Deficiencies (last 1 years)
Deficiencies (over 1 years)
1 deficiencies/year
Deficiencies are regulatory violations found during state inspections.
78% better than Wisconsin average
Wisconsin average: 4.6 deficiencies/yearDeficiencies per year
4
3
2
1
0
Census
Latest occupancy rate
41 residents
Based on a October 2025 inspection.
Census over time
Inspection Report
Complaint Investigation
Deficiencies: 0
Date: Oct 30, 2025
Visit Reason
A complaint investigation was conducted to determine if Shawano Place was in substantial compliance with Wisconsin statutes and administrative codes governing community-based residential facilities.
Complaint Details
Complaint investigation concluded on October 30, 2025, to determine compliance with Wis. Stat. ch. 50 and Wis. Admin. Code ch. DHS 83. Statement of Deficiency #TNSU11 issued.
Findings
The Department issued a Statement of Deficiency (SOD #TNSU11) for violations of Wis. Stat. ch. 50 and Wis. Admin. Code ch. DHS 83, establishing grounds for regulatory action and requiring the licensee to comply with all requirements within 45 days.
Report Facts
Days to achieve compliance: 45
Appeal filing deadline: 10
Posting duration for citations: 90
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Kenneth Brotheridge | Assisted Living Director | Signed the notice letter regarding the Statement of Deficiency and order to comply. |
| Vicky Wittman | Assisted Living Regional Director | Contact person for questions about the letter. |
Inspection Report
Complaint Investigation
Census: 41
Deficiencies: 1
Date: Oct 30, 2025
Visit Reason
The surveyor conducted a complaint investigation at Shawano Place due to a complaint about lack of cleanliness in resident rooms.
Complaint Details
The complaint was substantiated. The investigation found one deficient practice related to cleanliness. Resident 5 had filed a grievance about their room not being cleaned. Interviews with staff and residents confirmed cleaning issues after the housekeeper quit and no replacement was hired until after the survey date.
Findings
The investigation substantiated the complaint, identifying one deficient practice related to the facility not ensuring all resident rooms were kept safe, clean, and comfortable. Multiple resident bedrooms and toilets were found unclean with stains, soiled toilets, and debris on floors. Staffing shortages in housekeeping were noted, with caregiving staff assigned additional cleaning duties.
Deficiencies (1)
Facility did not ensure all resident rooms were kept safe, clean, and comfortable; observed unkept floors, soiled toilets, stains, and debris in multiple resident rooms and common areas.
Report Facts
Residents present: 41
Resident rooms observed: 5
Rooms with unkept floors: 3
Rooms with soiled toilets: 3
Medication aides on day shift: 2
Caregivers on day shift: 2
Resident rooms assigned per caregiver per day: 8
Resident rooms cleaned per shift: 4
Employees mentioned
| Name | Title | Context |
|---|---|---|
| ADMIN-A | Administrator | Provided information about housekeeping staffing and investigation of complaints |
| MA-B | Medication Aide | Interviewed regarding cleaning duties |
| CGV-C | Caregiver | Interviewed regarding cleaning duties and staffing |
| MA-E | Caregiver | Interviewed regarding cleaning duties and staffing |
| POAF-D | Power of Attorney for Finances | Interviewed regarding Resident 3's room cleanliness |
Inspection Report
Abbreviated Survey
Census: 40
Deficiencies: 0
Date: Jul 30, 2025
Visit Reason
An abbreviated survey was conducted at Shawano Place on 07/30/2025 to assess compliance with regulatory standards.
Findings
No deficient practice was identified during this abbreviated survey.
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