NC DHSR ACLS: Inspections, Ratings and Penalties

Listing of Facilities with Penalties

This is a listing of penalties that have been imposed for adult care home and family care home violations in accordance with G.S. § 131D-34 within the last 36 months. Click on the link to access the inspection report related to the penalty. For any penalty where there is no link, please send an email to [email protected] to obtain a copy of the inspection report.

Alamance County

Facility	Facility License	Inspection Date & Nature of Validation	Rules Areas Cited	Level Cited	Penalty Amount	Date Penalty Imposed	Current Status
Alamance House	HAL-001-148	1/24/2022	10A NCAC 13F .1004(a) Medication Administration; G.S. 131D-21(2) Declaration of Resident's Rights	Unabated B	$29,000.00	9/21/2022	Settlement Agreement
Alamance House	HAL-001-148	4/12/2022	10A NCAC 13F .1004(a) Medication Administration G.S. 131D-21(2) Declaration of Resident's Rights	A2	$1,000.00	5/31/2023	Paid in Full
Alamance House	HAL-001-148	6/20/2022	10A NCAC 13F .0901(b) Personal Care and Supervision	A2	$2,000.00	3/8/2023	Settlement Agreement
Alamance House	HAL-001-148	6/20/2022	10A NCAC 13F .0902(b) Health Care	A2	$2,000.00	3/8/2023	Settlement Agreement
Alamance House	HAL-001-148	6/20/2022	10A NCAC 13F .1004(a) Medication Administration	Unabated A2	$60,000.00	3/8/2023	Settlement Agreement
Alamance House	HAL-001-148	6/20/2022	10A NCAC 13F .1308(a) Special Care Unit Staff	A2	$2,000.00	3/8/2023	Settlement Agreement
Alvarado's Family Care	FCL-001-101	4/24/2024	10A NCAC 13G .0302 (b) Design And Construction	A2	$1,000.00	6/12/2024	Paid in Full
Bethany Tender Love and Care	FCL-001-047	6/25/2021	10A NCAC 13G .1701 (c) Infection Prevention & Control Program (temp);	Unabated B	$9,400.00	4/20/2022	Paid in Full
Divine Supportive Homes	FCL-001-190	4/3/2024	10A NCAC 13G .0503(a) Medication Administration Competency Evaluati	Unabated B	$12,500.00	9/18/2024	Appealed
Ephron Family Care Home (Closed)	FCL-001-178	4/12/2023	10A NCAC 13G .1004(a) Medication Administration	A2	$2,000.00	7/7/2023	Not Paid - Referred to Controller's Office
Golden Years Assisted Living (Closed)	HAL-001-026	10/20/2021	10A NCAC 13F .1801 (c) Infection Prevention & Control Program (temp); G.S. 131D-21(2) Declaration of Resident's Rights	A2	$2,000.00	8/17/2022	Paid in Full
Homeplace of Burlington	HAL-001-141	8/2/2023	10A NCAC 13F .1004(a) Medication Administration	Unabated B	$16,000.00	1/31/2024	Paid in Full
We Care Family Care	FCL-001-113	7/6/2023	10A NCAC 13G .0403(a) Qualifications of Medication Staff	Unabated B	$3,900.00	1/31/2024	Paid in Full
We Care Family Care	FCL-001-113	9/13/2023	10A NCAC 13G .1004(a) Medication Administration	A2	$1,000.00	1/31/2024	Paid in Full

Ashe County

Facility	Facility License	Inspection Date & Nature of Validation	Rules Areas Cited	Level Cited	Penalty Amount	Date Penalty Imposed	Current Status
Forest Ridge	HAL-005-016	8/4/2022	10A NCAC 13F .0901(c) Personal Care and Supervision G.S. 131D-21(4) Declaration of Resident's Rights	A1	$3,500.00	2/15/2023	Paid in Full

