Inspection Report
Renewal
Capacity: 73
Deficiencies: 7
Jan 31, 2024
Visit Reason
The inspection was conducted as a renewal licensing study for Springvale Assisted Living to assess compliance with applicable rules and regulations.
Findings
The facility was found to be in non-compliance with multiple rules including lack of proper licensing with the county health department, incomplete tuberculosis risk assessment, missing medication administration documentation, improper food storage and handling, and unsafe storage of hazardous materials.
Deficiencies (7)
| Description |
|---|
| Facility serving food to the public without license from Genesee County Health Department. |
| Lack of detailed information in residents' service plans regarding medication administration and behaviors. |
| Facility did not complete the tuberculosis annual risk assessment. |
| Missing initials on medication administration records for multiple residents. |
| Walk-in refrigerator, freezer, and dry storage contained opened, unsealed, and undated food items. |
| Leftover food such as ice cream was not destroyed as required. |
| Cleaning supplies stored in an unlocked cabinet accessible to cognitively impaired residents. |
Report Facts
Number of staff interviewed and/or observed: 10
Number of residents interviewed and/or observed: 5
Facility capacity: 73
Inspection Report
Renewal
Deficiencies: 0
Jan 17, 2023
Visit Reason
An administrative review of the licensing activity for the past year was conducted to assess compliance with public health code and administrative rules regulating home for the aged facilities.
Findings
The review revealed substantial compliance with applicable regulations, resulting in the renewal of the Home for the Aged license for a 12-month period effective 2023-02-15.
Report Facts
License duration: 12
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Kimberly Horst | Licensing Staff | Signed the renewal letter and communicated licensing decision |
Inspection Report
Complaint Investigation
Capacity: 73
Deficiencies: 3
Sep 27, 2022
Visit Reason
The inspection was conducted in response to complaints alleging that Resident A was treated disrespectfully, including being dragged on the ground and not having family contacted after an elopement attempt.
Findings
The investigation found that Resident A exhibited aggressive behaviors and attempted to leave the facility's enclosed courtyard. The facility did not ensure Resident A was protected as required, and medication administration and service plan deficiencies were identified. Violations were established related to protection and medication supervision.
Complaint Details
Complaint alleged Resident A was grabbed and dragged on the ground by caregivers after trying to elope, family was not contacted, and Resident A was found with a soiled brief, no sheets on bed, and scrapes on feet. The complaint was substantiated with violations established.
Deficiencies (3)
| Description |
|---|
| Facility did not ensure Resident A was protected while under supervision, violating protection requirements. |
| Resident A's medication administration was not properly supervised according to the service plan. |
| Resident A's service plan lacked detailed information on managing anxiety and behaviors requiring medication administration. |
Report Facts
Capacity: 73
Complaint Receipt Date: Sep 23, 2022
Investigation Initiation Date: Sep 26, 2022
Report Due Date: Nov 23, 2022
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Stephanie Surinck | Administrator | Interviewed regarding Resident A's behavior and care |
| Kimberly Horst | Licensing Staff | Author of the Special Investigation Report |
| Toni Graham | Hospice Care Nurse | Interviewed regarding Resident A's care and medication |
Inspection Report
Original Licensing
Capacity: 73
Deficiencies: 0
Aug 8, 2017
Visit Reason
The inspection was conducted as an original licensing study to determine compliance with applicable licensing statutes and administrative rules for Springvale Assisted Living.
Findings
The facility was found to be in substantial compliance with home for the aged public health code and administrative rules. A temporary license with a maximum capacity of 73 beds was recommended and issued.
Report Facts
Licensed bed capacity: 73
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Elizabeth Gregory | Licensing Staff | Author of the licensing study report and recommendation. |
| Russell B. Misiak | Area Manager | Approved the licensing study report and recommendation. |
| Samantha Thelen | Authorized Representative of the facility. | |
| Dawn Buhler | Administrator | Administrator of Springvale Assisted Living. |
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