Inspection Reports for Main Street Manor
641 Main St., Old Town, ME 04468, ME, 04468
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Inspection Report
Complaint Investigation
Census: 4
Capacity: 5
Deficiencies: 0
Oct 17, 2025
Visit Reason
The inspection was conducted as a complaint investigation under complaint number 2025-AHP-42593 for Main Street Manor.
Findings
Main Street Manor is in substantial compliance with part B of 10-144 C.M.R. Chapter 113, Assisted Housing Program Licensing Rule; Residential Care Facilities.
Complaint Details
Complaint investigation under complaint number 2025-AHP-42593; facility found in substantial compliance.
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Ashlee Leighton | Administrator | Named as Administrator of Main Street Manor in the inspection report. |
Inspection Report
Plan of Correction
Census: 4
Capacity: 5
Deficiencies: 5
Jun 3, 2025
Visit Reason
The visit was conducted as a biennial survey to assess compliance with licensing and infection prevention regulations for Main Street Manor, a Level III Residential Care Facility.
Findings
The facility was found non-compliant with licensing requirements, specifically failing to obtain required background checks for staff, provide adequate diabetes management training for unlicensed assistive personnel, and maintain complete medication administration records. Additionally, the facility failed to show evidence of successful completion of required annual in-service training for staff.
Severity Breakdown
Class II: 1
Class III: 1
Deficiencies (5)
| Description | Severity |
|---|---|
| Failure to utilize the Maine Background Check Center to obtain comprehensive background checks for 1 of 3 staff with direct access to residents. | Class II |
| Unlicensed assistive personnel were not trained by a registered nurse in diabetes management, including dietary requirements, medication management, insulin handling, and standard precautions. | Class III |
| Failure to provide evidence that staff completed annual diabetes training for 3 of 3 staff reviewed. | — |
| Medication administration records (MARs) contained multiple unexplained blanks for medications scheduled at various times for 2 residents. | — |
| Failure to show evidence of successful completion of required annual in-service training for 3 of 3 staff reviewed. | — |
Report Facts
Census: 4
Total Capacity: 5
Unexplained blanks in MAR: 8
Unexplained blanks in MAR: 8
Unexplained blanks in MAR: 8
Unexplained blanks in MAR: 25
Unexplained blanks in MAR: 21
Unexplained blanks in MAR: 6
Staff training records reviewed: 3
Inspection Report
Biennial Survey
Census: 4
Capacity: 5
Deficiencies: 4
Jun 3, 2025
Visit Reason
The inspection was a biennial survey to assess compliance with licensing and functioning regulations for a Level III Residential Care Facility, including infection prevention and control.
Findings
The facility was found non-compliant with several regulations including failure to obtain comprehensive background checks for staff, lack of required diabetes management training for staff, incomplete medication administration records with unexplained blanks, and failure to provide evidence of required annual in-service training for staff.
Severity Breakdown
Class II: 1
Class III: 1
Deficiencies (4)
| Description | Severity |
|---|---|
| Facility did not utilize the Maine Background Check Center to obtain comprehensive background checks for 1 of 3 staff providing direct care. | Class II |
| Failed to provide evidence that staff are trained to manage persons with diabetes for 3 of 3 staff training records reviewed. | Class III |
| Medication administration records contained unexplained blanks for medications administered or refused for 2 of 2 resident records reviewed. | — |
| Failed to show evidence of successful completion of required annual in-service trainings for 3 of 3 staff records reviewed. | — |
Report Facts
Staff with direct access: 3
Residents present: 4
Total licensed capacity: 5
Unexplained blanks in MAR: 8
Unexplained blanks in MAR: 25
Unexplained blanks in MAR: 21
Unexplained blanks in MAR: 6
Staff training records reviewed: 3
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Ashlee Leighton | Administrator | Confirmed lack of completed MBCC background check and acknowledged findings at exit interview |
Inspection Report
Original Licensing
Census: 4
Capacity: 5
Deficiencies: 0
Jun 1, 2023
Visit Reason
This document is the End of Provisional Survey for licensing of Main Street Manor - Leighton Enterprises, a Level III Residential Care Facility.
Findings
The facility is in substantial compliance with the Regulations Governing the Licensing and Functioning of Assisted Housing Programs: Level III Residential Care Facilities, Part of 10-144, Chapter 113.
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