Inspection Reports for Renewed Spirit
319 Bellwood Avenue South, Maplewood, MN 55117, MN, 55117
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Inspection Report
Annual Inspection
Census: 4
Deficiencies: 6
Apr 16, 2024
Visit Reason
The Minnesota Department of Health conducted a survey to evaluate and assess compliance with state licensing statutes for the Assisted Living with Dementia Care license.
Findings
The licensee was found in substantial compliance but had several deficiencies including missing annual performance reviews for an employee, incomplete emergency disaster plan, failure to provide required written notice for emergency relocation, incomplete annual staff training, unsecured medication storage, and failure to maintain resident privacy during personal care.
Severity Breakdown
Level 2: 6
Deficiencies (6)
| Description | Severity |
|---|---|
| Employee records lacked a current annual performance review for one clinical nurse supervisor. | Level 2 |
| Emergency disaster plan did not include all required content such as missing resident plan review, cooperation with emergency officials, subsistence needs, shelter in place, medical documentation system, role under waiver, communication plan, and annual training. | Level 2 |
| Failed to provide written notice with required content to resident and representatives for emergency relocation. | Level 2 |
| An employee failed to complete all required annual training topics including mandated reporting of maltreatment of vulnerable adults. | Level 2 |
| Medications requiring refrigeration were stored unsecured in a kitchen refrigerator accessible to unauthorized personnel. | Level 2 |
| Resident privacy was not maintained during personal care as bathroom door was left partially open exposing the resident. | Level 2 |
Report Facts
Residents present during survey: 4
Time period for correction: 21
Time period for correction: 7
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| CNS-B | Clinical Nurse Supervisor | Named in deficiency for missing annual performance review and failure to provide emergency relocation notice |
| RN-D | Registered Nurse | Named in deficiency for missing required annual training |
| ULP-C | Unlicensed Personnel | Named in deficiency for failure to maintain resident privacy during personal care |
| LALD-A | Licensed Assisted Living Director | Provided statements regarding deficiencies and facility practices |
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