Inspection Reports for The Canopy at Azalea Grove
6002 N Oak Street Extension, Valdosta, GA 31605, United States, GA, 31605
Back to Facility ProfileInspection Report Summary
The most recent inspection on August 6, 2025, identified deficiencies related to unsanitary conditions in the laundry area and inadequate cleaning of residents’ private living spaces. Earlier inspections showed a mixed record, with several complaint investigations finding no violations, but prior reports noted issues with staffing plans, resident care, and medication administration. Main themes of deficiencies included housekeeping and environmental cleanliness, as well as past concerns about staffing adequacy and resident safety, including a fatal aspiration incident and medication documentation problems. Most complaint investigations were unsubstantiated, except for the substantiated cases involving care and safety failures in 2022 and 2020. The facility’s inspection history shows ongoing challenges with environmental cleanliness and resident care, with some improvement in complaint outcomes but recurring issues in key operational areas.
Deficiencies (last 6 years)
Deficiencies (over 6 years)
2.3 deficiencies/year
Deficiencies are regulatory violations found during state inspections.
53% better than Georgia average
Georgia average: 4.9 deficiencies/year
Deficiencies per year
8
6
4
2
0
Inspection Report
Complaint Investigation
Deficiencies: 2
Date: Aug 6, 2025
Visit Reason
The purpose of this visit was to investigate complaints GA50004661 and GA50004649, with the investigation starting on 2025-07-14, an onsite visit on 2025-07-15, and completion on 2025-07-22.
Complaint Details
The investigation was complaint-related, investigating two complaint numbers GA50004661 and GA50004649. The findings included unsanitary conditions and failure to maintain cleanliness standards.
Findings
The facility failed to maintain a clean and sanitary environment, including lack of separation between clean and dirty laundry, unsanitary laundry room conditions, failure to clean residents' private living spaces periodically, and persistent strong urine odors in the memory care unit. Housekeeping was not present during the visit and rooms were only cleaned once weekly.
Deficiencies (2)
Failed to ensure the facility had a storage area for clean laundry separate from dirty laundry; laundry room in poor and unsanitary condition with piles of unwashed clothing.
Failed to ensure residents' private living spaces were cleaned periodically and as needed to prevent health hazards.
Report Facts
Laundry baskets observed: 6
Housekeeping cleaning frequency: 1
Inspection Report
Complaint Investigation
Deficiencies: 0
Date: Apr 1, 2025
Visit Reason
The purpose of this visit was to investigate intakes #GA50001724 and #GA50001089.
Complaint Details
Investigation of intakes #GA50001724 and #GA50001089 with no rule violations found.
Findings
No rule violations were cited as a result of this investigation.
Inspection Report
Complaint Investigation
Deficiencies: 0
Date: Mar 17, 2025
Visit Reason
The purpose of this visit was to investigate intakes #GA50001112 and #GA50001047.
Complaint Details
Investigation of intakes #GA50001112 and #GA50001047 found no rule violations.
Findings
No rule violations were cited as a result of this investigation.
Inspection Report
Complaint Investigation
Deficiencies: 0
Date: Feb 17, 2025
Visit Reason
The purpose of this visit was to investigate intakes #GA50000888, GA50000996, and GA50001044.
Complaint Details
Investigation of intakes #GA50000888, GA50000996, and GA50001044 with no rule violations found.
Findings
No rule violations were cited as a result of this investigation.
Inspection Report
Complaint Investigation
Deficiencies: 0
Date: Dec 4, 2024
Visit Reason
The purpose of this visit was to investigate intakes #GA00252113 and #GA00252135.
Complaint Details
Investigation of intakes #GA00252113 and #GA00252135 with no rule violations found.
Findings
No rule violations were cited as a result of this investigation.
Inspection Report
Complaint Investigation
Deficiencies: 0
Date: Oct 29, 2024
Visit Reason
The purpose of this visit was to investigate intakes #GA00250677, GA00250694, GA00251248, and GA00251643.
Complaint Details
Investigation of multiple intakes with no rule violations found.
Findings
No rule violations were cited as a result of this investigation.