Avery County

Facility	Facility License	Inspection Date & Nature of Validation	Rules Areas Cited	Level Cited	Penalty Amount	Date Penalty Imposed	Current Status
Cranberry House	HAL-006-007	12/19/2022	10A NCAC 13F .0902(b) Health Care	A1	$2,000.00	5/12/2023	Paid in Full
Cranberry House	HAL-006-007	12/19/2022	10A NCAC 13F .0909 Resident Rights	A2	$1,000.00	5/12/2023	Paid in Full
Cranberry House	HAL-006-007	12/19/2022	10A NCAC 13F .1004(a) Medication Administration	A2	$2,000.00	5/12/2023	Paid in Full
Cranberry House	HAL-006-007	12/19/2022	10A NCAC 13F .1212(d) Reporting of Accidents and Incidents	A2	$1,000.00	5/12/2023	Paid in Full
The Heritage of Sugar Mountain	HAL-006-005	5/4/2021	10A NCAC 13F .0311(d) Other Requirements; G.S. 131D-21(2) Declaration of Resident's Rights	A2	$2,000.00	2/4/2022	Settlement Agreement

Beaufort County

Facility	Facility License	Inspection Date & Nature of Validation	Rules Areas Cited	Level Cited	Penalty Amount	Date Penalty Imposed	Current Status
Pantego Rest Home	HAL-007-025	2/1/2024	10A NCAC 13F .0902(b) Health Care	A1	$7,000.00	5/17/2024	Not Paid - Referred to Controller's Office

Bertie County

Facility	Facility License	Inspection Date & Nature of Validation	Rules Areas Cited	Level Cited	Penalty Amount	Date Penalty Imposed	Current Status
Pathways	FCL-008-030	6/22/2021	10A NCAC 13G .0901(b) Personal Care and Supervision; G.S. 131D-21(2) Declaration of Resident's Rights	A2	$750.00	4/20/2022	Paid in Full
Virginia's Place	FCL-008-029	12/29/2022	10A NCAC 13G .0902(b) Health Care	A2	$1,000.00	6/16/2023	Paid in Full
Windsor House	HAL-008-034	1/5/2023	10A NCAC 13F .1004(a) Medication Administration	Unabated B	$11,300.00	6/16/2023	Settlement Agreement
Windsor House	HAL-008-034	2/16/2024	10A NCAC 13F .0901(b) Personal Care and Supervision	A2	$1,000.00	6/12/2024	Paid in Full
Winston Gardens	HAL-008-042	1/13/2023	10A NCAC 13F .0901(b) Personal Care and Supervision	A2	$1,500.00	6/16/2023	Appealed
Winston Gardens	HAL-008-042	1/13/2023	10A NCAC 13F .0901(c) Personal Care and Supervision	A1	$14,000.00	6/16/2023	Appealed
Winston Gardens	HAL-008-042	1/13/2023	10A NCAC 13F .0902(b) Health Care	A1	$16,000.00	6/16/2023	Appealed
Winston Gardens	HAL-008-042	1/13/2023	10A NCAC 13F .1801(b) Infection Prevention & Control Policies & Pro	A2	$1,500.00	6/16/2023	Appealed
Winston Gardens	HAL-008-042	4/5/2023	10A NCAC 13F .1004(a) Medication Administration	Unabated B	$28,600.00	3/27/2024	Appealed

Bladen County

Facility	Facility License	Inspection Date & Nature of Validation	Rules Areas Cited	Level Cited	Penalty Amount	Date Penalty Imposed	Current Status
Oak Grove Family Care Home	FCL-009-028	3/27/2024	10A NCAC 13G .0601 (b)(2) Management And Other Staff	A2	$1,000.00	9/4/2024	Paid in Full
Oak Grove Family Care Home #2	FCL-009-017	1/11/2024	10A NCAC 13G .0909 Residents' Rights	A1	$1,000.00	9/4/2024	Paid in Full
Oak Grove Family Care Home #2	FCL-009-017	1/11/2024	10A NCAC 13G .1701 (a) Infection Prevention & Control Policies & Pro	A2	$500.00	9/4/2024	Paid in Full
Oak Grove Family Care Home #2	FCL-009-017	1/11/2024	10A NCAC 13G .1701 (b) Infection Prevention & Control Policies & Pro	A2	$500.00	9/4/2024	Paid in Full
West Bladen Assisted Living	HAL-009-025	10/22/2021	10A NCAC 13F .0901(a) Personal Care and Supervision; G.S. 131D-21(4) Declaration of Resident's Rights	A1	$500.00	8/31/2022	Paid in Full
West Bladen Assisted Living	HAL-009-025	10/22/2021	10A NCAC 13F .0902(b) Health Care; G.S. 131D-21(2) Declaration of Resident's Rights	A2	$1,000.00	8/31/2022	Paid in Full
West Bladen Assisted Living	HAL-009-025	7/26/2023	10A NCAC 13F .0904(c)(7) Nutrition And Food Service	A2	$4,000.00	5/10/2024	Appealed

