Inspection Reports for Kennybrook Village
200 SW Brookside Dr, Grimes, IA 50111, United States, IA, 50111
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Inspection Report
Complaint Investigation
Deficiencies: 0
Oct 6, 2025
Visit Reason
A complaint investigation for complaint #129210-C was conducted on October 6, 2025.
Findings
The facility was found to be in substantial compliance.
Complaint Details
Complaint #129210-C was investigated and the facility was found to be in substantial compliance.
Inspection Report
Plan of Correction
Deficiencies: 0
Jan 31, 2025
Visit Reason
The document serves as a Plan of Correction following a Recertification Survey, indicating acceptance of credible allegation of substantial compliance.
Findings
The facility will be certified in compliance effective January 31, 2025, with the Health portion of the Recertification Survey based on acceptance of the Plan of Correction.
Inspection Report
Annual Inspection
Census: 35
Deficiencies: 4
Jan 9, 2025
Visit Reason
The inspection was conducted as part of the facility's Annual Recertification survey and investigation of Facility Reported Incidents #123505-I and #125723-I from January 06, 2024 to January 09, 2024.
Findings
The facility was found deficient in meeting nutritional needs and menu preparation, food temperature maintenance, food procurement and storage safety, and quality assurance and performance improvement (QAPI) program implementation. Multiple repeat deficiencies were noted related to menu compliance and food safety practices.
Deficiencies (4)
| Description |
|---|
| Menus did not meet nutritional needs and were not properly prepared in advance or followed, including failure to serve appropriate diet and portions for residents on pureed diets. |
| Food and drink were not maintained at safe and appetizing temperatures during meal service. |
| Food procurement, storage, preparation, and serving practices were not sanitary, including improperly labeled and stored food items. |
| The facility failed to maintain an effective Quality Assurance and Performance Improvement (QAPI) program to address previously identified quality deficiencies. |
Report Facts
Facility census: 35
Facility Reported Incidents: 2
Food temperature readings: 123.5
Food temperature readings: 117
Food temperature readings: 124.8
Food temperature readings: 122
Food temperature readings: 124
Food temperature readings: 120
Portion sizes: 6
Portion sizes: 2
Portion sizes: 1
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Staff B Cook | Cook | Observed preparing pureed pork and handling food without proper measurement or hygiene |
| Staff C Dietary Aide | Dietary Aide | Observed placing serving utensils and measuring food portions |
| Certified Dietary Manager | Certified Dietary Manager (CDM) | Provided information on facility policies and training related to food service and temperature monitoring |
| Administrator | Administrator | Provided statements on facility policies and corrective actions |
| Culinary Manager | Culinary Manager | Conducted education, audits, and in-service training for dietary staff as part of plan of correction |
| Executive Director | Executive Director | Reeducated leadership team on QAPI process and involved in monitoring plan performance |
Inspection Report
Complaint Investigation
Deficiencies: 0
Aug 14, 2024
Visit Reason
A complaint investigation for Complaint #120965-C was conducted from August 13, 2024 through August 14, 2024.
Findings
The facility was found to be in substantial compliance.
Complaint Details
Complaint #120965-C was investigated and the facility was found to be in substantial compliance.
Inspection Report
Plan of Correction
Deficiencies: 0
Oct 20, 2023
Visit Reason
The document reflects acceptance of a credible allegation of substantial compliance and the facility's Plan of Correction, leading to certification in compliance.
Findings
The facility was found to be in substantial compliance based on the credible allegation and Plan of Correction, resulting in certification effective October 20, 2023.
Inspection Report
Annual Inspection
Census: 39
Deficiencies: 5
Sep 28, 2023
Visit Reason
The inspection was conducted as part of the facility's annual recertification survey and investigation of complaint #111359-C and facility reported incident #111556-I.
Findings
The facility was found deficient in maintaining a safe, clean, comfortable, and homelike environment, activities of daily living, menus meeting resident needs, food safety and preparation, and food procurement and storage. Complaint #111359-C was substantiated, while incident #111556-I was not substantiated.
Complaint Details
Complaint #111359-C was substantiated. Facility reported incident #111556-I was not substantiated.
