Inspection Reports for
PLYMOUTH PLACE, INC. (Assisted Living)
315 N LaGrange Rd, LaGrange Park, IL, 60526
Back to Facility Profile2 Reports
Inspection Report — Jul 21, 2025
Annual Inspection
Date: Jul 21, 2025
Visit Reason
Annual Licensure Survey. Violations cited: 295.4010 a) d) 3) e), 295.4060 2) A) i) ii) iii) iv) v).
Findings
The establishment failed to revise service plans to address residents' physical and verbal behaviors, elopement risks, fall injuries, and cast care. The facility also failed to ensure required dementia-specific orientation training was completed by newly hired direct care and non-direct care staff.
Deficiencies (2)
A4010 (295.4010 Service Plan) - The establishment failed to revise service plans to address physical and verbal aggressive behaviors, elopement and exit seeking behaviors, unwitnessed falls with injury, cast care, and staff responsibilities for these interventions for residents R1, R2, R3, and R4.
A4060 (295.4060 Alzheimer's and Dementia Programs) - The establishment failed to ensure five newly hired direct care employees and three non-direct care employees completed required dementia-specific orientation training prior to assuming job responsibilities.
Report Facts
Residents affected: 4
Employees affected: 8
Inspection Report — Aug 22, 2024
Annual Inspection
Date: Aug 22, 2024
Visit Reason
Annual Licensure Survey Conducted. For This Survey, the Establishment is in compliance with Part 295 Assisted Living and Shared Housing Establishment Administrative Code and 210 ILCS 9/1 Assisted Living and Shared Housing Act.
Findings
The establishment was found in compliance with all applicable regulations during this annual licensure survey.
4 CMS Surveys
Inspection Report — Jan 24, 2025
Date: Jan 24, 2025
Visit Reason
The document does not contain an A 000 Initial Comment block specifying the visit type; therefore, inspection_type is set to 'other'.
Findings
The facility was found to have multiple deficiencies including unsafe medication storage, inadequate room heating, unsafe resident transfers, food safety violations, unsafe bed maintenance, and unsafe sharps disposal practices.
Deficiencies (6)
F0554 - The facility failed to ensure residents were assessed to self-administer medications and keep them at their bedsides, with unlabeled and unauthorized medications found at bedside for four residents.
F0584 - The facility failed to ensure residents were provided with a warm, comfortable room, with a heating unit broken for more than a week in a resident's room.
F0689 - The facility failed to safely transfer, position, and implement fall prevention interventions for residents at risk for falls, including improper use of mechanical lifts and unsecured beds leading to falls for multiple residents.
F0812 - The facility failed to maintain the kitchen in a manner to prevent foodborne illness, including dented cans, unlabeled and undated food items, improper food storage order, and inadequate sanitizer levels.
F0909 - The facility failed to ensure resident beds were safely maintained, with exposed bed frames and unsecured mattresses contributing to resident falls.
F0921 - The facility failed to ensure residents' rooms with sharps disposal containers were safely maintained, with multiple sharps containers overfilled above the indicated full line.
Report Facts
Residents affected: 4
Residents affected: 2
Residents affected: 4
Residents affected: 77
Residents affected: 2
Residents affected: 5
Inspection Report — Jan 2, 2025
Date: Jan 2, 2025
Visit Reason
The document does not contain an A 000 Initial Comment block specifying the visit type; therefore, inspection_type is set to 'other'.
Findings
The facility failed to provide appropriate wound care treatment and assessments for multiple residents, resulting in actual harm including a leg amputation for one resident. Documentation and communication failures were noted, including falsified wound care records and lack of physician notification.
Deficiencies (1)
F0684 - The facility failed to ensure appropriate wound care treatment and assessments were provided according to physician orders and resident needs, resulting in actual harm including a left above the knee leg amputation for resident R1 and inadequate wound care for residents R2 through R8.
Report Facts
Residents affected: 8
Inspection Report — Feb 16, 2024
Date: Feb 16, 2024
Visit Reason
The document does not contain an A 000 Initial Comment block specifying the visit type; therefore, the inspection type is classified as 'other'.
Findings
The facility failed to properly label, date, seal, and store food items in the kitchen, posing a minimal harm or potential for actual harm to many residents. Issues included expired products, unlabeled and unsealed foods, dented cans, freezer burn on meats, and improper hair restraint use by staff.
Deficiencies (1)
F0812 - The facility failed to properly label, date, seal, and store food items in the kitchen, including expired products, dented cans, unlabeled and unsealed foods, and improper hair restraint use by staff, affecting many residents.
Report Facts
Inspection Report — Mar 30, 2023
Annual Inspection
Date: Mar 30, 2023
Visit Reason
Annual Licensure Survey
Findings
The facility was found to have multiple deficiencies including failure to provide dignified care, inadequate grievance response, failure to assist with personal hygiene, improper pressure ulcer care, inadequate range of motion exercises, unsafe resident transfers, improper incontinence and catheter care, failure to follow food preparation and serving guidelines, unsanitary kitchen practices, and lapses in infection prevention and control.
Deficiencies (12)
F0550 (Resident Rights) - The facility failed to treat residents in a dignified manner during care, including leaving residents uncovered and failing to introduce themselves or explain procedures to residents.
F0577 (Resident Rights) - The facility failed to ensure that survey results were posted in a conspicuous area accessible to residents and visitors.
F0583 (Resident Rights) - The facility failed to ensure privacy during personal care, leaving residents exposed and uncovered during care.
F0585 (Resident Rights) - The facility failed to address grievances from residents regarding staffing and call light response times, with unresolved concerns documented over a year.
F0677 (Activities of Daily Living) - The facility failed to assist residents needing help with personal hygiene, including grooming and nail care for three residents.
F0686 (Pressure Ulcer Care) - The facility failed to reposition a resident per plan of care to offload pressure for a resident with a stage 4 pressure ulcer.
F0688 (Range of Motion) - The facility failed to provide passive range of motion exercises as required for a resident with limited range of motion.
F0689 (Accident Hazards) - The facility failed to ensure safety during resident transfers and wheelchair transport, resulting in a resident fall with injury requiring sutures and emergency care.
F0690 (Incontinence Care) - The facility failed to provide proper incontinence and catheter care to residents, including failure to clean catheter sites and maintain catheter drainage bags off the floor.
F0803 (Nutrition) - The facility failed to follow recipe guidance and menu portion sizes for pureed diets, resulting in incorrect preparation and serving sizes.
F0812 (Food Safety) - The facility failed to wash pots and pans in a sanitary manner and maintain ingredient containers and food prep areas in a clean condition.
F0880 (Infection Control) - The facility failed to follow infection control practices including hand hygiene and glove changing, and failed to ensure a resident on contact isolation remained in her room.
Report Facts
Residents affected: 2
Residents affected: 62
Residents affected: 2
Residents affected: 7
Residents affected: 3
Residents affected: 1
Residents affected: 1
Residents affected: 3
Residents affected: 4
Residents affected: 2
Residents affected: 62
Residents affected: 5
Viewing
Loading inspection reports...
