Inspection Report
Complaint Investigation
Census: 35
Deficiencies: 0
Jul 10, 2025
Visit Reason
A complaint investigation was conducted due to allegations that the facility neglected to assess, monitor, and intervene in a timely manner, failed to ensure residents were properly trained to self-administer medications, and failed to ensure dependent residents were provided ADL assistance.
Findings
Based on observations, record review, and interviews with residents, staff, and families, the center was found to be in compliance with regulations and no deficiencies were cited.
Complaint Details
The complaint investigation was substantiated by a thorough review including observations, interviews, and record examination, but no deficiencies were cited.
Report Facts
Sample size: 5
Facility Census: 35
Inspection Report
Complaint Investigation
Census: 32
Deficiencies: 6
Apr 11, 2025
Visit Reason
The inspection was conducted as a complaint investigation based on allegations that the facility failed to provide palatable meals, failed to honor residents' food choices, failed to ensure safe assistance to prevent injury, and failed to maintain a safe, clean, and comfortable environment.
Findings
The investigation found that the facility generally provided alternative menus and honored resident choices with no complaints about food. However, deficiencies were cited including failure to advise a resident and representative of risks associated with bed rail use, failure to complete a significant change assessment, failure to secure medication carts and resident information, and failure to maintain and provide resident records and incident reports as required.
Complaint Details
The complaint investigation was based on allegations that the facility failed to provide palatable meals and honor residents' food choices, failed to ensure safe assistance to prevent injury, and failed to maintain a safe, clean, and comfortable environment. The investigation included observations, interviews, and record reviews. Some allegations were not substantiated, but deficiencies were cited as noted.
Severity Breakdown
SS=D: 4
SS=F: 2
Deficiencies (6)
| Description | Severity |
|---|---|
| Failed to advise a resident and the resident's representative of the risks associated with the use of a bed rail for 1 of 8 sampled residents. | SS=D |
| Failed to complete a significant change assessment for 1 of 8 residents sampled. | SS=D |
| Failed to ensure unattended medication carts were locked, HIPAA information and MAR were secured, and medications were stored and secured inside locked medication carts. | SS=F |
| Failed to retain resident records for at least five years for 1 of 8 residents sampled. | SS=D |
| Failed to ensure all resident records were readily available upon request for 1 of 8 residents sampled. | SS=D |
| Failed to maintain incident reports for a period of two years. | SS=F |
Report Facts
Facility census: 32
Sample size: 8
Date of inspection: Apr 11, 2025
Date of plan of correction completion: Apr 28, 2025
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Tempal Killman | Enforcement Analyst | Signed enforcement letters and correspondence related to the inspection and follow-up. |
| Regina Herring | Administrator | Facility administrator named in the report and plan of correction. |
| CMA #1 | Certified Medication Aide | Interviewed regarding medication cart security and policies. |
| CMA #2 | Certified Medication Aide | Interviewed regarding medication cart security and resident assistance. |
| DON | Director of Nursing | Interviewed regarding resident assessments, risk agreements, and medication policies. |
Inspection Report
Complaint Investigation
Census: 13
Deficiencies: 4
Oct 10, 2023
Visit Reason
A licensure survey and complaint investigation were conducted due to allegations including inadequate qualified staff, failure to protect residents' rights, unsafe environment, failure to provide therapeutic diets, and expired food safety concerns.
Findings
The facility was found deficient in multiple areas including unsafe and unsanitary food storage and preparation, water temperatures exceeding allowed limits in bathing rooms, incomplete resident contracts, and failure to review plans of accommodation quarterly. Specific issues included debris in the kitchen, unlabeled and thawed food items stored improperly, water temperatures above 115°F in bathing rooms, missing charges in resident contracts, and lack of quarterly review of accommodation plans.
Complaint Details
Complaint investigation was initiated based on allegations of inadequate qualified staff, failure to protect residents' rights, unsafe environment, failure to provide therapeutic diets, and expired food safety concerns. The investigation included observations, interviews, and record reviews.
Deficiencies (4)
| Description |
|---|
| Food was stored in an unsafe and unsanitary manner; kitchen was not kept clean and in good repair, including debris under fryer and cook top, white residue on flooring, missing baseboards, and black accumulation behind dishwasher. |
| Water temperatures in bathing rooms exceeded 115 degrees Fahrenheit, with documented temperatures up to 120 degrees. |
| Resident service contract for one resident did not include charges for services. |
| Plan of accommodation was not reviewed quarterly for one resident as required. |
Report Facts
Residents: 13
Unpasteurized eggs: 48
Water temperature: 120
Water temperature: 115
Dishwasher sanitizing cycle: 10
Date of inspection: Oct 10, 2023
Date of report completion: Oct 17, 2023
Date of plan of correction completion: Nov 30, 2023
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Tomee Andrews | Administrator | Named in relation to findings and plan of correction submissions. |
| Lisa Calvin | Enforcement Analyst | Signed enforcement correspondence. |
| Tempal Killman | Administrative Assistant II | Signed acceptance letter for plan of correction. |
Inspection Report
Renewal
Capacity: 50
Deficiencies: 0
Jan 24, 2023
Visit Reason
This document is a renewal license issued to Crystal Place Retirement Inc. to conduct and maintain an Assisted Living Center.
