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Inspection visit

Routine inspection (multi-day)

HIGHLANDS MANOR INCLicense 1976096755 citations on this visit
5 citations recorded

Inspector’s narrative

What the inspector wrote

Licensing Program Analyst (LPA) Mariana Agban conducted an unannounced continuation of the annual visit. The LPA met with Administrator Ruslan Levin and explained the reason for the visit. During today's visit, the LPA reviewed files for three (3) residents to ensure compliance with licensing forms. LPA observed that R3 has an incomplete Admission Agreement and lacks appraisal needs and services (LIC 603A). Additionally, R4 and R5 have no updated physician report (LIC 602). LPA also conducted a review of staff records to ensure that forms and training are current and comply with licensing requirements. LPA noted that S2 and S3 are missing the LIC 503 forms. The administrator advised that all required forms will be emailed to LPA Agban promptly. Finally, LPA conducted a review of medication records. The LPA found that medications and medication records were inconsistent. Exit interview conducted, citations issued, appeal rights given and copy of this report delivered.

Citations

5 citations recorded*CCLD

What does Type A vs Type B mean?

Type A. Serious citation. Imminent or substantial risk to children. The regulator requires corrective action immediately and may impose a civil penalty.

Type B. Lower-severity citation. Corrective action required, no imminent risk. The regulator monitors compliance on the next visit.

  • 87412(a)Type B

    Based on record review, the licensee did not comply with the section cited above. S2 and S3 are missing LIC 503 forms which poses/posed a potential health, safety or personal rights risk to persons in care.

  • 87458(c)(1)Type B

    Based on record review the licensee did not comply with the section cited above. LPA observed R4 and R5 do not have updated medical assessment which poses/posed a potential health, safety or personal rights risk to persons in care.

  • 87463(a)Type B

    Based on record review, the licensee did not comply with the section cited above. LPA observed R3 does not have appraisal needs and services plan which poses/posed a potential health, safety or personal rights risk to persons in care.

  • 87465(d)(2)Type B

    Based on observation and record review the licensee did not comply with the section cited above. LPA observed medication records for 5 out 5 residents were inconsistent which poses/posed a potential health, safety or personal rights risk to persons in care.

  • 87506(b)(15)Type B

    Based on record review the licensee did not comply with the section cited above. LPA observed that R3 has incomplete admission agreement which poses/posed a potential health, safety or personal rights risk to persons in care.

FAQ · About this visit

Common questions about this visit

What happened during the April 17, 2025 inspection of HIGHLANDS MANOR INC?

This was a other inspection of HIGHLANDS MANOR INC on April 17, 2025. 5 citations were issued: 5 Type B.

Were any citations issued to HIGHLANDS MANOR INC on April 17, 2025?

Yes, 5 citations were issued (0 Type A, 5 Type B). The first citation was for: "Based on record review, the licensee did not comply with the section cited above. S2 and S3 are missing LIC 503 forms wh..."

What type of inspection was this?

This was a other inspection. other inspections are conducted by CCLD as part of their licensing oversight.

SourceView on CCLDView original report

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Data from CCLD public records. Last updated . If you believe any information is inaccurate, report it here.