Brunswick County

Facility	Facility License	Inspection Date & Nature of Validation	Rules Areas Cited	Level Cited	Penalty Amount	Date Penalty Imposed	Current Status
TerraBella Southport	HAL-010-010	11/2/2021	10A NCAC 13F .0902(b) Health Care; G.S. 131D-21(4) Declaration of Resident's Rights	A1	$5,250.00	8/17/2022	Paid in Full
TerraBella Southport	HAL-010-010	1/12/2022	10A NCAC 13F .0902(b) Health Care; G.S. 131D-21(4) Declaration of Resident's Rights	A1	$7,000.00	9/21/2022	Paid in Full
TerraBella Southport	HAL-010-010	4/12/2023	10A NCAC 13F .0901(c) Personal Care and Supervision	A1	$7,000.00	8/2/2023	Paid in Full
TerraBella Southport	HAL-010-010	6/7/2024	10A NCAC 13F .0902(b) Health Care	A1	$14,000.00	9/18/2024
The Bluefields (formerly named Leland House)	HAL-010-007	7/27/2021	10A NCAC 13F .0909 Resident Rights; G.S. 131D-21(4) Declaration of Resident's Rights	A2	$20,000.00	8/31/2022	Settlement Agreement
The Bluefields (formerly named Leland House)	HAL-010-007	7/27/2021	10A NCAC 13F .1004(a) Medication Administration; G.S. 131D-21(4) Declaration of Resident's Rights	A1	$15,000.00	8/31/2022	Settlement Agreement
The Landings of Oak Island	HAL-010-013	5/5/2023	10A NCAC 13F .1004(a) Medication Administration	A2	$1,000.00	1/31/2024	Settlement Agreement
The Landings of Oak Island	HAL-010-013	5/17/2023	10A NCAC 13F .1004(a) Medication Administration	A1	$4,000.00	1/31/2024	Settlement Agreement

