Deficiencies per Year
8
6
4
2
0
Severe
High
Moderate
Low
Unclassified
Inspection Report
Complaint Investigation
Deficiencies: 0
Apr 3, 2025
Visit Reason
Investigation of Complaint #116719-C and Incident #126179-I at the facility.
Findings
No deficiencies were cited during the investigation of the complaint and incident.
Complaint Details
Investigation of Complaint #116719-C and Incident #126179-I resulted in no deficiencies cited.
Inspection Report
Plan of Correction
Census: 19
Deficiencies: 5
Jun 26, 2024
Visit Reason
The document is a plan of correction submitted in response to deficiencies cited during an initial survey conducted on 6/26/2024 to determine compliance with licensing rules for a Residential Care Facility (RCF).
Findings
The survey identified multiple deficiencies including issues with medication management policies, baseline tuberculosis screening, food service policies, service plans lacking measurable goals and objectives, and resident activity goals. The facility failed to comply with several regulatory requirements related to medication administration, tuberculosis testing, food handling training, service planning, and resident activities.
Deficiencies (5)
| Description |
|---|
| Medication management policy was not specific to a Residential Care Facility and failed to meet regulatory requirements. |
| Facility failed to comply with baseline tuberculosis screening requirements for residents. |
| Food service policy was not appropriate for a Residential Care Facility and staff lacked orientation on safe food handling. |
| Service plans for residents failed to include measurable goals and objectives. |
| Resident activity program failed to ensure residents had individual activity goals. |
Report Facts
Census: 19
Residents reviewed for TB screening: 4
Residents reviewed for service plans: 4
Residents reviewed for activity goals: 4
Meals received daily: 2
Additional meals option: 1
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Ben Eddy | Campus Administrator | Named as contact for plan of correction and signed the document |
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