Inspection Reports for Forever Living Residence Home Care
1608 Aztec Way, Las Vegas, NV 89169, NV, 89169
Back to Facility ProfileDeficiencies per Year
8
6
4
2
0
Severe
High
Moderate
Low
Unclassified
Census Over Time
Census
Capacity
Inspection Report
Complaint Investigation
Census: 4
Deficiencies: 1
Jun 2, 2025
Visit Reason
The inspection was conducted as a result of a complaint investigation triggered by three complaints received by the facility, including one substantiated complaint regarding discrimination based on HIV status.
Findings
The facility was found to have discriminated against a resident by refusing admission due to the resident's HIV positive status. The facility conducted refresher training on non-discrimination policies to address the deficiency.
Complaint Details
Three complaints were investigated: one substantiated complaint (#NV00073195) related to discrimination, one substantiated without deficient practice (#NV00073603), and one unsubstantiated (#NV74038).
Severity Breakdown
Severity: 2: 1
Deficiencies (1)
| Description | Severity |
|---|---|
| Discrimination prohibited - facility discriminated against a resident based on HIV status by refusing admission. | Severity: 2 |
Report Facts
Complaints investigated: 3
Substantiated complaints: 1
Census: 4
Inspection Report
Annual Inspection
Census: 5
Capacity: 6
Deficiencies: 0
Nov 6, 2024
Visit Reason
The inspection was conducted as an annual State Licensure survey in accordance with Nevada Administrative Code (NAC), Chapter 449, Residential Facilities for Groups.
Findings
The facility received a grade of A with no deficiencies identified during the survey. Five resident records and four employee files were reviewed.
Report Facts
Resident records reviewed: 5
Employee files reviewed: 4
Inspection Report
Annual Inspection
Census: 4
Capacity: 6
Deficiencies: 1
Nov 20, 2023
Visit Reason
The inspection was conducted as an annual State Licensure survey in accordance with Nevada Administrative Code Chapter 449 for Residential Facility for Groups.
Findings
The facility received a grade of A. One deficiency was identified related to health and sanitation due to excessive weeds and an unused bathtub on the premises, which the owner acknowledged and corrected promptly.
Severity Breakdown
Severity: 2: 1
Deficiencies (1)
| Description | Severity |
|---|---|
| Facility failed to ensure the premises were clean and well maintained, including excessive weeds approximately four inches throughout the backyard perimeter planter and an unused bathtub against the side of the house. | Severity: 2 |
Report Facts
Licensed beds: 6
Resident census: 4
Deficiency severity: 2
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Charo Dale | Administrator | Named as Laboratory Director's or Provider/Supplier Representative who signed the report |
Inspection Report
Annual Inspection
Census: 5
Capacity: 6
Deficiencies: 0
Dec 7, 2022
Visit Reason
The inspection was conducted as an annual grading and infection control State Licensure survey in accordance with Nevada Administrative Code Chapter 449 for Residential Facilities for Groups.
Findings
The facility received a grade of A with no regulatory deficiencies identified. Five resident files and four employee files were reviewed, and no further action was necessary.
Report Facts
Licensed beds: 6
Residents present: 5
Resident files reviewed: 5
Employee files reviewed: 4
Inspection Report
Annual Inspection
Census: 5
Capacity: 6
Deficiencies: 0
Nov 1, 2021
Visit Reason
The inspection was conducted as an annual grading and infection control State Licensure survey combined with a complaint investigation at the facility.
Findings
The facility received a grade of A. One complaint regarding dogs biting a visiting care provider was investigated and found not substantiated. The facility was provided guidance on regulatory requirements related to non-discrimination and cultural competency policies.
Complaint Details
Complaint #NV00064815 with one allegation was investigated and not substantiated. The allegation that the residents' two dogs bit a visiting care provider was disproven based on interviews, observations, and incident report reviews.
Report Facts
Licensed beds: 6
Resident census: 5
Inspection Report
Routine
Census: 6
Capacity: 6
Deficiencies: 0
Nov 25, 2020
Visit Reason
This inspection was a COVID-19 focused infection control survey conducted to assess compliance with infection control measures related to COVID-19 at the facility.