Buncombe County

Facility	Facility License	Inspection Date & Nature of Validation	Rules Areas Cited	Level Cited	Penalty Amount	Date Penalty Imposed	Current Status
Brookdale Asheville Overlook	HAL-011-036	4/29/2024	10A NCAC 13F .1004(a) Medication Administration	A1	$6,000.00	9/18/2024	Paid in Full
Brooks-Howell Home	NH0017	10/14/2022	10A NCAC 13D .2208(e) Safety	A2	$10,000.00	11/8/2022	Paid in Full
Chunn's Cove Assisted Living	HAL-011-262	5/23/2022	10A NCAC 13F .0901(b) Personal Care and Supervision G.S. 131D-21(4) Declaration of Resident's Rights	A1	$2,000.00	2/15/2023	Paid in Full
Chunn's Cove Assisted Living	HAL-011-262	7/26/2023	10A NCAC 13F .0904(e)(4) Nutrition and Food Service	Unabated B	$12,900.00	11/21/2023	Settlement Agreement
Chunn's Cove Assisted Living	HAL-011-262	1/16/2024	10A NCAC 13F .0901(b) Personal Care and Supervision	A1	$9,000.00	7/31/2024	Appealed
Chunn's Cove Assisted Living	HAL-011-262	1/16/2024	10A NCAC 13F .0901(c) Personal Care and Supervision	A2	$3,000.00	7/31/2024	Appealed
Fairview Family Care #2 (Closed)	FCL-011-023	4/22/2022	10A NCAC 13G .0909 Residents' Rights G.S. 131D-21(4) Declaration of Resident's Rights	A1	$6,000.00	2/15/2023	Not Paid - Referred to Controller's Office
Fairview Family Care #3 (Closed)	FCL-011-024	4/22/2022	10A NCAC 13G .0909 Residents' Rights G.S. 131D-21(4) Declaration of Resident's Rights	A1	$6,000.00	2/15/2023	Not Paid - Referred to Controller's Office
Fairview Family Care Home #1(Closed)	FCL-011-024	3/2/2021	10A NCAC 13G .1004(a) Medication Administration; G.S. 131D-21(2) Declaration of Resident's Rights	A2	$1,000.00	3/16/2022	Not Paid - Referred to Controller's Office
Fairview Family Care Home #1(Closed)	FCL-011-022	5/3/2021	10A NCAC 13G .0902(b) Health Care; G.S. 131D-21(4) Declaration of Resident's Rights	A1	$3,500.00	4/20/2022	Not Paid - Referred to Controller's Office
Fairview Family Care Home #1(Closed)	FCL-011-022	5/3/2021	10A NCAC 13G .0909 Residents' Rights; G.S. 131D-21(4) Declaration of Resident's Rights	A2	$2,000.00	4/20/2022	Not Paid - Referred to Controller's Office
Fairview Family Care Home #1(Closed)	FCL-011-022	5/3/2021	10A NCAC 13G .1004(a) Medication Administration; G.S. 131D-21(2) Declaration of Resident's Rights	Unabated A2	$25,125.00	4/20/2022	Not Paid - Referred to Controller's Office
Fairview Family Care Home #1(Closed)	FCL-011-022	6/25/2021	10A NCAC 13G .0601(a) Management and Other Staff; G.S. 131D-21(2) Declaration of Resident's Rights	A1	$7,000.00	5/16/2022	Not Paid - Referred to Controller's Office
Fairview Family Care Home #1(Closed)	FCL-011-022	6/25/2021	10A NCAC 13G .0901(b) Personal Care and Supervision; G.S. 131D-21(2) Declaration of Resident's Rights	Unabated B	$13,500.00	5/16/2022	Not Paid - Referred to Controller's Office
Fairview Family Care Home #1(Closed)	FCL-011-022	6/25/2021	10A NCAC 13G .0902(b) Health Care; G.S. 131D-21(4) Declaration of Resident's Rights	Unabated A1	$11,500.00	5/16/2022	Not Paid - Referred to Controller's Office
Fairview Family Care Home #2 (Closed)	FCL-011-023	6/22/2021	10A NCAC 13G .0901(a) Personal Care and Supervision; G.S. 131D-21(2) Declaration of Resident's Rights	A2	$500.00	5/16/2022	Not Paid - Referred to Controller's Office
Fairview Family Care Home #2 (Closed)	FCL-011-023	6/22/2021	10A NCAC 13G .1004(a) Medication Administration; G.S. 131D-21(4) Declaration of Resident's Rights	A2	$500.00	5/16/2022	Not Paid - Referred to Controller's Office
Fairview Family Care Home #4 (Closed)	FCL-011-025	1/13/2021	10A NCAC 13G .0901(b) Personal Care and Supervision; G.S. 131D-21(4) Declaration of Resident's Rights	A2	$1,000.00	3/16/2022	Not Paid - Referred to Controller's Office
