Inspection Reports for
Kingston Residence of Fort Wayne
7515 WINCHESTER RD, FORT WAYNE, IN, 46819
Back to Facility Profile11 Reports
Inspection Report — Mar 4, 2025
Complaint Investigation State
Date: Mar 4, 2025
Visit Reason
This visit was for the Investigation of Complaint IN00453406.
Complaint Details
Complaint IN00453406-No deficiencies related to the allegations are cited.
Findings
No deficiencies related to the allegations are cited. The facility was found to be compliant with 42 CFR Parts 483.10, 483.12, 483.25 and 483.35 in regard to the Investigation of Complaint IN00453406.
Inspection Report — Dec 12, 2024
Complaint Investigation State
Date: Dec 12, 2024
Visit Reason
This visit was conducted for the investigation of Complaint IN00446298.
Complaint Details
Complaint IN00446298 was investigated and found to have no related deficiencies; the complaint was not substantiated.
Findings
No deficiencies related to the allegations in Complaint IN00446298 were cited. The facility was found to be in compliance with applicable regulations.
Inspection Report — Oct 24, 2024
State
Date: Oct 24, 2024
Visit Reason
This visit was for a State Residential Licensure Survey conducted on October 24, 2024.
Findings
Kingston Residence of Fort Wayne was found to be in compliance with 410 IAC 16.2-5 in regard to the State Residential Licensure Survey.
Inspection Report — Sep 24, 2024
Complaint Investigation State
Date: Sep 24, 2024
Visit Reason
This visit was for the Investigation of Residential Complaint IN00441193.
Complaint Details
Investigation of Residential Complaint IN00441193 found no deficiencies related to the allegations.
Findings
No deficiencies related to the allegations were cited. The facility was found to be in compliance with 410 IAC 16.2-5 regarding the complaint investigation.
Inspection Report — Jul 26, 2024
Complaint Investigation State
Date: Jul 26, 2024
Visit Reason
This visit was for the Investigation of Complaint IN00438594.
Complaint Details
Investigation of Complaint IN00438594 found no deficiencies related to the allegations.
Findings
No deficiencies related to the allegations are cited. Kingston Residence of Fort Wayne was found to be in compliance with 410 IAC 16.2-5 in regard to the Investigation of Complaint IN00438594.
Inspection Report — Jun 26, 2024
Complaint Investigation State
Date: Jun 26, 2024
Visit Reason
This visit was conducted for the investigation of Complaint IN00436932.
Complaint Details
Complaint IN00436932 was investigated and found to have no deficiencies related to the allegations.
Findings
No deficiencies related to the allegations were cited. The facility was found to be in compliance with 410 IAC 16.2-5 regarding the complaint investigation.
Inspection Report — Mar 18, 2024
Complaint Investigation State
Date: Mar 18, 2024
Visit Reason
This visit was conducted for the investigation of Complaint IN00430404.
Complaint Details
Investigation of Complaint IN00430404 found no deficiencies related to the allegations.
Findings
No deficiencies related to the allegations were cited. The facility was found to be in compliance with 410 IAC 16.2-5 regarding the complaint investigation.
Inspection Report — Jan 29, 2024
Complaint Investigation State
Date: Jan 29, 2024
Visit Reason
This visit was for a State Residential Licensure Survey including the Investigation of Complaints IN00424237 and IN00426197.
Complaint Details
Complaint IN00424237 involved misappropriation of Resident H's credit card by a Certified Nursing Assistant (CNA 7) contracted through an agency. The facility investigated, involved police, and removed the employee from shifts. Resident was reimbursed. Complaint IN00426197 involved failure to prevent elopement of Resident 7 who left the facility unsupervised in cold weather without a wander guard in place. The facility lacked adequate documentation and interventions to prevent elopement.
Findings
The facility failed to prevent theft of personal property for one resident and failed to implement interventions to prevent elopement of another resident. Additionally, the facility failed to maintain kitchen sanitation standards.
Deficiencies (3)
Failed to ensure prevention of theft of personal property for 1 of 1 Resident (Resident H).
Failed to implement interventions to prevent elopement of 1 of 5 residents reviewed (Resident 7).
Failed to ensure kitchen sanitation was maintained; issues included leaking sink, food particles and debris under equipment, and lack of hairnets outside pantry area.
Report Facts
Credit Card Charges: 5
Elopement Risk Score: 24
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Amanda Craig | Executive Director | Signed the report and involved in facility administration. |
| CNA 7 | Certified Nursing Assistant | Employee contracted through an agency who misappropriated Resident H's credit card. |
Inspection Report — Dec 14, 2023
Complaint Investigation State
Date: Dec 14, 2023
Visit Reason
This visit was for the Investigation of Complaint IN00422317 and included a Residential COVID-19 Quality Assurance Walk Through.
Complaint Details
Complaint IN00422317 was investigated and no deficiencies related to the allegations were cited.
Findings
No deficiencies related to the complaint allegations were cited. The facility was found to be in compliance with 410 IAC 16.2-5 regarding the complaint investigation and the COVID-19 quality assurance walk through.
Inspection Report — Sep 13, 2023
Complaint Investigation State
Date: Sep 13, 2023
Visit Reason
This visit was for the Investigation of Complaint IN00416677.
Complaint Details
Complaint IN00416677- No deficiencies related to the allegations are cited.
Findings
No deficiencies related to the allegations are cited. Kingston Residence of Fort Wayne was found to be in compliance with 410 IAC 16.2-5 in regard to the Investigation of Complaint IN00416677.
Inspection Report — Mar 7, 2023
State
Date: Mar 7, 2023
Visit Reason
This visit was for a State Residential Licensure Survey conducted on March 6 and 7, 2023 to assess compliance with state regulations.
Findings
The facility failed to ensure that service plans were reviewed and signed by residents or their responsible parties for 7 of 7 residents reviewed. Service plans lacked signatures and dates from residents or responsible parties, and the facility did not have a formal policy for service plans at the time of the survey.
Deficiencies (1)
Failed to ensure service plans were reviewed and signed for 7 of 7 residents reviewed (Residents 2, 3, 4, 5, 6, 7, and 8).
Report Facts
Residents with unsigned service plans: 7
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Hugo Mata | Executive Director | Signed the report and provided information about the facility's plan of correction |
| Director of Nurses (DON) | Interviewed regarding service plan procedures and resident evaluations; name not fully provided |
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