Findings
The facility was found to have implemented multiple infection control measures including temperature checks, screening questions, use of PPE, social distancing, and sanitization protocols. No residents or staff tested positive for COVID-19 at the time of the survey.
Report Facts
Gloves: 600
Surgical masks: 200
N-95 masks: 20
KN-95 masks: 10
Gowns: 50
Hand sanitizer bottles: 2
Electronic temporal thermometers: 2
Residents served meals at dining table: 2
Residents served meals in bedroom: 4
Inspection Report
Annual Inspection
Census: 5
Capacity: 6
Deficiencies: 0
Jan 16, 2020
Visit Reason
The inspection was conducted as the Annual Grading State Licensure Survey for the facility in accordance with Nevada Administrative Code, Chapter 449, Residential Facilities for Groups.
Findings
The facility received a grade of A with no regulatory deficiencies identified. Five resident records and four employee records were reviewed during the survey.
Inspection Report
Annual Inspection
Census: 5
Capacity: 6
Deficiencies: 1
Feb 5, 2019
Visit Reason
The inspection was conducted as the annual State Licensure survey in accordance with Nevada Administrative Code Chapter 449 for Residential Facilities for Groups.
Findings
The facility received a grade of A. One deficiency was identified related to the improper use of side rail restraints on one resident's bed, which is prohibited by regulation.
Severity Breakdown
2: 1
Deficiencies (1)
| Description | Severity |
|---|---|
| Facility failed to ensure side rail restraints were not placed on the bed for 1 of 5 residents (Resident #3). | 2 |
Report Facts
Resident files reviewed: 5
Employee files reviewed: 4
Licensed beds: 6
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Charo Dale | Administrator | Signed the inspection report and plan of correction |
Inspection Report
Renewal
Capacity: 4
Deficiencies: 0
Mar 28, 2017
Visit Reason
The inspection was conducted as a Bed Increase survey to evaluate the facility's request for licensure of two additional Residential Facility for Group beds for elderly and disabled persons and/or persons with chronic illnesses.
Findings
No regulatory deficiencies were identified during the survey. The facility is currently licensed for four beds and is requesting licensure for two additional beds.
Report Facts
Current licensed beds: 4
Requested additional beds: 2
Inspection Report
Renewal
Capacity: 4
Deficiencies: 0
Mar 28, 2017
Visit Reason
The inspection was conducted as a Bed Increase survey to evaluate the facility's request for licensure of two additional Residential Facility for Group beds.
Findings
No regulatory deficiencies were identified during the survey. The facility is currently licensed for four beds and is requesting two additional beds.
Report Facts
Current licensed beds: 4
Requested additional beds: 2
Inspection Report
Annual Inspection
Census: 3
Capacity: 4
Deficiencies: 3
Sep 28, 2016
Visit Reason
The inspection was conducted as an annual State Licensure survey for re-licensure of the facility.
Findings
The facility received a grade of A but had deficiencies related to cleanliness with dead cockroaches found in the linen closet, medication administration errors for 2 of 3 residents, and failure to properly secure medications for 1 resident.
Severity Breakdown
2: 3
Deficiencies (3)
| Description | Severity |
|---|---|
| Facility failed to ensure premises were clean and sanitary; two dead cockroaches found on floor of linen closet with no shelving or barrier between comforters and floor. | 2 |
| Facility failed to ensure medications for 2 of 3 residents were given as prescribed or prescribed by a physician; discrepancies in medication administration records and missing physician orders. | 2 |
| Facility failed to ensure medications for 1 of 3 residents were locked and secured; insulin vial and needles kept in unlocked pencil box at bedside without physician documentation authorizing self-administration. | 2 |
Report Facts
Deficiencies cited: 3
Facility licensed beds: 4
Resident census: 3
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Charo Dale | Administrator | Named as primary contact and responsible party in the inspection report |
Inspection Report
Annual Inspection
Census: 3
Capacity: 4
Deficiencies: 3
Sep 28, 2016
Visit Reason
This inspection was conducted as an annual State Licensure survey of the facility on 9/28/2016 by the Division of Public and Behavioral Health.
