Inspection Report
Renewal
Census: 18
Capacity: 19
Deficiencies: 0
May 2, 2025
Visit Reason
The inspection was conducted as a renewal inspection to determine compliance with applicable licensing statutes and rules for license renewal of Divine Life Assisted Living Center 4 LLC.
Findings
The facility was determined to be in substantial compliance with all applicable rules and statutes. The licensing consultant recommended issuance of a 2-year regular adult foster care license.
Report Facts
Number of residents interviewed and/or observed: 18
Facility capacity: 19
Number of staff interviewed and/or observed: 3
Number of others interviewed: 1
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Jana Lipps | Licensing Consultant | Author of the inspection report and licensing consultant |
| Achal Patel | Licensee Designee | Co-designee of the facility license |
| Vivek Thakore | Licensee Designee | Co-designee of the facility license |
| Cheri Lynn Weaver | Administrator | Facility administrator |
Inspection Report
Original Licensing
Capacity: 19
Deficiencies: 0
Mar 18, 2024
Visit Reason
The visit was conducted to modify the age range of residents served at the facility from 45-99 years of age to 18-99 years of age as part of the original licensing study addendum.
Findings
The facility is licensed to care for traumatically brain injured, physically handicapped, aged, and Alzheimer's populations. The request to lower the age range to accept adults 18 years and older was found appropriate given the populations served. The licensees are aware of their responsibility to ensure resident compatibility.
Report Facts
Capacity: 19
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Achal Patel | Designee/Administrator | Co-licensee designee requesting modification of age range |
| Vivek Thakore | Designee | Co-licensee designee aware of resident compatibility responsibility |
| Jana Lipps | Licensing Consultant | Author of the addendum report |
| Dawn Timm | Area Manager | Approved the addendum report |
Inspection Report
Renewal
Census: 14
Capacity: 19
Deficiencies: 1
Apr 10, 2023
Visit Reason
The visit was conducted as a renewal licensing study inspection for Divine Life Assisted Living Center 4 LLC to assess compliance with licensing requirements.
Findings
The facility was found to be in non-compliance with the rule requiring hot water temperature to be maintained between 105 and 120 degrees Fahrenheit at resident faucets. During inspection, water temperature did not register above 100 degrees Fahrenheit in two of three bathrooms checked.
Deficiencies (1)
| Description |
|---|
| Hot and cold running water that is under pressure shall be provided. The hot water temperature for a resident's use must be maintained at 105 to 120 degrees Fahrenheit at the faucet. Water temperature did not register above 100 degrees Fahrenheit in two of three bathrooms checked. |
Report Facts
Number of residents interviewed and/or observed: 14
Facility capacity: 19
Number of staff interviewed and/or observed: 3
Number of others interviewed: 2
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Jana Lipps | Licensing Consultant | Author of the inspection report and findings |
| Achal Patel | Administrator and Licensee Designee | Named as licensee/designee and administrator |
| Vivek Thakore | Licensee Designee | Named as licensee/designee |
Inspection Report
Original Licensing
Census: 17
Capacity: 19
Deficiencies: 0
Oct 28, 2020
Visit Reason
The visit was conducted as an original licensing inspection to determine compliance with applicable licensing statutes and administrative rules for Divine Life Assisted Living Center 4 LLC.
Findings
The facility was found to be in substantial compliance with licensing requirements, including physical plant and fire safety rules. A temporary license with a capacity of 19 residents was recommended. The facility is adequately staffed and equipped to provide care for residents with physical handicaps, Alzheimer's disease, and related conditions.
Report Facts
Licensed capacity: 19
Current census: 17
Staffing pattern: 2
Resident bedroom count: 18
Square footage of indoor living and dining areas: 850
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Achal Patel | Administrator and Licensee Designee | Named as administrator and licensee designee with qualifications and experience detailed in the report. |
| Leslie Herrguth | Licensing Consultant | Author of the licensing study report and recommendation. |
| Dawn N. Timm | Area Manager | Approved the licensing recommendation. |
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