Inspection Report
Complaint Investigation
Deficiencies: 0
Date: Aug 26, 2024
Visit Reason
The purpose of this visit was to investigate intake #GA00249443 following a complaint.
Complaint Details
Investigation of intake #GA00249443 found no rule violations.
Findings
No rule violations were cited as a result of this investigation.
Inspection Report
Complaint Investigation
Deficiencies: 0
Date: Feb 26, 2024
Visit Reason
The visit was conducted to investigate intake #GA00243450 as part of a complaint investigation.
Complaint Details
Investigation of intake #GA00243450; no rule violations found.
Findings
No rule violations were cited as a result of this investigation.
Inspection Report
Complaint Investigation
Deficiencies: 0
Date: Sep 6, 2023
Visit Reason
A visit was made to the facility on 09/06/23 to investigate intake #GA00237388, #GA00237411, and #GA00238118.
Complaint Details
Investigation of three intakes (#GA00237388, #GA00237411, and #GA00238118) with no citations issued.
Findings
No citations were issued as a result of this investigation.
Inspection Report
Complaint Investigation
Deficiencies: 0
Date: May 23, 2023
Visit Reason
The purpose of this visit was to investigate intake GA00231901 and GA00232129.
Complaint Details
Investigation of intake GA00231901 and GA00232129 with no rule violations cited.
Findings
No rule violations were cited as a result of this investigation.
Inspection Report
Complaint Investigation
Census: 18
Deficiencies: 2
Date: Nov 3, 2022
Visit Reason
A visit was made to the facility on 11/03/22 to investigate intake #GA 00228814, with the investigation completed on 11/07/22.
Complaint Details
Investigation was complaint-driven based on intake #GA 00228814. The complaint involved staffing inadequacies and failure to notify representatives after a resident fall. The complaint was investigated from 11/03/22 to 11/07/22.
Findings
The facility failed to maintain accurate staffing plans and schedules accounting for resident needs, resulting in staff being alone on the Memory Care unit during breaks. Additionally, the facility failed to take immediate appropriate action and notify the resident's representative after a resident was found on the floor, despite staff awareness of the incident.
Deficiencies (2)
Failure to develop and maintain accurate staffing plans and monthly work schedules showing planned and actual coverage for all employees, including relief workers.
Failure to ensure immediate appropriate action and notification of representative/legal surrogate after a resident was found on the floor with pain complaints.
Report Facts
Resident census: 18
Staff scheduled: 4
Residents in sample: 3
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Staff C | Assigned to medication cart for Assisted Living side; alerted after resident fall; stated he/she had other duties and returned to assisted living unit | |
| Staff D | Assigned to Memory Care unit; left unit for breaks without relief | |
| Staff E | Alone on Memory Care unit during Staff D's break; alerted after resident fall; made rounds every 1.5 to 2 hours; did not notify representative |
Inspection Report
Complaint Investigation
Deficiencies: 7
Date: Sep 15, 2022
Visit Reason
The purpose of this visit was to investigate complaint intakes #GA00226569, #GA00226566, and #GA00226623 with onsite visits on 9/12/22 and 9/13/22, completed on 9/15/22.
Complaint Details
The visit was complaint-related, investigating intakes #GA00226569, #GA00226566, and #GA00226623. The investigation included incidents involving Resident #1's death due to aspiration and failure to provide appropriate care, and Resident #2's pain management issues.
Findings
The facility failed to implement policies supporting resident dignity and safety, failed to maintain awareness of residents' health status, failed to provide protective care and watchful oversight, failed to ensure free movement in memory care unit, failed to provide two direct care staff at all times, failed to involve family in care planning, and failed to provide adequate and appropriate care and services including pain management for residents.
Deficiencies (7)
Failure to implement policies supporting dignity, respect, choice, independence, and privacy for Resident #1, resulting in a fatal aspiration incident.
Failure to maintain awareness of Resident #1's health status and intervene appropriately, leading to death by aspiration.
Failure to provide protective care and watchful oversight for Resident #1.
Failure to ensure free movement in memory care unit as resident doors were locked, restricting resident movement.
Failure to provide two direct care staff persons on site in memory care unit at all times.
