Deficiencies (last 3 years)
Deficiencies (over 3 years)
3 deficiencies/year
Deficiencies are regulatory violations found during state inspections.
35% better than Wisconsin average
Wisconsin average: 4.6 deficiencies/yearDeficiencies per year
8
6
4
2
0
Census
Latest occupancy rate
80% occupied
Based on a April 2025 inspection.
Census over time
Inspection Report
Complaint Investigation
Deficiencies: 0
Apr 3, 2025
Visit Reason
A standard survey and complaint investigation was conducted to determine if Kenosha Place was in substantial compliance with Wisconsin Statutes and Administrative Code governing community-based residential facilities.
Findings
The Department issued a Statement of Deficiency (SOD #JIQ111) for violations of Wis. Stat. ch. 50 and Wis. Admin. Code ch. DHS 83, resulting in a Notice of Violation and an imposed forfeiture totaling $950.00.
Complaint Details
The visit was complaint-related as it included a complaint investigation along with a standard survey. Specific substantiation status is not stated.
Report Facts
Forfeiture amount: 950
Forfeiture amount: 800
Forfeiture amount: 150
Reduced forfeiture amount: 617.5
Compliance timeframe: 45
Payment timeframe: 10
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| MaryBeth Hoffman | Assisted Living Regional Director | Contact person for questions about the letter |
| Kenneth Brotheridge | Assisted Living Director | Signed the Notice and Order letter |
Inspection Report
Complaint Investigation
Census: 24
Capacity: 30
Deficiencies: 6
Apr 3, 2025
Visit Reason
The surveyor completed a standard survey and complaint investigation to assess compliance with regulatory requirements and investigate a complaint.
Findings
Six deficiencies were identified, including two repeat deficiencies. The complaint was unsubstantiated. Deficiencies included failure to obtain communicable disease screening for employees, incomplete department-approved training, incomplete individualized service plans for residents, unsecured toxic substances, lack of heating system maintenance documentation, and combustible materials stored too close to heating equipment.
Complaint Details
The complaint investigation was unsubstantiated.
Deficiencies (6)
| Description |
|---|
| Failure to obtain documentation that employees were screened for communicable diseases including tuberculosis within 90 days before employment for 5 of 6 caregivers reviewed. |
| Failure to ensure 3 of 6 employees completed department-approved training including fire safety within 90 days after employment; this was a repeat deficiency. |
| Failure to ensure comprehensive individualized service plans for 3 residents included residents' needs, desired outcomes, measurable goals, methods for delivering care, responsible persons, and frequency of care. |
| Failure to securely store cleaning compounds and toxic substances in two areas: kitchenette cabinet and main kitchen. |
| Failure to provide documentation of inspection for 2 gas furnaces at least every 3 years. |
| Combustible materials stored within 18 inches of a furnace and within 26 inches of a water heater. |
Report Facts
Deficiencies identified: 6
Employees reviewed: 6
Residents reviewed: 3
Facility licensed capacity: 30
Current census: 24
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Administrator A | Administrator | Interviewed regarding deficiencies and compliance. |
| Former Administrator I | Former Administrator | Interviewed regarding deficiencies and compliance. |
| Regional Wellness Director H | Regional Wellness Director | Interviewed regarding deficiencies and compliance. |
| Maintenance Director J | Maintenance Director | Mentioned in relation to heating system maintenance and fire safety training certification lapse. |
Inspection Report
Follow-Up
Census: 20
Deficiencies: 0
Jan 2, 2024
Visit Reason
Surveyor completed a verification visit and 2 complaint investigations at Kenosha Place.
Findings
Statement of Deficiency P70Y11 was corrected and no new deficiencies were identified. Two complaints were unsubstantiated.
Complaint Details
Two complaints were investigated and found to be unsubstantiated.
Report Facts
Revisit fee: 200
Inspection Report
Complaint Investigation
Deficiencies: 0
Apr 7, 2023
Visit Reason
A standard survey and complaint investigation was conducted on 04/07/2023 to determine if Kenosha Place was in substantial compliance with Wisconsin statutes and administrative codes governing community-based residential facilities.
Findings
The Department issued a Statement of Deficiency (SOD #P70411) for violations of Wis. Stat. ch. 50 and Wis. Admin. Code ch. DHS 83, resulting in a Notice of Violation and an imposed forfeiture of $200.
Complaint Details
The visit was complaint-related and included a standard survey. The Department found violations substantiated by the issuance of SOD #P70411.
Report Facts
Forfeiture amount: 200
Reduced forfeiture amount: 130
Forfeiture payment timeframe: 10
Compliance timeframe: 45
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| MaryBeth Hoffman | Assisted Living Regional Director | Contact person for questions about the letter |
| Kenneth Brotheridge | Assisted Living Director | Signed the Notice and Order letter |
Inspection Report
Complaint Investigation
Census: 23
Capacity: 30
Deficiencies: 3
Apr 7, 2023
Visit Reason
Surveyor completed a standard survey and complaint investigation at Kenosha Place on 04/07/2023. The visit was triggered by a complaint, which was found to be unsubstantiated.
Findings
Three deficiencies were identified related to employee training, resident record maintenance, and storage of toxic substances. The complaint was unsubstantiated. Residents were observed moving freely throughout the facility.
Complaint Details
Complaint was investigated and found to be unsubstantiated.
Deficiencies (3)
| Description |
|---|
| Department-approved training courses not ensured for 1 of 3 employees; Caregiver C lacked evidence of training in first aid and choking within 90 days of employment. |
| Resident records not maintained for 2 of 2 residents, missing required assessments, plans, and documentation including annual evacuation and quarterly psychotropic medication reviews. |
| Cleaning compounds, polishes, insecticides, and toxic substances were not securely stored; laundry room contained unsecured bottles of urine stain remover and bio-suds advanced enzyme detergent. |
Report Facts
Deficiencies identified: 3
Licensed capacity: 30
Census: 23
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Caregiver C | Named in deficiency for lack of required training in first aid and choking | |
| Administrator B | Administrator | Interviewed regarding training and record maintenance; reported misreading registry and replacement of laundry door lock |
| Assistant Administrator A | Assistant Administrator | Interviewed regarding training requirements and record maintenance; reported working on uploading resident documents |
| Caregiver D | Reported laundry room keycode was removed about 1 year ago |
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