Findings
The license certifies that Crystal Place Assisted Living is authorized to operate with a maximum capacity of 50 beds, effective from 02/23/2023 to 02/22/2026.
Report Facts
Maximum licensed beds: 50
Inspection Report
Complaint Investigation
Census: 16
Deficiencies: 7
Oct 13, 2022
Visit Reason
A complaint investigation was conducted due to allegations including inadequate staffing, lack of medical director, dietary staff, and failure to provide a safe, homelike environment.
Findings
Deficient practices were substantiated related to inadequate staffing, failure to provide nutritious meals, lack of nursing documentation, and unsafe environment during construction. Deficient practices were unsubstantiated for abuse, lack of medical director, and dietary staff presence. The facility was required to submit a plan of correction.
Complaint Details
The complaint investigation was initiated due to allegations of failure to ensure residents were not abused, inadequate staffing, lack of medical director, lack of dietary staff, failure to provide nutritious meals, lack of nursing documentation, and failure to provide a clean, safe, homelike environment. Some allegations were substantiated and others were unsubstantiated.
Severity Breakdown
SS=D: 1
SS=E: 1
SS=F: 5
Deficiencies (7)
| Description | Severity |
|---|---|
| Failed to have a registered nurse complete an admission assessment within 30 days before or at admission for one resident. | SS=D |
| Failed to provide a safe, homelike environment during construction for three residents. | SS=F |
| Failed to provide or arrange registered nurse supervision of skilled nursing interventions for one resident self-administering insulin and blood sugar monitoring. | SS=F |
| Failed to provide or arrange qualified staff to administer medications and perform medication reviews for all residents. | SS=F |
| Failed to designate an administrator responsible for the day to day operation of the assisted living center. | SS=F |
| Failed to employ a licensed dietitian or qualified nutritionist to develop the diet plan and address special diets. | SS=F |
| Failed to provide reasonable accommodations for three residents for alternative menu items and food preferences. | SS=E |
Report Facts
Residents sampled: 9
Current residents: 16
Deficiencies cited: 7
Correction completion timeframe: 60
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Teri Ellis | Administrator | Signed multiple plans of correction. |
| Lisa Calvin | Enforcement Analyst | Signed enforcement and correspondence letters. |
| Ernestine Scovens | MSN, RN, CHFS | Completed investigative report. |
Inspection Report
Original Licensing
Capacity: 50
Deficiencies: 0
Aug 22, 2022
Visit Reason
This document is the initial licensing certification for Crystal Place Retirement Inc. to conduct and maintain an Assisted Living Center.
Findings
The license certifies that Crystal Place Retirement Inc. is authorized to operate an Assisted Living Center with a maximum capacity of 50 beds, effective from 08/26/2022 to 02/22/2023.
Report Facts
Maximum licensed beds: 50
Inspection Report
Renewal
Capacity: 50
Deficiencies: 0
Feb 24, 2021
Visit Reason
This document serves as a license renewal for Crystal Place, L.L.C., an Assisted Living Center located in Oklahoma City, OK.
Findings
The license renewal certifies that the facility is authorized to conduct and maintain an assisted living center with a maximum capacity of 50 beds, effective from 01/08/2021 to 01/07/2022.
Report Facts
Maximum licensed beds: 50
Inspection Report
Renewal
Census: 30
Deficiencies: 0
Apr 3, 2019
Visit Reason
A re-licensure survey was conducted on April 3, 2019, to assess compliance for renewal of the assisted living center license.
Findings
No deficiencies or deficient practices were cited during the inspection.
Report Facts
Resident census: 30
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Kay Determan | Long Term Care Enforcement Reviewer | Signed the inspection report |
Inspection Report
Renewal
Capacity: 50
Deficiencies: 0
Jan 8, 2019
Visit Reason
The document is a license renewal issued to Crystal Place, L.L.C. to conduct and maintain an Assisted Living Center, indicating the renewal of the facility's license.
Findings
The license certifies that Crystal Place, L.L.C. is authorized to operate an Assisted Living Center with a maximum capacity of 50 beds, effective from January 8, 2019, through January 7, 2020.
Report Facts
Maximum licensed beds: 50
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