Findings
The facility received a grade of A but was found deficient in maintaining clean and sanitary premises, proper medication administration and storage. Specifically, dead cockroaches were found in the linen closet, medications for two residents were not administered as prescribed or properly documented, and medications for one resident were not securely stored.
Severity Breakdown
2: 3
Deficiencies (3)
| Description | Severity |
|---|---|
| Facility failed to ensure the premises were clean and sanitary; two dead cockroaches were observed on the floor of the linen closet. | 2 |
| Medications for 2 of 3 residents were not given as prescribed or prescribed by a physician; discrepancies in medication instructions and lack of physician orders were noted. | 2 |
| Medications for 1 of 3 residents were not locked and secured; insulin vial and supplies were kept in an unlocked box at the resident's bedside without physician authorization for self-administration. | 2 |
Report Facts
Licensed beds: 4
Current census: 3
Medication bottles: 4
Dead cockroaches: 2
Severity level 2 deficiencies: 3
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Employee #2 explained the home gets sprayed three times a month and acknowledged dead bugs were missed. | ||
| Employee #4 explained the beverage supplements were brought by Resident #1's family and wrote medication instructions on the MAR. |
Inspection Report
Annual Inspection
Census: 4
Capacity: 4
Deficiencies: 3
Nov 9, 2015
Visit Reason
The inspection was an annual State Licensure survey conducted to assess compliance with regulations for a residential facility for elderly and disabled persons.
Findings
The facility received a grade of A but had several deficiencies including failure to maintain cleanliness of vents and yard, admission of a resident not meeting eligibility requirements, and failure to ensure tuberculosis testing compliance for one resident.
Severity Breakdown
Severity: 2: 3
Deficiencies (3)
| Description | Severity |
|---|---|
| Facility failed to ensure vents were clean and the yard was maintained properly. | Severity: 2 |
| Facility admitted a resident who did not meet admission eligibility requirements. | Severity: 2 |
| Facility failed to ensure one resident met tuberculosis testing requirements. | Severity: 2 |
Report Facts
Resident census: 4
Total licensed capacity: 4
Deficiency count: 3
Inspection Report
Annual Inspection
Census: 4
Capacity: 4
Deficiencies: 3
Nov 9, 2015
Visit Reason
This annual State Licensure survey was conducted to assess compliance with regulatory requirements for the residential facility licensed for four group beds for elderly and disabled persons and/or persons with chronic illness.
Findings
The facility received a grade of A but had deficiencies including failure to maintain clean vents and properly maintain the yard, admission of a resident who did not meet eligibility requirements, and failure to ensure tuberculosis testing compliance for one resident.
Severity Breakdown
Severity: 2: 3
Deficiencies (3)
| Description | Severity |
|---|---|
| Facility failed to ensure vents were clean and the yard was maintained properly, with dust buildup on vents and storage of several large boxes, a commode, and windows in the yard. | Severity: 2 |
| Facility admitted a resident who did not meet admission requirements, including a resident with dementia and other diagnoses who went missing after leaving the facility unsupervised. | Severity: 2 |
| Facility failed to ensure one resident met tuberculosis testing requirements, lacking documented evidence of a positive TB test prior to chest x-ray. | Severity: 2 |
Report Facts
Resident files reviewed: 4
Employee files reviewed: 4
Residents admitted: 3
Residents not meeting admission requirements: 1
Inspection Report
Annual Inspection
Census: 3
Capacity: 4
Deficiencies: 8
Dec 4, 2013
Visit Reason
The inspection was a State Licensure annual grading survey conducted to assess compliance with health, safety, and regulatory standards for a residential facility for elderly and disabled persons.
Findings
The facility received a grade of B with multiple deficiencies identified including issues with cleanliness and maintenance, fire extinguisher inspection, use of restraints, medication administration and documentation, medication labeling, Alzheimer's endorsement, and chronic illness training for employees.
