Inspection Report
Original Licensing
Census: 98
Deficiencies: 10
Nov 10, 2023
Visit Reason
Initial survey conducted to assess compliance with state licensing statutes for assisted living facility with dementia care license.
Findings
The licensee was found in substantial compliance but had multiple level two violations including failure to ensure food was prepared and served according to Minnesota Food Code, inadequate infection control practices, incomplete resident record documentation, failure to maintain physical environment in good repair, unsigned service plans, medication management deficiencies, unsecured medications, incomplete treatment management plans, and improper storage of cleaning supplies in secured unit.
Severity Breakdown
Level 2: 10
Deficiencies (10)
| Description | Severity |
|---|---|
| Food was not prepared and served according to Minnesota Food Code, including storage of milk above required temperature. | Level 2 |
| Failure to establish and maintain an infection control program consistent with accepted standards, including improper glove use and unclean whirlpool tub. | Level 2 |
| Resident records lacked documentation of services provided as identified in the service plan for one resident. | Level 2 |
| Facility physical environment not maintained in good repair, including blocked fire doors, extension cords for refrigerators, open water connections, and improperly maintained emergency generator. | Level 2 |
| Resident service plans lacked signatures from resident or licensee for three residents. | Level 2 |
| Failure to transcribe physician medication orders accurately for one resident. | Level 2 |
| Medications were not properly secured and accessible to resident in one case. | Level 2 |
| Treatment management plan incomplete for one resident, lacking required elements including documentation and monitoring of treatment. | Level 2 |
| Failure to document administration of treatments as ordered and reasons for non-administration for one resident. | Level 2 |
| Cleaning supplies stored unsecured in memory care unit accessible to residents. | Level 2 |
Report Facts
Residents present: 98
Residents receiving dementia care: 35
Fine amount: 500
Milk temperature: 44
Refrigerator display temperature: 47
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Jess Schoenecker | Supervisor, State Evaluation Team | Signed official notice letter regarding licensing and correction orders |
| Casey Kipping | Public Health Sanitarian III | Conducted Food and Beverage Establishment Inspection |
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