Inspection Reports for Plainview Estates
2507 Fairview Avenue, Cloquet, MN 55720, MN, 55720
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Inspection Report
Follow-Up
Census: 7
Capacity: 8
Deficiencies: 30
Apr 15, 2025
Visit Reason
Follow-up survey conducted on April 15, 2025, to determine correction of orders from the November 20, 2024 survey.
Findings
The facility was found in substantial compliance but had not corrected all state correction orders. Deficiencies included disaster planning and emergency preparedness, medication administration issues, and food service violations.
Severity Breakdown
Level 1: 3
Level 2: 28
Deficiencies (30)
| Description | Severity |
|---|---|
| Failed to have a written emergency preparedness plan with all required content including risk assessment, communication plan, and missing person policy. | Level 2 |
| Failed to develop a staffing plan with metrics to meet scheduled and unscheduled resident needs. | Level 2 |
| Failed to ensure food was prepared and served according to Minnesota Food Code. | Level 2 |
| Failed to provide staff access to an on-call registered nurse 24/7. | Level 2 |
| Failed to maintain complete staff records including annual performance reviews and policy acknowledgements. | Level 2 |
| Failed to post 911 emergency number prominently near telephones and in common areas. | Level 1 |
| Failed to comply with Minnesota State Fire Code including door locks, emergency lighting, power strips, extension cords, storage in crawlspace, smoke alarm maintenance, and light fixture covers. | Level 2 |
| Failed to develop and maintain fire safety and evacuation plans with required content, training, and drills. | Level 2 |
| Failed to execute resident contracts with all required content including dementia care disclosure and designated representative options. | Level 1 |
| Failed to provide written instructions for delegated nursing tasks for residents. | Level 2 |
| Failed to provide dementia care training program description to residents or families in written or electronic form. | Level 1 |
| Failed to complete resident reassessments and monitoring within required timeframes and failed to complete smoking assessment. | Level 2 |
| Failed to revise resident service plan to include provided services such as compression stockings. | Level 2 |
| Failed to include required content in service plan such as methods and frequency of monitoring residents and staff. | Level 2 |
| Failed to provide specific resident instructions for medication administration including insulin site rotation and inhaler use. | Level 2 |
| Failed to follow medication administration process including documentation and one resident given incorrect dose of Metamucil. | Level 2 |
| Failed to document medication administration immediately after administration and failed to follow RN instructions. | Level 2 |
| Failed to include all required information in medication setup documentation. | Level 2 |
| Failed to obtain current prescriber orders for all medications for one resident. | Level 2 |
| Failed to renew prescriptions at least every 12 months for one resident. | Level 2 |
| Failed to securely store medications during medication administration process. | Level 2 |
| Failed to maintain medications in original containers with legible labels including opened-on dates and expiration dates. | Level 2 |
| Failed to develop and maintain up-to-date treatment and therapy management policies and procedures. | Level 2 |
| Failed to develop and maintain individualized treatment or therapy management record with all required content. | Level 2 |
| Failed to ensure continuity of care with competent staff to provide services agreed to in service plan and contract. | Level 2 |
| Failed to ensure medication administration process was completed as instructed including giving medications one at a time. | Level 2 |
| Failed to ensure medication administration documentation included signature, title, date, time, method, and reason for missed medications. | Level 2 |
| Failed to ensure medications were administered as prescribed and PRN medication documentation was complete. | Level 2 |
| Failed to ensure current prescriber orders were maintained for treatments and therapies and renewed at least every 12 months. | Level 2 |
| Failed to ensure residents received health care and assisted living services with continuity from properly trained and competent staff. | Level 2 |
Report Facts
Residents present: 7
Licensed capacity: 8
Fines assessed: 500
Medication setup syringes: 7
Days late for assessments: 11
Days late for assessments: 2
Temperature: 37
Temperature: 36
Temperature: 40
Temperature: 39
Cooking temperature: 180
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Tracy Elder | Certified Food Protection Manager | Named as manager in food inspection report |
| Jessie Chenze | Supervisor, State Evaluation Team | Contact for survey and enforcement |
| CNS-C | Clinical Nurse Supervisor | Named in multiple medication and supervision findings |
| ULP-B | Unlicensed Personnel | Named in medication administration and infection control findings |
| ULP-G | Unlicensed Personnel | Named in medication administration and supervision findings |
| HM-D | House Manager | Named in multiple findings related to policies and procedures |
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