficiencies including failure to label open food items in the kitchen refrigerator with open/use by dates. Complaint investigations found no actual harm but noted issues with abuse protocols and pharmacy procedures. The facility submitted a plan of correction which was initially rejected and later accepted after amendment. A revisit confirmed correction of cited deficiencies.
Complaint Details
Two complaint investigations were conducted regarding allegations that the center failed to ensure residents were not physically, verbally, or psychosocially abused and failed to report allegations of abuse to the State Agency. Another complaint alleged failure to implement effective pharmacy procedures and inadequate staffing. Investigations included observations, interviews, and record reviews. Residents reported feeling safe and staff were knowledgeable about abuse protocols.
Severity Breakdown
SS=E: 1
Deficiencies (1)
| Description | Severity |
|---|---|
| Failed to ensure open food items were labeled with the open/use by date in the kitchen refrigerator. | SS=E |
Report Facts
Facility Census: 32
Deficiencies cited: 1
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Cheryl Salyer | Executive Director / Administrator / RCD/ED | Named in relation to plan of correction submission and facility administration |
| Tempal Killman | Enforcement Analyst | Author of enforcement and correspondence letters |
Inspection Report
Re-Inspection
Census: 28
Deficiencies: 9
Jun 14, 2023
Visit Reason
A relicensure survey was conducted from 06/13/23 through 06/14/23 to assess compliance with assisted living center regulations.
Findings
The survey identified multiple deficiencies including failure to include admission criteria and service descriptions in resident contracts, food storage and preparation violations, incomplete assessments, medication administration and review issues, and lack of quarterly quality assurance meetings. A follow-up revisit confirmed substantial compliance as of September 1, 2023.
Severity Breakdown
SS=E: 6
SS=F: 3
Deficiencies (9)
| Description | Severity |
|---|---|
| Failed to include admission criteria in resident contracts for three sampled residents. | SS=E |
| Failed to include description of services such as evacuation provisions, medication administration, nursing supervision, and cognitive orientation in contracts. | SS=E |
| Failed to maintain kitchen in accordance with food service regulations including cleanliness, chemical storage, dishmachine monitoring, food coverage, and refrigerator door handle repair. | SS=F |
| Failed to dispose of potentially hazardous foods within 24 hours. | SS=E |
| Failed to ensure whole eggs served were pasteurized when not thoroughly cooked. | SS=E |
| Failed to complete comprehensive assessments within 14 days after admission and/or annually for two of eight sampled residents. | SS=E |
| Failed to ensure physician's orders were transcribed, noted, and implemented for one resident receiving warfarin. | SS=E |
| Failed to ensure medication reviews were completed monthly by RN or pharmacist for two months of six reviewed. | SS=F |
| Failed to maintain an internal quality assurance committee that met at least quarterly. | SS=F |
Report Facts
Residents present: 28
Deficiencies cited: 9
Plan of correction completion date: Sep 1, 2023
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Cheryl Salyer | Administrator/LPN | Named in relation to interview statements and plan of correction submissions. |
| Lisa Calvin | Enforcement Analyst | Signed enforcement and revisit letters. |
| Tempal Killman | Administrative Assistant II | Signed acceptance letter for amended plan of correction. |
Notice
Capacity: 39
Deficiencies: 0
Oct 3, 2022
Visit Reason
This document serves as a license renewal notice certifying that HCP10C Creekside, LLC is licensed to conduct and maintain an Assisted Living Center named Creekside Village.
Findings
The document certifies the facility's licensure status and provides license details including maximum bed capacity and effective dates.
Report Facts
Maximum beds: 39
Inspection Report
Renewal
Capacity: 39
Deficiencies: 0
Jun 9, 2021
Visit Reason
This document is a license renewal issued to HCP1OC Creekside, LLC for the operation of an Assisted Living Center named Creekside Village.
Findings
The license certifies that the facility is authorized to conduct and maintain an Assisted Living Center with a maximum capacity of 39 beds. No deficiencies or findings are noted in this document.
Report Facts
Maximum licensed beds: 39
Inspection Report
Renewal
Capacity: 39
Deficiencies: 0
Mar 16, 2021
Visit Reason
This document is a license renewal issued to HCP10C Creekside, LLC for the operation of an Assisted Living Center named Creekside Village.
Findings
The license certifies that the facility is authorized to conduct and maintain an Assisted Living Center with a maximum capacity of 39 beds. No deficiencies or findings are stated in this document.
Report Facts
Maximum licensed beds: 39
Inspection Report
Abbreviated Survey
Census: 28
Deficiencies: 0
Jul 27, 2020
Visit Reason
The visit was a COVID-19 Special Focus Infection Control Survey conducted to determine if the facility was in compliance with proper infection prevention and control practices to prevent the development and transmission of COVID-19.
Findings
No deficiencies were cited during the COVID-19 Special Focus Survey conducted on July 27, 2020.
Report Facts
Total residents: 28
Inspection Report
Renewal
Census: 27
Deficiencies: 7
Aug 8, 2019
Visit Reason
A State Licensure survey was conducted at Creekside Village Assisted Living Center from August 6 through August 8, 2019, as a re-licensure survey to assess compliance with state regulations.
Findings
The survey identified multiple deficiencies including inappropriate placement of residents requiring chemical restraints, food storage and temperature issues, incomplete assessments, inadequate nurse supervision, failure to use a licensed dietitian, and incomplete background checks for employees. The deficiencies had the potential for more than minimal harm.
Severity Breakdown
E: 4
F: 2
D: 1
Deficiencies (7)
| Description | Severity |
|---|---|
| Failed to ensure 1 of 3 sampled residents identified as an elopement risk did not require a chemical restraint and failed to provide a notice of discharge as outlined in the service agreement. | E |
| Failed to ensure cooked meat and vegetables were served hot to all 27 residents who ate food from the center's kitchen. | F |
| Failed to complete a significant change assessment for 1 of 2 residents who had a significant change in condition. | D |
| Failed to provide registered nurse supervision of skilled nursing interventions including medication monitoring and ensuring medications were kept in locked and secured locations. | E |
| Failed to use a licensed dietitian or qualified nutritionist to ensure the correct diet was served to 1 sampled resident with a physician ordered therapeutic diet. | E |
| Failed to maintain a written record of a schedule II narcotic medication prescribed for 1 sampled resident. | E |
| Failed to conduct criminal history background checks for 2 of 12 employees hired since last survey. | F |
Report Facts
Resident census: 27
Number of employees missing background checks: 2
Number of sampled residents with deficiencies: 9
Inspection Report
Renewal
Capacity: 39
Deficiencies: 0
Aug 5, 2019
Visit Reason
The document is a license renewal issued to HCP10C Creekside, LLC for the operation of an Assisted Living Center named Creekside Village.
Findings
The document certifies the facility's license renewal and confirms the maximum licensed capacity of 39 beds. No inspection findings or deficiencies are noted.
Report Facts
Maximum licensed beds: 39
Loading inspection reports...
