Public Record
Covenant Living - Windsor Park
From CMS
Facility profile
- CMS overall rating
- 5 / 5
- Certified beds
- 80
- Avg. residents per day
- 65.3
*CMS Five-Star
*CMS
*CMS
Inspection record
On record from CMS
- Citations on record
- 37
- Inspections on file
- 8
- Last inspection
- 2025-06-03
*CMS
*CMS
*CMS
Citations
37 citations on record
Each deficiency cited on a CMS health inspection of this facility, sourced from the federal record. Open a report for the raw CMS Scope and Severity grade on each finding.
What do CMS severity letters mean?
Serious (G-L). Actual harm to a resident, or immediate jeopardy. Codes G through I indicate actual harm; J through L indicate immediate jeopardy to resident health or safety.
General (A-F). No actual harm found, or harm that is minimal. The facility must still submit a Plan of Correction. Most CMS citations land here.
Each letter combines severity with scope: how many residents the deficiency affected.
- 0689Seriousactual harm
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
- 0693Generalpotential for harm
Ensure that feeding tubes are not used unless there is a medical reason and the resident agrees; and provide appropriate care for a resident with a feeding tube.
- 0697Generalpotential for harm
Provide safe, appropriate pain management for a resident who requires such services.
- 0698Generalpotential for harm
Provide safe, appropriate dialysis care/services for a resident who requires such services.
- 0761Generalpotential for harm
Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.
- 0880Generalpotential for harm
Provide and implement an infection prevention and control program.
- 0039Generalpotential for harm
Conduct testing and exercise requirements.
- 0225Generalpotential for harm
Have stairways and smokeproof enclosures used as exits that meet safety requirements.
- 0345Generalpotential for harm
Have approved installation, maintenance and testing program for fire alarm systems.
- 0353Generalpotential for harm
Inspect, test, and maintain automatic sprinkler systems.
- 0361Generalpotential for harm
Ensure that waiting areas, nurse’s stations, gift shops, and cooking facilities, open to the corridor are properly protected.
- 0372Generalpotential for harm
Ensure smoke barriers are constructed to a 1 hour fire resistance rating.
- 0712Generalpotential for harm
Have simulated fire drills held at unexpected times.
- 0271Generalpotential for harm
Have exits that are accessible at all times.
- 0353Generalpotential for harm
Inspect, test, and maintain automatic sprinkler systems.
- 0355Generalpotential for harm
Properly select, install, inspect, or maintain portable fire extinguishes.
- 0372Generalpotential for harm
Ensure smoke barriers are constructed to a 1 hour fire resistance rating.
- 0677Generalpotential for harm
Provide care and assistance to perform activities of daily living for any resident who is unable.
- 0688Generalpotential for harm
Provide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM and/or mobility, unless a decline is for a medical reason.
- 0690Generalpotential for harm
Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.
- 0880Generalpotential for harm
Provide and implement an infection prevention and control program.
- 0281Generalpotential for harm
Install proper backup exit lighting.
- 0919Generalpotential for harm
Meet requirements for the use of electrical equipment.
- 0920Generalpotential for harm
Ensure proper usage of power strips and extension cords.
- 0554Generalpotential for harm
Allow residents to self-administer drugs if determined clinically appropriate.
- 0133Generalpotential for harm
Install a two-hour-resistant firewall separation.
- 0600Generalpotential for harm
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
- 0803Generalpotential for harm
Ensure menus must meet the nutritional needs of residents, be prepared in advance, be followed, be updated, be reviewed by dietician, and meet the needs of the resident.
- 0609Generalpotential for harm
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
- 0610Seriousimmediate jeopardy
Respond appropriately to all alleged violations.
- 0835Generalpotential for harm
Administer the facility in a manner that enables it to use its resources effectively and efficiently.
- 0686Generalpotential for harm
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
- 0133Generalpotential for harm
Install a two-hour-resistant firewall separation.
- 0341Generalpotential for harm
Install a fire alarm system that can be heard throughout the facility.
- 0351Generalpotential for harm
Install an approved automatic sprinkler system.
- 0363Generalpotential for harm
Install corridor and hallway doors that block smoke.
- 0883Generalpotential for harm
Develop and implement policies and procedures for flu and pneumonia vaccinations.
Inspection findings
What the surveyors documented
The verbatim CMS Form 2567 statement of deficiencies for each survey, straight from the federal record. Open a report for the full findings and plan of correction.
- Inspection1 deficiency
F 0689 Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. Level of Harm - Actual harm Residents Affected - Few **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interview, and record…
Read full statement of deficiencies - Inspection12 deficiencies
F 0693 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Ensure that feeding tubes are not used unless there is a medical reason and the resident agrees; and provide appropriate care for a resident with a feeding tube. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO…
Read full statement of deficiencies - Inspection13 deficiencies
F 0554 Allow residents to self-administer drugs if determined clinically appropriate. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interview, and record review, the facility failed to obtain…
Read full statement of deficiencies - Inspection10 deficiencies
F 0609 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on interview…
Read full statement of deficiencies
FAQ
Questions and answers
- What is Covenant Living - Windsor Park?
- Covenant Living - Windsor Park is a Medicare- and Medicaid-certified nursing home in Carol Stream, IL, tracked by the Centers for Medicare & Medicaid Services (CMS). Its CMS Certification Number (CCN) is 145606.
- What is the CMS rating for Covenant Living - Windsor Park?
- Covenant Living - Windsor Park has a CMS overall rating of 5 out of 5 stars. CMS rates nursing homes on health inspections, staffing, and quality measures.
- How many beds does Covenant Living - Windsor Park have?
- Covenant Living - Windsor Park is certified for 80 beds. It serves an average of 65.3 residents per day.
- How many citations does Covenant Living - Windsor Park have?
- Covenant Living - Windsor Park has 37 citations on record from CMS health inspections, each tied to a federal deficiency tag.
- When was Covenant Living - Windsor Park last inspected?
- Covenant Living - Windsor Park was last inspected on June 3, 2025. CMS surveys nursing homes about once a year and after complaints.
- What can I do if I have concerns about care at this facility?
- Start by raising the concern with the facility administrator or director of nursing. Every state also runs a free long-term care ombudsman program that advocates for residents and families; the federal Eldercare Locator at eldercare.acl.gov can connect you with yours. Complaints about quality of care can also be filed with your state survey agency.
*Sourced from the Centers for Medicare & Medicaid Services (CMS). See the official record on CMS Care Compare. If you believe any information is inaccurate, report it here.
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