Deficiencies per Year
12
9
6
3
0
High
Moderate
Inspection Report
Follow-Up
Census: 31
Deficiencies: 10
Feb 13, 2025
Visit Reason
Follow-up survey to determine if orders from the December 4, 2024 survey were corrected.
Findings
The follow-up survey verified that the facility is in substantial compliance. The prior survey identified multiple deficiencies including food service violations, staff record deficiencies, tuberculosis prevention program issues, emergency preparedness plan gaps, emergency relocation notification failures, background study deficiencies, and incomplete staff training and assessments.
Severity Breakdown
Level 1: 0
Level 2: 9
Level 3: 1
Deficiencies (10)
| Description | Severity |
|---|---|
| Food was not prepared and served according to the Minnesota Food Code, including plumbing cross connections and equipment maintenance issues. | Level 2 |
| Employee records lacked required content including annual performance evaluations and training documentation for one unlicensed personnel. | Level 2 |
| Failed to maintain a tuberculosis prevention and control program according to CDC guidelines, missing two-step TST or equivalent screening for two employees. | Level 2 |
| Failed to maintain a written emergency preparedness plan with all required content including annual review and volunteer policies. | Level 2 |
| Failed to provide required written notice and notification to Ombudsman for emergency relocation of a resident. | Level 2 |
| Failed to submit and receive background studies for ten employees, resulting in an immediate correction order. | Level 3 |
| Unlicensed personnel lacked training in required areas including documentation, reporting changes, environment maintenance, diet preparation, and boundaries. | Level 2 |
| Unlicensed personnel lacked training in additional required areas including resident observation, body functioning, and recognizing resident needs. | Level 2 |
| Staff providing services lacked orientation to assisted living licensing requirements and regulations. | Level 2 |
| Registered nurse failed to conduct resident reassessment within required 90-day timeframe and failed to conduct change of condition assessment for a resident. | Level 2 |
Report Facts
Residents present: 31
Fine amount: 3000
Background studies missing: 10
Days late for resident assessment: 31
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| ULP-J | Unlicensed Personnel | Named in multiple findings for missing training documentation and orientation. |
| Casey DeVries | Supervisor, State Evaluation Team | Signed follow-up survey letter. |
| Christina Amdahl | Certified Food Protection Manager | Named in food service inspection reports. |
| Gregory T. Nelson | Public Health Sanitarian | Signed food service inspection reports. |
Loading inspection reports...
