Inspection Reports for The Waterford At Williamsburg Assisted Living
3940 Pine Lake Rd, Lincoln, NE 68516, USA, NE, 68516
Back to Facility ProfileDeficiencies per Year
4
3
2
1
0
Severe
High
Moderate
Low
Unclassified
Census Over Time
Inspection Report
Renewal
Capacity: 44
Deficiencies: 0
Mar 25, 2024
Visit Reason
The document is a renewal application and license verification for The Waterford at Williamsburg assisted-living facility, confirming licensure through the renewal date and requesting renewal of the facility license.
Findings
The documents confirm that The Waterford at Williamsburg meets statutory requirements for licensure as an assisted-living facility, with no deficiencies or violations noted in the materials provided.
Report Facts
Total licensed beds: 44
Fire permit beds: 50
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Jura Michael | Administrator | Named as administrator on the renewal application |
| Dan Klein Jr. | Authorized Representative | Signed the renewal application as authorized representative |
| Dan Klein Jr. | Listed as contact for The Waterford Group, Inc. | |
| Dan A. Klein Sr. | Listed as contact for The Waterford Group, Inc. |
Notice
Capacity: 44
Deficiencies: 0
Apr 8, 2019
Visit Reason
This document serves as the licensure renewal application and verification for The Waterford at Williamsburg Assisted-Living Facility, including related operational permits and ownership information.
Findings
The documents confirm that The Waterford at Williamsburg is licensed as an assisted-living facility with a total licensed capacity of 44 beds, and holds an operational permit for health care with a maximum occupancy of 50. No inspection findings or deficiencies are reported.
Report Facts
Total licensed beds: 44
Maximum occupancy: 50
Renewal fee: 1650
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Christy Merritt | Administrator | Named as the facility administrator in the licensure renewal application. |
| Dan Klein Sr. | Named as an individual owner managing The Waterford at Williamsburg. | |
| Dan Klein Jr. | Named as an individual owner managing The Waterford at Williamsburg. |
Inspection Report
Complaint Investigation
Deficiencies: 0
May 2, 2018
Visit Reason
An unannounced visit was conducted to investigate a complaint at The Waterford At Williamsburg on May 2, 2018, by representatives of the Department of Health and Human Services Division of Public Health.
Findings
The investigation found the facility was in compliance with regulatory requirements regarding pest control, grievance/complaint handling, meal attractiveness and palatability, and nutritional adequacy of foods/meals.
Complaint Details
The complaint alleged failure to ensure an effective pest control program, failure to address grievances/complaints, failure to ensure meals are attractive and palatable, and failure to ensure foods/meals meet nutritional needs. All allegations were found to be unsubstantiated.
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Dan Taylor | RN, Training Coordinator | Signed the report as Training Coordinator, Office of LTC Facilities - Licensure Unit - Division of Public Health |
Inspection Report
Renewal
Capacity: 44
Deficiencies: 0
Mar 3, 2017
Visit Reason
This document is a licensure renewal application and certification for The Waterford at Williamsburg assisted-living facility, verifying that the facility is licensed through the date indicated on the renewal card.
Findings
The document certifies that The Waterford at Williamsburg meets statutory requirements as an assisted-living facility and includes ownership information and operational permits related to fire safety.
Report Facts
Total licensed beds: 44
Renewal fee: 1650
Maximum occupancy: 50
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Christy Merritt | Administrator | Named as administrator on the renewal application |
| Dan A. Klein | Authorized Representative | Signed the renewal application as authorized representative |
| Dan Klein Jr. | Authorized Representative | Signed the renewal application as authorized representative |
Inspection Report
Complaint Investigation
Deficiencies: 0
Sep 22, 2016
Visit Reason
An unannounced visit was conducted to investigate a complaint alleging the facility failed to protect residents from abuse.
Findings
The facility was found to protect residents from abuse with no violations noted. Reviews of grievances, observations, and interviews revealed no concerns related to abuse.
Complaint Details
The complaint alleged failure to protect residents from abuse. The investigation found no substantiated abuse or violations.
