Inspection Reports for Serenity Living Care Inc
2300 Carver Avenue East, Maplewood, MN 55119, MN, 55119
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Inspection Report
Follow-Up
Census: 3
Capacity: 4
Deficiencies: 17
Jul 8, 2025
Visit Reason
Follow-up survey conducted on July 8, 2025, to determine correction of orders found on the survey completed on April 23, 2025.
Findings
The facility was found in substantial compliance but had not corrected all state correction orders from the previous survey. Deficiencies included failure to document actions taken to comply with correction orders, incomplete staff records, lack of a complete emergency preparedness plan, failure to report suspected maltreatment, missing annual performance reviews for employees, incomplete tuberculosis screening, fire safety code violations, incomplete resident assessments and service plans, medication storage and administration issues, and lack of training and competency documentation for delegated nursing tasks.
Severity Breakdown
Level 2: 15
Level 3: 1
Deficiencies (17)
| Description | Severity |
|---|---|
| Failed to record actions taken to comply with all correction orders from April 23, 2025 survey. | Level 2 |
| Failed to ensure employee records contained required content including annual performance reviews for two employees. | Level 2 |
| Failed to have a written emergency preparedness plan with all required content. | Level 2 |
| Failed to comply with State Fire Code including missing fire department notification of fire incident and missing hardwired smoke alarm. | Level 2 |
| Failed to maintain physical environment in good repair including burn marks on carpet. | Level 2 |
| Failed to develop fire safety and evacuation plan with required content and provide required training. | Level 2 |
| Failed to immediately report suspected maltreatment to Minnesota Adult Abuse Reporting Center for one resident. | Level 2 |
| Failed to develop and implement an up-to-date individual abuse prevention plan for one resident. | Level 2 |
| Failed to ensure registered nurse conducted direct supervision of staff performing delegated nursing tasks within 30 days for two employees. | Level 2 |
| Failed to ensure food was prepared and served according to Minnesota Food Code. | Level 2 |
| Failed to ensure tuberculosis prevention and control program included baseline two-step testing for one employee. | Level 2 |
| Failed to ensure registered nurse conducted ongoing resident monitoring and reassessment within 90 days for three residents. | Level 3 |
| Failed to provide written notice with required content after emergency relocation for one resident. | Level 2 |
| Failed to ensure current written service plan was revised and authenticated by resident or representative for one resident. | Level 2 |
| Failed to complete annual medication reassessment for one resident. | Level 2 |
| Failed to store medications securely for one resident. | Level 2 |
| Failed to ensure training and competency was completed for blood glucose testing for two employees. | Level 2 |
Report Facts
Fine amount: 1500
Fine amount: 3000
Residents present: 3
Total licensed capacity: 4
Days for correction: 7
Days for correction: 21
Days for correction: 2
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Renee L. Anderson | Supervisor, State Evaluation Team | Named in letter regarding follow-up survey and fines. |
| Licensed Assisted Living Director A | Licensed Assisted Living Director | Named in multiple findings including failure to complete performance reviews, emergency preparedness plan, maltreatment reporting, resident assessments, service plan revisions, fire safety, and medication storage. |
| Clinical Nurse Supervisor B | Clinical Nurse Supervisor | Named in findings related to staff supervision, resident assessments, maltreatment reporting, and medication reassessment. |
| Unlicensed Personnel C | Unlicensed Personnel | Named in findings related to staff records, tuberculosis screening, delegated nursing supervision, and blood glucose testing competency. |
| Unlicensed Personnel D | Unlicensed Personnel | Named in findings related to staff records, delegated nursing supervision, and blood glucose testing competency. |
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