Inspection Reports for Three Stars Group Homes LLC
630 Virginia Street, St. Paul, MN 55103, MN, 55103
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Inspection Report
Annual Inspection
Census: 4
Deficiencies: 11
Jan 31, 2024
Visit Reason
The Minnesota Department of Health conducted a full survey to evaluate and assess compliance with state licensing statutes for an assisted living facility.
Findings
The survey identified multiple violations including failure to prepare and serve food according to Minnesota Food Code, lack of a comprehensive emergency preparedness plan, non-compliance with fire safety and evacuation requirements, incomplete resident contracts, missing background study for an employee, incomplete resident reassessments, unsecured medication storage, and incomplete treatment management plans and orders.
Severity Breakdown
Level 1: 2
Level 2: 9
Deficiencies (11)
| Description | Severity |
|---|---|
| Food was not prepared and served according to the Minnesota Food Code, including cross-contamination risks. | Level 2 |
| Failed to maintain a written emergency preparedness plan with all required content. | Level 2 |
| Failed to provide functioning and interconnected smoke alarms throughout the facility. | Level 2 |
| Failed to develop and maintain a fire safety and evacuation plan with required content, training, and drills. | Level 2 |
| Resident contracts lacked required Health Facility Identification number. | Level 1 |
| Resident contracts included prohibited waiver of liability language. | Level 1 |
| Failed to submit and receive a required background study for an employee affiliated with the assisted living license. | Level 2 |
| Failed to complete resident reassessment within required 90-day intervals. | Level 2 |
| Failed to securely store prescription medications and restrict access to authorized personnel only. | Level 2 |
| Failed to develop an individualized treatment management plan including all required content for a resident. | Level 2 |
| Failed to obtain and maintain current signed prescriber orders for treatments and therapies for a resident. | Level 2 |
Report Facts
Residents present: 4
Days between assessments: 122
Temperature: 39
Temperature: 40
Certification expiration: Nov 1, 2024
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Casey DeVries | Supervisor, State Evaluation Team | Contact person for the survey and report. |
| Idris Geyre | Certified Food Protection Manager | Person in charge during food and beverage establishment inspection. |
| Gregory T. Nelson | Public Health Sanitarian | Conducted the food and beverage establishment inspection. |
| LALD-E | Licensed Assisted Living Director | Interviewed multiple times regarding deficiencies and compliance. |
| RN-A | Registered Nurse | Interviewed regarding resident assessments, treatment plans, and medication management. |
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