Failure to ensure Resident #1's family participated in the development of the resident's written care plan.
Failure to ensure each resident received adequate, appropriate care and services, including failure to provide pain medication to Resident #2.
Report Facts
Incident date: Jul 31, 2022
Incident time: 1040
Resuscitation duration: 60
Distance: 50
Staff assigned: 2
Resident #2 medication times: 8
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Staff G | Floater staff involved in Resident #1 incident, delayed CPR initiation due to DNR status uncertainty | |
| Staff D | Staff involved in Resident #1 incident, assisted with medications and resident movement | |
| Staff J | Staff involved in Resident #1 incident, delayed CPR initiation due to DNR status uncertainty | |
| Staff H | Staff who initiated Heimlich maneuver and CPR for Resident #1, searched for DNR status | |
| Staff C | CNA | Staff involved in Resident #2 pain management failure |
| Staff E | Observed working alone in memory care unit with 10 residents | |
| Staff A | Interviewed about lack of DNR documentation and care plan meetings |
Inspection Report
Complaint Investigation
Deficiencies: 0
Date: Jul 28, 2022
Visit Reason
The purpose of this visit was to conduct a compliance inspection and investigate intake #GA00225629.
Complaint Details
Investigation of intake #GA00225629 with no rule violations cited.
Findings
No rule violations were cited as a result of this inspection and investigation.
Inspection Report
Complaint Investigation
Deficiencies: 0
Date: May 13, 2021
Visit Reason
The purpose of this visit was to investigate intake #GA00213871. The investigation started on 2021-05-04 and was completed on 2021-05-13.
Complaint Details
Investigation of intake #GA00213871 was conducted with no rule violations cited.
Findings
No rule violations were cited as a result of this investigation.
Inspection Report
Complaint Investigation
Deficiencies: 0
Date: Mar 8, 2021
Visit Reason
The purpose of this visit was to investigate intake #GA00212405 and conduct the compliance inspection.
Complaint Details
Investigation began on 2021-03-09 and was completed on 2021-03-16. No rule violations were cited.
Findings
No rule violations were cited as a result of this investigation.
Inspection Report
Complaint Investigation
Deficiencies: 3
Date: Sep 30, 2020
Visit Reason
The purpose of this visit was to investigate intake #GA00208212, which was started on 2020-09-21 and completed on 2020-09-30.
Complaint Details
The investigation was initiated due to intake #GA00208212. The complaint involved failure to properly document medication administration and failure to procure medications timely, leading to missed or delayed medication doses for residents.
Findings
The facility failed to update the Medication Administration Record (MAR) for 3 of 4 sampled residents, resulting in missing staff signatures for medications administered. Additionally, the facility failed to procure medications timely, causing interruptions in medication administration for the same residents. Interviews revealed a systematic problem with medication documentation and administration, including agency nurses lacking access to the electronic system and no system in place to verify medication administration.
Deficiencies (3)
Facility failed to update the Medication Administration Record (MAR) each time medication was offered or taken for 3 of 4 sampled residents.
Facility failed to procure medications timely, resulting in interruptions in routine dosing for 3 of 4 sampled residents.
Facility failed to ensure each resident received care and services which were adequate, appropriate, and in compliance with state law and regulations for 3 of 4 sampled residents.
Report Facts
Medication administration missing signatures: 3
Days medication not available: 7
Dates with missing medication administration: 9
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Staff A | Interviewed staff who acknowledged lack of access to MARs and unawareness of medication administration status | |
| JJ | Interviewed individual reporting medication administration issues and providing notes about Resident #1's missed medications |
Inspection Report
Complaint Investigation
Deficiencies: 0
Date: Aug 18, 2020
Visit Reason
The visit was conducted to investigate intake #GA00207028, beginning on 2020-08-10 and completed on 2020-08-18.
Complaint Details
Investigation of intake #GA00207028 was completed with no rule violations cited.
Findings
No rule violations were cited as a result of this investigation.
Inspection Report
Original Licensing
Deficiencies: 0
Date: May 4, 2020
Visit Reason
The purpose of this inspection was to conduct the initial inspection of the facility.
Findings
No rules violations were cited as a result of this inspection.
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