Inspection Reports for Patten Pond House
99 Patten Pond Rd, Surry, ME 04684, ME, 4684
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Inspection Report
Plan of Correction
Capacity: 8
Deficiencies: 0
Oct 29, 2025
Visit Reason
This document is a Statement of Deficiencies and Plan of Correction related to a case investigation (2025-AHP-42700) for Patten Pond House under the Assisted Housing Program.
Findings
Patten Pond House is in substantial compliance with part of 10-144 C.M.R. Chapter 113, Assisted Housing Program Licensing Rule; Residential Care Facilities.
Inspection Report
Capacity: 8
Deficiencies: 1
Aug 6, 2025
Visit Reason
The inspection was conducted to assess compliance with the Regulations Governing the Licensing and Functioning of Assisted Housing Programs for a Level IV Residential Care Facility, specifically regarding the development and implementation of resident service plans.
Findings
The facility was found non-compliant because a resident's service plan was not modified to include goals and services addressing known behaviors and care needs related to incontinence, which resulted in a persistent ammonia-like odor in the resident's bedroom and common areas. This was a repeat deficiency from a previous inspection.
Deficiencies (1)
| Description |
|---|
| Resident service plan was not modified to include goals and services for known behaviors and care needs related to incontinence. |
Report Facts
Total Capacity: 8
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Samantha Grey | Administrator | Named as the facility administrator |
| Staff #1 | Described resident behaviors and related services during inspection |
Inspection Report
Plan of Correction
Capacity: 8
Deficiencies: 2
Aug 6, 2025
Visit Reason
The inspection was conducted to assess compliance with the Regulations Governing the Licensing and Functioning of Assisted Housing Programs, specifically focusing on the service plan requirements and infection prevention and control at Patten Pond House, a Level IV Residential Care Facility.
Findings
The facility was found not in compliance due to failure to develop and implement a service plan addressing resident needs and behaviors, particularly for Resident #1 who exhibited incontinence and related care needs. A pungent ammonia-like odor consistent with urine was noted in common areas and Resident #1's bedroom. The service plan was not modified to include goals and services for known behaviors and care needs.
Deficiencies (2)
| Description |
|---|
| Service plan was not developed and implemented within 30 days of admission to address resident needs and behaviors. |
| Resident #1's service plan was not modified to include goals and services for known behaviors and care needs related to incontinence. |
Report Facts
Total licensed capacity: 8
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Samantha Grey | Administrator | Administrator signed the report and is mentioned in the plan of correction |
| Staff #1 | Described Resident #1's behaviors and related services during the inspection |
Inspection Report
Capacity: 8
Deficiencies: 0
Jul 31, 2025
Visit Reason
The document is a statement of deficiencies and plan of correction for Patten Pond House, a Level IV Residential Care Facility, related to licensing and certification oversight.
Findings
Patten Pond House is in substantial compliance with the Regulations Governing the Licensing and Functioning of Assisted Housing Programs: Level IV Residential Care Facilities, and Infection Prevention and Control, Part of 10-144, Chapter 113.
Inspection Report
Biennial Survey
Census: 7
Capacity: 8
Deficiencies: 3
Mar 17, 2025
Visit Reason
The inspection was a biennial survey and case investigation to assess compliance with the Regulations Governing the Licensing and Functioning of Assisted Housing Programs for a Level IV Residential Care Facility.
Findings
The facility was found not in substantial compliance due to failures in safe and acceptable medication and treatment procedures, including incomplete documentation of scheduled treatments and medication administration records for multiple residents.
Deficiencies (3)
| Description |
|---|
| Failed to ensure safe and acceptable methods were used for documentation of scheduled treatments for 2 of 3 resident records reviewed (Resident #2 and #3). |
| Medication Administration Records (MAR) lacked documentation of whether medication was administered or refused for 2 of 3 resident records reviewed (Resident #1 and #3). |
| MARs did not include full signatures of those administering medications for 1 of 3 resident records reviewed (Resident #3). |
Report Facts
Census: 7
Total Capacity: 8
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Samantha Grey | Administrator | Named as the facility administrator and involved in confirming findings |
Inspection Report
Complaint Investigation
Capacity: 8
Deficiencies: 0
Apr 29, 2024
Visit Reason
The inspection was conducted as a complaint investigation identified by case numbers 2024-AHP-36861 and 2024-AHP-36196.
Findings
Patten Pond House, a Level IV Residential Care Facility, was found to be in compliance with the Regulations Governing the Licensing and Functioning of Assisted Housing Programs: Level IV Residential Care Facilities, Part of 10-144, Chapter 113.
Complaint Details
Complaint investigation with case numbers 2024-AHP-36861 and 2024-AHP-36196 resulted in a finding of compliance.
Inspection Report
Complaint Investigation
Capacity: 8
Deficiencies: 0
Apr 17, 2024
Visit Reason
The inspection was conducted as a complaint investigation identified as 2024-AHP-36805 for Patten Pond House, a Level IV Residential Care Facility.
Findings
Patten Pond House was found to be in compliance with the Regulations Governing the Licensing and Functioning of Assisted Housing Programs: Level IV Residential Care Facilities, Part of 10-144, Chapter 113.
Inspection Report
Plan of Correction
Census: 8
Capacity: 8
Deficiencies: 0
Dec 28, 2023
Visit Reason
This document is a Statement of Deficiencies and Plan of Correction for Patten Pond House, a Level IV Residential Care Facility, related to regulatory licensing and certification oversight.
Findings
Patten Pond House 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. No specific deficiencies are detailed in the report.
Inspection Report
Census: 8
Capacity: 8
Deficiencies: 0
Nov 28, 2023
Visit Reason
The document is a statement of deficiencies and plan of correction related to a case investigation for Patten Pond House, a Level IV Residential Care Facility.
Findings
Patten Pond House is in substantial compliance with the Regulations Governing the Licensing and Functioning of Assisted Housing Programs: Level IV Residential Care Facilities, Part of 10-144, Chapter 113.
Inspection Report
Annual Inspection
Census: 8
Capacity: 8
Deficiencies: 1
Feb 8, 2023
Visit Reason
The inspection was conducted as part of an annual and complaint investigation to assess compliance with regulations governing the licensing and functioning of Level IV Residential Care Facilities.
Findings
The facility was found not in compliance due to a medication management deficiency where one medication stored for resident #1 did not have a practitioner's order on file.
Complaint Details
The visit included a complaint investigation component. The deficiency was substantiated based on medication and records review and staff interview confirming no practitioner's order for resident #1's medication.
Deficiencies (1)
| Description |
|---|
| No practitioner's order at the facility for one medication stored with resident #1's current medications (Eliquis 5 mg dated 9/9/22). |
Report Facts
Census: 8
Total Capacity: 8
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Diana Frederick | Administrator | Named as facility administrator in the report header |
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