230 Country Time Circle|
Leicester, NC 28728
Statements of Deficiencies (form used by the state to document inspections) are posted for adult care facilities with survey dates beginning November 1, 2014 and deficiencies or violations were identified.
Note: A Yes under the column, IDR Pending, indicates the facility has requested Informal Dispute Resolution (IDR), a process that gives a facility the opportunity to dispute all or some of the findings of a state inspection. If the Statement of Deficiency is changed as a result of IDR, the web page will be updated.
|Inspection Type||Document Type||Inspection Date||Pages||IDR Pending|
|ACLS Annual||No Deficiencies Cited||3/28/2017||No|
|ACLS Follow-up||Statement of Deficiency||10/1/2015||No|
|Constr Biennial Follow-up||No Deficiencies Cited||8/20/2015||0||No|
|Constr Biennial Follow-up||Statement of Deficiency||5/22/2015||2||No|
|Constr Biennial||Statement of Deficiency with Plan of Correction||11/6/2014||4||No|
|Constr Biennial||Statement of Deficiency||11/6/2014||3||No|
Star Ratings are based on the results of DHSR inspections and some inspections by the County Department of Social Services (DSS).
|Stars||Score||Issue Date||Merits||Demerits||Inspection Type|
|(3)||91||4/6/2017||2.5||0||County Monitoring Visit||View Worksheet|
|(2)||88.5||7/12/2016||0||10||County Monitoring Visit||View Worksheet|
|(ZERO STARS)||(0)||68.75||4/13/2009||5||0||Reissue||View Worksheet|
|(ZERO STARS)||(0)||63.75||4/7/2009||13.75||0||Follow-up||View Worksheet|
|(ZERO STARS)||(0)||50||3/6/2009||0||50||Annual||View Worksheet|
Penalties imposed during the last 36 months are listed.
|Penalty Issued Date||Penalty Amount||Penalty Type||Reason for Issuance||Current Status||Amount Paid||Date of Payment|
|Rule Cited||Nature of Violation|
|8/10/2017||$6,000.00||Type A1||10A NCAC 13G .1004(a) Medication Administration; G.S. 131D-21(2) Declaration of Residents' Rights||Faciity failed to assure that the preparation and administration o medications and treatments by staff were in accordance with physician orders as maintained in the resident's record and rules in thei Section and the facility's policies and procedures resulting in one resident taking another residen's medications and having to be hospitalized.|