Inspection Reports for Jabez Customized Living Services
8350 Pierce Street Northeast, Spring Lake Park, MN 55432, MN, 55432
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Inspection Report
Annual Inspection
Census: 4
Capacity: 4
Deficiencies: 9
Apr 10, 2024
Visit Reason
The Minnesota Department of Health conducted a full survey to evaluate and assess compliance with state licensing statutes for an assisted living facility.
Findings
The licensee was found in substantial compliance but had several violations including food preparation not meeting Minnesota Food Code, incomplete emergency preparedness plan, physical environment not in good repair, inadequate fire safety and evacuation plans and training, failure to offer residents the opportunity to designate a representative, incomplete employee orientation and annual training, incomplete dementia care training, and incomplete resident reassessment and monitoring.
Severity Breakdown
Level 1: 1
Level 2: 8
Deficiencies (9)
| Description | Severity |
|---|---|
| Food was not prepared and served according to the Minnesota Food Code. | Level 2 |
| Failed to develop an all-hazards risk assessment emergency preparedness program and plan including required elements. | Level 2 |
| Physical environment not maintained in a continuous state of good repair; broken window not yet replaced. | Level 2 |
| Failed to develop and maintain a fire safety and evacuation plan with required content and provide required training. | Level 2 |
| Failed to offer residents the opportunity to identify a designated representative in writing with required statutory language. | Level 1 |
| Failed to ensure employees received orientation to assisted living facility licensing requirements before providing services. | Level 2 |
| Failed to ensure employees received at least eight hours of annual training for each 12 months of employment in required topics. | Level 2 |
| Failed to ensure all direct care staff received at least eight hours of initial dementia care training within 160 working hours of employment. | Level 2 |
| Failed to ensure registered nurse completed ongoing resident reassessment and monitoring on or before day 14 and day 90 and failed to use the uniform assessment tool. | Level 2 |
Report Facts
Residents present: 4
Total licensed capacity: 4
Compliance dates: 21
Compliance date: 180
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Pandora White | Licensed Assisted Living Director / Registered Nurse (LALD/RN) | Named in relation to inspection findings and discussions. |
| Kelly Thorson | Supervisor, State Evaluation Team | Signed the state inspection letter. |
| Melissa Ramos | Environmental Health Specialist | Signed the food and beverage establishment inspection report. |
| Unlicensed Personnel C | Direct Care Staff | Named in relation to missing orientation, annual training, and dementia care training. |
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