Inspection Reports for Key Living LLC
842 102nd Lane, Northeast Blaine, MN 55434, MN, 55434
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Inspection Report
Follow-Up
Census: 4
Capacity: 5
Deficiencies: 14
Jul 31, 2024
Visit Reason
Follow-up survey conducted on July 31, 2024, to determine if orders from the April 12, 2024 survey were corrected.
Findings
The follow-up survey verified that the facility is back in compliance with previous correction orders issued on April 12, 2024.
Severity Breakdown
Level 1: 3
Level 2: 11
Deficiencies (14)
| Description | Severity |
|---|---|
| Failed to ensure licensed assisted living director was listed as Director of Record with the Board of Executives for Long Term Services and Supports. | Level 1 |
| Failed to develop and implement a staffing plan to determine staffing levels to meet residents' needs. | Level 2 |
| Failed to engage in and maintain documentation of quality management activity appropriate to the size and services of the facility. | Level 2 |
| Failed to establish and maintain a tuberculosis prevention and control program based on CDC guidelines. | Level 2 |
| Failed to have a written emergency preparedness plan with all required content and failed to post it prominently. | Level 2 |
| Failed to develop and maintain a fire safety and evacuation plan with required content, provide required training and drills. | Level 2 |
| Failed to execute a written contract with required content related to medical assistance waivers and housing support program for one resident. | Level 1 |
| Contract included a waiver of facility liability for health, safety, or personal property of a resident. | Level 1 |
| Failed to provide written notice with required content for emergency relocation for one resident. | Level 2 |
| Failed to complete 14-day and 90-day resident reassessments using the uniform assessment tool for one resident. | Level 2 |
| Service plan lacked required content including fees for services and contingency plan for one resident. | Level 2 |
| Failed to develop and maintain individualized medication management record including specific resident instructions and monitoring for one resident. | Level 2 |
| Failed to develop and maintain individualized treatment and therapy management record with required content for one resident. | Level 2 |
| Failed to obtain written or electronic orders for treatments and therapies for one resident. | Level 2 |
Report Facts
Residents present: 4
Total licensed capacity: 5
Deficiency count: 14
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Kelly Thorson | Supervisor, State Evaluation Team | Signed follow-up survey letter dated August 29, 2024 |
| LALD/CNS-A | Licensed Assisted Living Director/Clinical Nurse Supervisor | Named in multiple findings related to licensing, staffing, quality management, TB program, emergency preparedness, fire safety, contracts, assessments, medication and treatment management |
| Casey Kipping | Public Health Sanitarian III | Signed Food and Beverage Establishment Inspection Report dated April 8, 2024 |
| Kerriann Godwin | Certified Food Protection Manager | Named in Food and Beverage Establishment Inspection Report |
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