Inspection Reports for Kangars Residential Home LLC
141 64 1/2 Way Northeast, Fridley, MN 55432, MN, 55432
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Inspection Report
Original Licensing
Census: 2
Capacity: 10
Deficiencies: 12
Nov 15, 2024
Visit Reason
The Minnesota Department of Health conducted an initial survey on November 15, 2024, to assess compliance with state licensing statutes for Kangars Residential Home LLC's assisted living facility license.
Findings
The licensee was found in substantial compliance but had several deficiencies including food service violations, incomplete employee records and training, tuberculosis screening issues, emergency preparedness plan deficiencies, contract language omissions, incomplete resident assessments and service plans, medication administration and disposal issues, and inadequate documentation and assessment of hospital bed rails.
Severity Breakdown
Level 2: 12
Deficiencies (12)
| Description | Severity |
|---|---|
| Failed to ensure food was prepared and served according to the Minnesota Food Code. | Level 2 |
| Failed to ensure employee records included all required content for one of three employees (ULP-A). | Level 2 |
| Failed to maintain a tuberculosis prevention and control program including two-step tuberculin skin test for one employee (ULP-A). | Level 2 |
| Failed to maintain a written emergency preparedness plan with all required content. | Level 2 |
| Failed to include required statutory language and verbatim notice regarding designation of a representative in the assisted living contract for two residents. | Level 2 |
| Failed to ensure training and competency evaluations were completed for all required skill areas prior to providing services for one unlicensed personnel (ULP-A). | Level 2 |
| Failed to conduct ongoing resident assessment and reassessment not to exceed 90 days for one resident (R1). | Level 2 |
| Failed to ensure current service plan included signatures documenting agreement for one resident (R2). | Level 2 |
| Failed to ensure specific medication administration instructions were documented in the resident's record for one resident (R1). | Level 2 |
| Failed to discard expired medication for one resident (R1). | Level 2 |
| Failed to document disposition of medications for one deceased resident (R3). | Level 2 |
| Failed to provide care and services according to acceptable health care standards for two residents (R1, R2) with hospital bed rails, including lack of documentation of entrapment zone measurements and ongoing assessments. | Level 2 |
Report Facts
Census: 2
Total Capacity: 10
Deficiencies cited: 12
Expired medication: 1
Dates of assessments: 90
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| ULP-A | Unlicensed Personnel | Named in findings related to incomplete employee records, tuberculosis screening, competency evaluations, and medication administration |
| CNS-C | Clinical Nurse Supervisor | Named in findings related to employee training, tuberculosis screening, emergency preparedness, service plan signature, medication administration, and bed rail assessments |
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