Inspection Report
Routine
Census: 202
Capacity: 89
Deficiencies: 6
Oct 24, 2024
Visit Reason
The Minnesota Department of Health conducted a survey to evaluate and assess compliance with state licensing statutes for The Waters On Mayowood assisted living facility.
Findings
The licensee was found in substantial compliance but had several deficiencies including food preparation not fully compliant with Minnesota Food Code, contract language waiving liability, incomplete dementia care training for one employee, failure to complete resident assessments after changes in condition, incomplete delegation instructions for PRN medications, and medication labeling issues.
Severity Breakdown
Level 1: 1
Level 2: 5
Deficiencies (6)
| Description | Severity |
|---|---|
| Food was not prepared and served according to the Minnesota Food Code, resulting in a level two violation at widespread scope. | Level 2 |
| The assisted living contract included language waiving the facility's liability for health, safety, or personal property of residents, a level one violation at widespread scope. | Level 1 |
| One of three employees failed to receive the required dementia care training within the required timeframe, a level two violation at isolated scope. | Level 2 |
| Registered nurse failed to complete assessments for changes in condition for two residents, a level two violation at isolated scope. | Level 2 |
| Failed to specify in writing instructions for PRN medications for one resident, a level two violation at isolated scope. | Level 2 |
| Medications for two residents lacked proper labeling and open dates, a level two violation at isolated scope. | Level 2 |
Report Facts
Residents present: 202
Residents under Assisted Living with Dementia Care license: 89
Dementia training hours completed: 2.5
Hours worked: 492
Time period for correction: 21
Time period for correction: 7
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Jodi Johnson | Supervisor, State Evaluation Team | Contact person for the survey report |
| ULP-H | Unlicensed Personnel | Employee who failed to complete required dementia care training |
| LALD/RN-B | Licensed Assisted Living Director/Registered Nurse | Confirmed dementia training deficiency for ULP-H |
| CNS-A | Clinical Nurse Supervisor | Acknowledged failure to complete resident assessments and medication delegation instructions |
| LPN-F | Licensed Practical Nurse | Observed administering medication to resident R7 |
| ULP-C | Unlicensed Personnel | Observed administering medications to resident R1 |
| RN-D | Registered Nurse | Observed checking blood sugar and medication cabinet for resident R2 |
| Rob Davis | Sanitarian 2 | Signed Food and Beverage Establishment Inspection Report |
| Thomas Hartmann | Certified Food Protection Manager | Certified manager for food service at facility |
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