Deficiencies per Year
4
3
2
1
0
Unclassified
Inspection Report
Renewal
Census: 26
Capacity: 64
Deficiencies: 2
May 21, 2024
Visit Reason
The visit was conducted as a renewal licensing inspection to evaluate compliance with state regulations and determine if the facility's license should be renewed.
Findings
The facility was found to be in non-compliance with kitchen and dietary rules, specifically regarding uncovered food items, unlabeled containers, food stored on the floor, and the absence of required thermometers in resident room refrigerators and freezers.
Deficiencies (2)
| Description |
|---|
| Several food items in the walk-in refrigerator were uncovered and not protected against contamination; containers were not labeled or dated; ice cream cartons were stored on the floor. |
| Required thermometers were not present in mini refrigerators and freezers in resident rooms, preventing verification of proper food storage temperatures. |
Report Facts
Number of staff interviewed and/or observed: 9
Number of residents interviewed and/or observed: 26
Facility capacity: 64
Inspection Report
Renewal
Deficiencies: 0
May 16, 2023
Visit Reason
The document serves as a renewal notification following an administrative review of licensing activity for the past year, confirming substantial compliance with public health code and administrative rules for home for the aged facilities.
Findings
The review revealed substantial compliance with applicable regulations, resulting in the renewal of the Home for the Aged license for a 12-month period effective May 16, 2023.
Inspection Report
Original Licensing
Capacity: 64
Deficiencies: 0
Dec 20, 2016
Visit Reason
The visit was conducted to document an increase in licensed bed capacity and the development of a memory care unit at White Lake Assisted Living.
Findings
The facility added six general assisted living apartments and developed a secure memory care unit with 14 single occupancy apartments. The building and fire safety approvals were completed, and the memory care program was found compliant with state requirements.
Report Facts
Licensed bed capacity increase: 64
Memory care unit apartments: 14
General assisted living apartments: 6
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Lauren Wohlfert | Licensing Staff | Conducted the inspection and authored the report. |
| Russell B. Misiak | Area Manager | Signed the recommendation for capacity increase and memory care program approval. |
| Lindsey Haley | Authorized Representative of the facility. | |
| Petra Forbes | Administrator | Administrator of the facility. |
Inspection Report
Original Licensing
Capacity: 38
Deficiencies: 0
Sep 5, 2012
Visit Reason
The visit was conducted as an original licensing study to determine compliance with applicable licensing statutes and administrative rules for White Lake Assisted Living.
Findings
The facility was found to be in substantial compliance with home for the aged public health code and administrative rules. The report recommends issuance of a temporary license with a maximum capacity of 38.
Report Facts
Capacity: 38
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Russell B. Misiak | Licensing Staff | Author of the licensing study report and recommendation for license issuance |
| Betsy Montgomery | Area Manager | Approved the licensing study report and recommendation |
| Gayle Califf | Administrator | Administrator of White Lake Assisted Living mentioned in policy consultation |
| June Thompson | Authorized Representative | Authorized representative of White Lake Assisted Living involved in policy consultation |
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