Severity Breakdown
Level 1: 2
Level 2: 5
Deficiencies (8)
| Description | Severity |
|---|---|
| Facility failed to ensure premises were clean and well maintained, including uncovered trash cans and missing window screen. | Level 2 |
| Facility failed to ensure annual inspection of fire extinguishers; extinguisher not tagged for 2013 certification. | — |
| Facility failed to ensure residents were not restrained with full side bed rails on unoccupied bed. | Level 1 |
| Facility failed to administer routine or as needed medications as prescribed for 1 of 3 residents due to medications not available on site. | Level 2 |
| Facility failed to maintain medication administration records accurately for 2 of 3 residents, including missed documentation and missed medication administration. | Level 1 |
| Facility failed to ensure medications were plainly labeled with resident and prescribing physician information for 1 of 3 residents. | Level 2 |
| Facility admitted a resident with Alzheimer's disease without the required Alzheimer's endorsement on license. | Level 2 |
| Facility failed to ensure 2 of 3 caregivers received required chronic illness training within 60 days of hire. | Level 2 |
Report Facts
Census: 3
Total Capacity: 4
Severity 2 Deficiencies: 5
Severity 1 Deficiencies: 2
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Rebecca Wolfkill | Administrator | Named in restraint and medication administration findings |
| Employee #1 | Named in chronic illness training deficiency | |
| Employee #3 | Named in chronic illness training deficiency |
Inspection Report
Annual Inspection
Census: 3
Capacity: 4
Deficiencies: 8
Dec 4, 2013
Visit Reason
This document is a State Licensure annual grading survey conducted on 12/4/2013 to assess compliance with regulations for a residential facility for group beds for elderly and disabled persons.
Findings
The facility received a grade of B with multiple deficiencies identified including failure to maintain clean and well-maintained premises, failure to inspect fire extinguishers annually, improper use of restraints, medication administration issues including missing medications and inaccurate medication records, unlabeled medications, admission of a resident with Alzheimer's disease without proper endorsement, and inadequate chronic illness training for employees.
Severity Breakdown
Level 1: 2
Level 2: 5
Deficiencies (8)
| Description | Severity |
|---|---|
| Facility failed to ensure premises was clean and well maintained, including uncovered trash cans, open bag of rice on floor, bucket with water in backyard, and missing window screen. | Level 2 |
| Facility failed to ensure fire extinguisher was inspected annually; extinguisher last certified 6/7/2012 and not tagged for 2013. | — |
| Facility failed to ensure residents were not restrained with full side bed rails (Bedroom #2). | Level 1 |
| Facility failed to administer medications as prescribed for 1 of 3 residents due to medications not being available on site. | Level 2 |
| Medication administration record (MAR) was inaccurate for 2 of 3 residents; missed documentation of medication administration and missed signatures. | Level 1 |
| Medications were not plainly labeled with resident or physician name or dosage for 1 of 3 residents. | Level 2 |
| Facility admitted a resident with Alzheimer's disease without an Alzheimer's disease endorsement on its license. | Level 2 |
| Facility failed to ensure 2 of 3 caregivers received at least 4 hours of chronic illness training within 60 days of hire. | Level 2 |
Report Facts
Facility licensed capacity: 4
Census: 3
Severity 2 deficiencies: 5
Severity 1 deficiencies: 2
Employee chronic illness training delay: 7
Employee chronic illness training delay: 10
Inspection Report
Annual Inspection
Census: 3
Capacity: 4
Deficiencies: 0
Dec 4, 2013
Visit Reason
The inspection was conducted as a State Licensure annual grading survey to assess compliance with regulatory requirements for the facility.
Findings
The facility received a grade of A with no deficiencies identified during the survey.
Inspection Report
Original Licensing
Capacity: 4
Deficiencies: 0
Dec 12, 2012
Visit Reason
Initial State licensure survey conducted to request licensure for four Residential Facility for Groups beds for elderly and disabled persons and persons with chronic illnesses.
Findings
No deficiencies were recorded during the initial licensure survey. The facility provided two resident files and four employee files for review.
Report Facts
Licensed beds: 4
Resident files reviewed: 2
Employee files reviewed: 4
Report
File
3YFA11_Redacted
Report
File
POC.pdf
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