Inspection Reports for Waverly Inn Memory Care Community
515 W Rand Rd, Arlington Heights, IL 60004, United States, IL, 60004
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Inspection Report
Complaint Investigation
Deficiencies: 1
Jun 8, 2025
Visit Reason
The inspection was conducted due to a complaint investigation regarding an allegation of abuse involving a resident (R1) at Waverly Inn Memory Care Community.
Findings
The facility failed to report an allegation of abuse to the Illinois Department of Public Health within the required 24-hour timeframe. The investigation into the abuse allegation was ultimately unsubstantiated due to lack of supporting evidence. The report detailed an incident where a Resident Assistant (E8) was observed pulling a resident's hair, but the abuse was reported late by another staff member (E6).
Complaint Details
The complaint involved an allegation of abuse where a Resident Assistant (E8) pulled a resident's hair during care. The allegation was reported late by another Resident Assistant (E6), and the investigation was unsubstantiated due to lack of evidence.
Deficiencies (1)
| Description |
|---|
| Failure to report an allegation of abuse to the Illinois Department of Public Health within 24 hours as required by regulation. |
Report Facts
Residents reviewed for abuse: 3
Residents in sample: 4
Incident date: Apr 8, 2025
Incident report fax date: Apr 21, 2025
Date abuse reported to state: Apr 21, 2025
Date nurse practitioner saw resident: Apr 14, 2025
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| E6 Resident Assistant | Resident Assistant | Reported the abuse incident late and witnessed the hair pulling |
| E8 Resident Assistant | Resident Assistant | Alleged to have pulled the resident's hair |
| E2 Director of Resident Services | Director of Resident Services | Conducted assessment and stated abuse investigation procedures |
| E1 Executive Director | Executive Director | Involved in abuse investigations with E2 |
Inspection Report
Enforcement
Deficiencies: 1
Jun 8, 2025
Visit Reason
The Illinois Department of Public Health conducted a FRI (Follow-up/Complaint/Focused) survey on June 8, 2025, to assess compliance with the Assisted Living and Shared Housing Establishment Code Section 295.
Findings
The establishment did not meet all compliance requirements and was cited for a general violation under section 295.6010, resulting in a $1000 fine. The facility was required to submit a Statement of Correction within 15 days and was informed of the appeal and dispute procedures.
Deficiencies (1)
| Description |
|---|
| General Violation under Assisted Living and Shared Housing Establishment Code Section 295.6010 |
Report Facts
Fine amount: 1000
Days to file Statement of Correction: 15
Days to file hearing request: 10
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Lauren Sukumar | Executive Director | Named as responsible for corrective actions and training completion |
| Gisella Sauseda | DRS | Named as responsible for completing internal audit and training |
Inspection Report
Annual Inspection
Deficiencies: 0
Apr 10, 2025
Visit Reason
The inspection was conducted as an annual licensure survey to assess compliance with Part 295 Assisted Living and Shared Housing Establishment Administrative Code and 210 ILCS 9/1 Assisted Living and Shared Housing Act.
Findings
The facility was found to be in compliance with all applicable regulations with no deficiencies identified during this annual licensure inspection.
Inspection Report
Complaint Investigation
Deficiencies: 0
Feb 27, 2025
Visit Reason
The inspection was conducted as a complaint investigation based on two substantiated complaints identified as IL00186441/2591211 and IL00187175/2591605.
Findings
The facility was found to be in compliance with Part 295 Assisted Living and Shared Housing Establishment Administrative Code and 210 ILCS 9/1 Assisted Living and Shared Housing Act, with no deficiencies cited.
Complaint Details
Two complaints were substantiated (IL00186441/2591211 and IL00187175/2591605), but no deficiencies were cited as a result of the investigation.
Inspection Report
Complaint Investigation
Deficiencies: 0
Jan 23, 2025
Visit Reason
The inspection was conducted as a complaint investigation and review of multiple Facility Reported Incidents (FRIs) to determine compliance with Part 295 Assisted Living and Shared Housing Establishment Administrative Code and 210 ILCS 9/1 Assisted Living and Shared Housing Act.
Findings
No deficiencies were written as all complaint investigations and FRIs reviewed were found to be not substantiated. The establishment was found to be in compliance with applicable assisted living regulations.
Complaint Details
Complaint Investigation #2498962/#IL180283 and multiple Facility Reported Incidents (#IL182135, #IL182483, #IL183234, #IL183288) were all not substantiated with no deficiencies written.
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