1 Report
Inspection Report — Apr 1, 2025
Complaint Investigation State
Date: Apr 1, 2025
Visit Reason
State-compiled facility profile showing 3 inspections from 2023 to 2025 with deficiency and complaint history.
Complaint Details
The state logged 46 complaints about this facility; 1 led to on-site inspections.
Findings
Across three inspections, 24 citations were issued including 8 standard health and 16 Life Safety Code citations. The facility had 46 complaints with one on-site inspection and no formal enforcement actions.
Citations (20)
Standard Health Citation — quality of care: Food Procurement, store/prepare/serve-sanitary was cited for deficiencies.
Standard Health Citation — quality of care: Free Of Accident Hazards/supervision/devices was cited for deficiencies.
Standard Health Citation — quality of care: Infection Control was cited with no harm potential.
Standard Health Citation — quality of care: Organization And Administration was cited with no harm potential.
Standard Health Citation — quality of care: Reporting Of Alleged Violations was cited for deficiencies.
Standard Health Citation — quality of care: Sufficient Nursing Staff was cited for deficiencies.
Life Safety Code Citation — NFPA requirements: Cooking Facilities was cited for deficiencies.
Life Safety Code Citation — NFPA requirements: Discharge From Exits was cited for deficiencies.
Life Safety Code Citation — NFPA requirements: Doors With Self-closing Devices was cited for deficiencies.
Life Safety Code Citation — NFPA requirements: Elevators was cited for deficiencies.
Life Safety Code Citation — NFPA requirements: Emergency Officials Contact Information was cited for deficiencies.
Life Safety Code Citation — NFPA requirements: Ep Program Patient Population was cited for deficiencies.
Life Safety Code Citation — NFPA requirements: Ep Training Program was cited for deficiencies.
Life Safety Code Citation — NFPA requirements: Exit Signage was cited for deficiencies.
Life Safety Code Citation — NFPA requirements: Fire Alarm System - Testing And Maintenance was cited for deficiencies.
Life Safety Code Citation — NFPA requirements: Illumination Of Means Of Egress was cited for deficiencies.
Life Safety Code Citation — NFPA requirements: Maintenance, Inspection & Testing - Doors was cited for deficiencies.
Life Safety Code Citation — NFPA requirements: Plan Based On All Hazards Risk Assessment was cited for deficiencies.
Standard Health Citation — quality of care: Reporting - National Health Safety Network was cited for deficiencies in December 2023 inspection.
Standard Health Citation — quality of care: Reporting - National Health Safety Network was cited for deficiencies in January 2023 inspection.
Report Facts
Inspections on page: 3
Total violations/deficiencies cited: 24
Inspections with violations: 3
Inspections without violations: 0
Total complaints: 46
On-site complaint inspections: 1
Total enforcement actions: 0
Total citations from complaints: 3
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