Deficiencies per Year
4
3
2
1
0
Unclassified
Inspection Report
Renewal
Census: 10
Capacity: 20
Deficiencies: 1
Jan 12, 2024
Visit Reason
The inspection was conducted as a renewal licensing study to verify implementation and compliance with a previously submitted corrective action plan.
Findings
The facility was found to be in non-compliance with environmental health rules due to water temperatures in each room exceeding 120 degrees Fahrenheit. An acceptable corrective action plan has been received and renewal of the license is recommended.
Deficiencies (1)
| Description |
|---|
| Water temperature in each room was above 120 degrees Fahrenheit, exceeding the required range of 105 to 120 degrees Fahrenheit. |
Report Facts
Number of residents interviewed and/or observed: 10
Number of staff interviewed and/or observed: 5
Facility capacity: 20
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Martin Gonzales | Licensing Consultant | Author of the inspection report and recommendation |
Inspection Report
Original Licensing
Capacity: 20
Deficiencies: 0
Aug 4, 2021
Visit Reason
The visit was conducted as an original licensing study to determine compliance with applicable licensing statutes and administrative rules for the Devonshire Retirement Village facility.
Findings
The facility was found to be in substantial compliance with all applicable licensing rules, including environmental health and fire safety requirements. The applicant demonstrated financial capability, staff qualifications, and adherence to administrative rules. A temporary license with a maximum capacity of 20 residents was recommended.
Report Facts
Facility capacity: 20
Number of furnaces and hot water heaters: 7
Bedroom count: 20
Dining area size: 221
Main living area size: 750
Sitting area size: 100
Staff to resident ratio: 1
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Rochelle Lyons | Licensee Designee | Named as licensee designee and applicant representative |
| Colleen Cavanaugh | Administrator | Named as facility administrator and participant in exit conference |
| Kent W Gieselman | Licensing Consultant | Conducted inspection and authored report |
| Mary E Holton | Area Manager | Approved the licensing recommendation |
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