Deficiencies (5)
| Description |
|---|
| Failed to maintain a clean, comfortable, and homelike environment; stained carpet and urine odor in resident rooms; temperature issues in resident rooms. |
| Failed to provide necessary care and services to ensure residents' abilities in activities of daily living were maintained or improved. |
| Failed to meet nutritional needs of residents; inappropriate serving sizes of vegetables. |
| Failed to provide food that is palatable, attractive, and at a safe and appetizing temperature; food served below acceptable holding temperature. |
| Failed to maintain sanitary practices in food procurement, storage, and preparation; missing HVAC vents, improper food storage, and staff not following hair and glove protocols. |
Report Facts
Census: 39
Deficiencies cited: 5
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Staff C | Dietary Aide (DA) | Observed partially filling serving scoops and improper food handling. |
| Staff B | Dietary Aide (DA) | Did not cover hair while handling food. |
| Staff A | Cook | Did not have facial hair covered while preparing food. |
| Assistant Director of Nursing | ADON | Stated resident had not received restorative program services due to staffing shortages. |
| Dietary Manager | Provided information on serving sizes and food storage policies. | |
| Rehabilitation Director | Stated resident should be on restorative program services. |
Inspection Report
Complaint Investigation
Census: 35
Deficiencies: 0
Feb 23, 2023
Visit Reason
A focused COVID-19 infection survey was conducted ending on 2/23/23, and an investigation of complaint #110060-C was conducted from 2/20 to 2/23/23.
Findings
The facility was in compliance with CMS and CDC recommended practices to prepare for COVID-19. The complaint investigation was not substantiated.
Complaint Details
Investigation of complaint #110060-C was conducted from 2/20 to 2/23/23. The complaint was not substantiated.
Report Facts
Total residents: 35
Inspection Report
Plan of Correction
Deficiencies: 0
Jul 11, 2022
Visit Reason
The document is a statement of deficiencies and plan of correction related to the facility's certification compliance.
Findings
The facility was certified in compliance based on acceptance of a credible allegation of compliance and plan of correction effective 7/11/22.
Inspection Report
Annual Inspection
Census: 40
Deficiencies: 2
Jun 23, 2022
Visit Reason
The inspection was conducted as part of the facility's annual recertification survey and investigation of complaint 99311-C from June 16, 2022 to June 23, 2022.
Findings
The facility was found to have deficiencies related to the accuracy of assessments and menus meeting resident nutritional needs. Specifically, the Minimum Data Set (MDS) assessment for one resident was inaccurately completed, and staff failed to serve the proper portion sizes for residents on a pureed texture diet.
Complaint Details
Complaint #99311-C was investigated and found to be unsubstantiated.
Severity Breakdown
SS=B: 1
SS=D: 1
Deficiencies (2)
| Description | Severity |
|---|---|
| Accuracy of Assessments: The facility failed to accurately complete a Minimum Data Set (MDS) assessment for one resident, misidentifying the resident's mental illness status. | SS=B |
| Menus Meet Resident Needs/Preparation/Followed: The facility failed to ensure staff served the proper serving size for residents on a pureed texture diet. | SS=D |
Report Facts
Census: 40
Deficiencies cited: 2
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Anyse Munro | Executive Director | Signed the report and attested to the findings |
Inspection Report
Annual Inspection
Census: 38
Deficiencies: 6
Jul 28, 2021
Visit Reason
The inspection was conducted as part of the facility's annual health survey and investigation of complaints 98659-C, 91141-C, 89527-C, and 89045-C, which were not substantiated.
Findings
The facility was found deficient in multiple areas including failure to complete a Significant Change Minimum Data Set (MDS) assessment timely, coordination of PASARR and assessments, comprehensive care plan updates, nurse staffing information posting, food safety and sanitation, and infection prevention and control practices. The facility reported a census of 37-38 residents during the survey.
Severity Breakdown
SS=D: 5
SS=B: 1
Deficiencies (6)
| Description | Severity |
|---|---|
| Failure to complete a Significant Change Minimum Data Set (MDS) assessment within 14 days for a resident placed on hospice care. | SS=D |
| Failure to coordinate PASARR and assessments including timely Level II PASRR evaluation and determination for residents with newly evident mental disorders. | SS=D |
| Failure to update comprehensive care plans timely and include required interdisciplinary team members and resident participation. | SS=D |
| Failure to post nurse staffing data in a prominent location visible to residents and visitors. | SS=B |
| Failure to maintain food safety standards including staff not wearing hair restraints and improper hand hygiene during food preparation and service. | SS=D |
| Failure to establish and maintain an infection prevention and control program including improper mask use, inadequate hand hygiene, and failure to provide a sanitary environment. | SS=D |
Report Facts
Resident census: 38
Resident census: 37
Residents reviewed: 16
Residents reviewed: 1
Residents reviewed: 1
Inspection Report
Routine
Census: 37
Deficiencies: 0
Jul 7, 2020
Visit Reason
A COVID-19 Focused Infection Control Survey was conducted by the Department of Inspection and Appeals to assess the facility's compliance with CMS and CDC recommended practices for COVID-19 preparation.
Findings
The facility was found to be in compliance with CMS and CDC recommended practices to prepare for COVID-19.
Report Facts
Total residents: 37
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