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Dan Taylor | RN, Training Coordinator, Licensure Unit, Division of Public Health-DHHS | Signed the report and identified as representative conducting the investigation. |
Inspection Report
Complaint Investigation
Deficiencies: 1
Jul 6, 2016
Visit Reason
An unannounced visit was conducted to investigate a complaint at The Waterford At Williamsburg on July 6-7, 2016, by representatives of the Department of Health and Human Services Division of Public Health.
Findings
The facility was found to follow the individual service plan and administer medications as ordered by a medical practitioner. However, the facility failed to follow the Five Rights for medication administration as observed during the inspection.
Complaint Details
The complaint alleged failure to follow the individual service plan, failure to administer medications as ordered, and failure to follow the Five Rights for medication administration. The first two allegations were not substantiated; the third was substantiated.
Deficiencies (1)
| Description |
|---|
| Failure to follow the Five Rights for medication administration. |
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Eve Lewis | Program Manager | Signed the report as Program Manager - Office of LTC Facilities - Licensure Unit - Division of Public Health - DHHS |
Inspection Report
Complaint Investigation
Census: 35
Deficiencies: 1
Apr 20, 2016
Visit Reason
An unannounced visit was conducted to investigate a complaint regarding staff direction and monitoring for resident care, sufficient staffing, and medication administration at The Waterford At Williamsburg.
Findings
The facility failed to ensure staff had proper direction and monitoring for medication administration due to absence of licensed nurses on staff, which was a violation of state regulations. The facility was found to have sufficient staffing and medications were administered as ordered, with no violations related to these issues.
Complaint Details
The complaint investigation found the facility failed to ensure staff had direction and monitoring for resident care, specifically medication administration, due to no licensed nurses on staff and improper assignment of responsibility to residents or family. The facility was compliant regarding sufficient staffing and medication administration as ordered.
Deficiencies (1)
| Description |
|---|
| Failure to ensure staff have direction and monitoring for resident care due to no licensed nurses on staff and improper assignment of responsibility for medication administration. |
Report Facts
Facility census: 35
Residents sampled: 5
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Christy Merritt | Administrator | Facility administrator interviewed regarding staffing and medication monitoring |
| Lori Wehrs | Registered Nurse | Surveyor conducting the complaint investigation |
| Eve Lewis | Program Manager | Signed letter regarding complaint investigation findings |
Inspection Report
Complaint Investigation
Census: 33
Deficiencies: 1
Jan 21, 2015
Visit Reason
An unannounced visit was conducted to investigate a complaint and perform the annual survey at The Waterford At Williamsburg on January 21-22, 2015.
Findings
The investigation found the facility had sufficient staffing, appropriate pest control, and adequate ventilation. However, the facility failed to ensure dietary supplies were clean to prevent food borne illness, violating regulation 175 NAC 4-006-10C.
Complaint Details
The complaint alleged insufficient staffing, inadequate pest control, inadequate ventilation, unclean dietary supplies, and failure to ensure residents meet retention criteria. Only the dietary supplies allegation was substantiated.
Deficiencies (1)
| Description |
|---|
| Failure to ensure dietary supplies are clean to prevent food borne illness, including unsanitary kitchen conditions and improper food handling by staff. |
Report Facts
Facility census: 33
Survey dates: January 21-22, 2015
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Eve Lewis | Program Manager - Office of LTC Facilities - Licensure Unit - Division of Public Health - DHHS | Signed the inspection report letter |
| Sherri Lovelace | Registered Nurse | Surveyor involved in complaint investigation |
| Victoria Smith | Registered Nurse | Surveyor involved in complaint investigation |
| Rebecca Young | Registered Nurse | Surveyor involved in complaint investigation |
Notice
Capacity: 44
Deficiencies: 0
APP2023
Visit Reason
This document serves as a renewal application and verification that The Waterford at Williamsburg assisted-living facility is licensed through the date indicated on the renewal card.
Findings
The document confirms that The Waterford at Williamsburg meets statutory requirements as an assisted-living facility and is licensed through the renewal expiration date.
