Inspection Reports for
Dahlonega Assisted Living & Memory Care

The visit was complaint-related, investigating multiple intakes (#GA50001026, #GA00252358, #GA50000560, #GA50000193).

The inspection found that the administrator or on-site manager failed to ensure that staff received required initial training within the first 60 days of employment on residents' rights, identification of abuse, neglect or exploitation, general infection control principles, and emergency preparedness for multiple staff members.

The investigation was initiated due to intake #GA00243894 concerning staffing shortages and resident care issues. The complaint included allegations of inadequate nursing coverage, improper medication administration, lack of supervision, failure to update care plans, failure to notify responsible parties after incidents, and failure to report abuse.

The facility failed to provide the required minimum nursing staffing hours for memory care residents, did not properly document medication administration and training related to morphine for a hospice resident, failed to provide adequate supervision and update care plans after incidents, did not take appropriate immediate action or notify responsible parties after adverse events, and failed to report resident abuse to the Department as required.

The investigation was initiated due to complaints #GA00236256 and #GA00235585 regarding medication discrepancies and resident care concerns. The complaint was substantiated based on record review and interviews.

The facility failed to ensure proper medication inventory and record keeping for Resident #2, resulting in unaccounted narcotic doses and staff termination for gross negligence. Additionally, the facility failed to ensure adequate care and medication management for Resident #1, who was found unresponsive and had several medications missing or delayed.

The complaint investigation was substantiated by findings including delayed response times to resident calls for assistance, with some calls taking over an hour to be answered, and residents being left unattended in distressing situations.

The facility failed to ensure keypad lock instructions were posted outside the memory care unit and failed to provide adequate and timely care to residents, including delayed responses to assistance calls and insufficient staffing on certain days.

The investigation was initiated due to intake #GA00226457 concerning Resident #1 who fell in the bathroom on 11/11/2021, waited for staff assistance, sustained a head injury and concussion, and whose incident was not properly reported or communicated to family or physician.

The facility failed to have a valid licensed administrator, failed to have a memory care certificate, and failed to provide adequate care and timely response to a resident who fell, resulting in a head injury and concussion. The facility also failed to report the serious injury and notify the resident's family or physician as required.

Investigation included intake #GA00216181.

The facility failed to include in the resident's file an inventory of valuable personal items brought to the assisted living community for one out of five sampled residents (Resident #1). Interviews confirmed the absence of a personal inventory sheet in the resident's file.

The investigation was triggered by an intake alleging that a caregiver became frustrated and shoved Resident #1 to the floor on 3/18/21. The incident was captured on security camera footage and involved a physical and verbal exchange between Resident #1 and Staff C. Staff C was counseled and additional training was provided. Resident #1 had diagnoses of dementia and atrial fibrillation.

The facility failed to ensure that Resident #1 was treated with dignity, kindness, consideration, and respect, resulting in a physical altercation where Staff C pushed Resident #1, causing the resident to fall. Staff C was counseled for poor performance related to the incident.

Investigation was complaint-related based on intake #GA00211286 and #GA00211291. The complaint involved denial of communication rights for Resident #1, which was substantiated by interviews and record review.

The facility failed to ensure that Resident #1 had the right to associate and communicate freely and privately with persons of their choice without censorship by staff. Interviews and record reviews revealed that Resident #1 was prevented from speaking with a specific individual (AA) due to instructions from the power of attorney and facility staff, violating resident rights.

The investigation was complaint-driven based on complaints #GA00209053, #GA00209402, and #GA00209522. The complaints included concerns about staffing shortages and inadequate resident care. Interviews with staff and residents confirmed staffing shortages and delayed response times to resident calls. One resident moved out due to these issues.

The facility failed to provide the minimum required awake direct care staff to resident ratio during waking and non-waking hours, resulting in insufficient staff to meet residents' needs. Additionally, the facility failed to ensure sufficient staff times were provided so that 14 of 15 residents received prescribed services, treatments, medications, and diet. Response times to resident calls were often delayed, and staff shortages led to a resident moving out of the facility.