Report Facts
Total licensed beds: 44
Fire permit number: 1.00254E+23
Number of beds (fire permit): 50
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Jura Michael | Administrator | Named as administrator on the renewal application |
| Dan Klein Jr. | Authorized Representative | Signed the renewal application as authorized representative |
| Dan Klein | Authorized Representative | Signed the renewal application as authorized representative |
Notice
Capacity: 50
Deficiencies: 0
APP2025
Visit Reason
This document serves as a renewal application and license verification for The Waterford at Williamsburg assisted-living facility.
Findings
The documents confirm the facility's licensure renewal status, ownership information, and operational permits including fire prevention certification.
Report Facts
Total licensed beds: 50
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Jura Michael | Administrator | Listed on the renewal application form |
| Dan Klein | Authorized Representative | Signed the renewal application |
| Dan Klein Jr. | Named in ownership and correspondence | |
| Dan A. Klein Sr. | Named in ownership and correspondence |
Notice
Capacity: 44
Deficiencies: 0
APP2016
Visit Reason
This document serves as a licensure renewal application and verification for The Waterford at Williamsburg assisted-living facility, confirming its licensed status and providing renewal details.
Findings
The document confirms the facility's licensure renewal status, ownership information, and operational permits including fire prevention occupancy limits. No inspection findings or deficiencies are reported.
Report Facts
Total licensed beds: 44
Maximum occupancy: 50
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Dan Klein Jr. | Authorized Representative | Signed the licensure renewal application. |
| Daniela A. Klein Jr. | Listed as an individual owner managing the facility. | |
| Christy Merritt | Administrator | Named as facility administrator in the renewal application. |
Notice
Capacity: 44
Deficiencies: 0
APP2018
Visit Reason
This document serves as a licensure renewal notification for The Waterford at Williamsburg assisted-living facility and includes an operational permit for fire prevention.
Findings
The facility is licensed as an assisted-living facility with a total licensed capacity of 44 beds. The operational permit issued by the City of Lincoln Bureau of Fire Prevention allows a maximum occupancy of 50.
Report Facts
Total licensed beds: 44
Maximum occupancy: 50
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Christy Merritt | Administrator | Named as facility administrator in the licensure renewal application |
| Dan A. Klein, Sr. | Named as individual owner managing the facility | |
| Dan Klein, Jr. | Named as individual owner managing the facility |
Notice
Capacity: 44
Deficiencies: 0
APP2020
Visit Reason
This document serves to verify that The Waterford at Williamsburg Assisted-Living Facility is licensed through the indicated renewal date and includes the renewal application and related permits.
Findings
The documents confirm that the facility meets statutory requirements for licensure as an assisted-living facility and includes a renewal application with ownership and capacity details, as well as a fire prevention operational permit.
Report Facts
Total licensed beds: 44
Renewal expiration date: Apr 30, 2021
Notice
Capacity: 44
Deficiencies: 0
APP2021
Visit Reason
The document serves as a renewal application and verification of licensure for The Waterford at Williamsburg assisted-living facility.
Findings
The document confirms that The Waterford at Williamsburg meets statutory requirements for licensure as an assisted-living facility and includes ownership and contact information.
Report Facts
Total licensed beds: 44
Maximum occupancy: 50
Renewal licensure fees: 950
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Dan Klein Jr. | Authorized representative signing the renewal application (page 2). | |
| Dan Klein Sr. | Named as an individual owner managing the facility (page 3). |
Notice
Capacity: 44
Deficiencies: 0
APP2022
Visit Reason
This document serves as a renewal application and license verification for The Waterford at Williamsburg assisted-living facility.
Findings
The documents confirm the facility's licensure status and renewal fees, along with a fire prevention operational permit indicating an occupancy limit of 50 beds.
Report Facts
Total licensed beds: 44
Occupancy limit: 50
Renewal license fees: 950
Renewal license fees: 1450
Renewal license fees: 1650
Renewal license fees: 1950
Loading inspection reports...