Fairview Family Care Home #4 (Closed)	FCL-011-025	3/18/2021	10A NCAC 13G .0902(b) Health Care; G.S. 131D-21(2) Declaration of Resident's Rights	Unabated B	$1,300.00	3/16/2022	Not Paid - Referred to Controller's Office
Harmony at Reynolds Mountain	HAL-011-361	4/4/2024	10A NCAC 13F .0909 Resident Rights	A1	$7,000.00	9/18/2024
Harmony at Reynolds Mountain	HAL-011-361	4/4/2024	10A NCAC 13F .0701 (b) Admission Of Residents	A1	$7,000.00	9/18/2024
Harmony at Reynolds Mountain	HAL-011-361	4/4/2024	10A NCAC 13F .0901(b) Personal Care and Supervision	A1	$7,000.00	9/18/2024
Harmony at Reynolds Mountain	HAL-011-361	4/4/2024	G.S. § 131D-25 Implementation	A1	$12,000.00	9/18/2024
Richmond Hill Assisted Living #1	HAL-011-376	9/15/2023	10A NCAC 13F .1004(a) Medication Administration	A1	$18,000.00	3/27/2024	Appealed
Richmond Hill Assisted Living #4	HAL-011-373	8/31/2023	10A NCAC 13F .0902(b) Health Care	A2	$4,000.00	1/31/2024	Appealed
Richmond Hill Assisted Living #4	HAL-011-373	8/31/2023	10A NCAC 13F .1004(a) Medication Administration	A2	$4,000.00	1/31/2024	Appealed
Richmond Hill Assisted Living #5	HAL-011-372	2/22/2024	10A NCAC 13F .0909 Resident Rights	A1	$16,000.00	6/12/2024	Appealed
Richmond Hill Rest Home #1	HAL-011-376	6/2/2021	10A NCAC 13F .0601 (a) Management Of Facilities; G.S. 131D-21(4) Declaration of Resident's Rights	A1	$4,000.00	5/16/2022	Settlement Agreement
Richmond Hill Rest Home #1	HAL-011-376	6/2/2021	10A NCAC 13F .0601 (b) Management Of Facilities With A Capacity Or; G.S. 131D-21(4) Declaration of Resident's Rights	A1	$4,000.00	5/16/2022	Settlement Agreement
Richmond Hill Rest Home #1	HAL-011-376	10/13/2021	10A NCAC 13F .1801 (c) Infection Prevention & Control Program (temp); G.S. 131D-21(2) Declaration of Resident's Rights	Unabated B	$21,200.00	9/21/2022	Settlement Agreement
Richmond Hill Rest Home #2	HAL-011-375	6/2/2021	10A NCAC 13F .0601 (a) Management Of Facilities; G.S. 131D-21(4) Declaration of Resident's Rights	A1	$4,000.00	5/16/2022	Settlement Agreement
Richmond Hill Rest Home #2	HAL-011-375	6/2/2021	10A NCAC 13F .0909 Resident Rights; G.S. 131D-21(4) Declaration of Resident's Rights	A1	$3,000.00	5/16/2022	Settlement Agreement
Richmond Hill Rest Home #2	HAL-011-375	4/1/2022	10A NCAC 13F .0902(b) Health Care; G.S. 131D-21(4) Declaration of Resident's Rights	A1	$12,000.00	12/21/2022	Settlement Agreement
Richmond Hill Rest Home #2	HAL-011-375	4/1/2022	10A NCAC 13F .1004(a) Medication Administration; G.S. 131D-21(4) Declaration of Resident's Rights	A2	$4,000.00	12/21/2022	Settlement Agreement
Richmond Hill Rest Home #2	HAL-011-375	10/6/2022	10A NCAC 13F .1004(a) Medication Administration	Unabated A2	$148,500.00	5/10/2024	Appealed
Richmond Hill Rest Home #3	HAL-011-374	6/1/2021	10A NCAC 13F .0601 (a) Management Of Facilities; G.S. 131D-21(4) Declaration of Resident's Rights	A1	$7,000.00	6/10/2022	Settlement Agreement
Richmond Hill Rest Home #3	HAL-011-374	6/1/2021	10A NCAC 13F .0601 (b) Management Of Facilities With A Capacity Or; G.S. 131D-21(4) Declaration of Resident's Rights	A1	$7,000.00	6/10/2022	Settlement Agreement
Richmond Hill Rest Home #4	HAL-011-373	6/1/2021	10A NCAC 13F .0601 (a) Management Of Facilities; G.S. 131D-21(4) Declaration of Resident's Rights	A1	$4,000.00	6/10/2022	Settlement Agreement
Richmond Hill Rest Home #4	HAL-011-373	6/1/2021	10A NCAC 13F .0909 Resident Rights; G.S. 131D-21(4) Declaration of Resident's Rights	A1	$3,000.00	6/10/2022	Settlement Agreement
Richmond Hill Rest Home #5	HAL-011-372	6/1/2021	10A NCAC 13F .0601 (a) Management Of Facilities; G.S. 131D-21(4) Declaration of Resident's Rights	A1	$4,000.00	6/10/2022	Settlement Agreement
Richmond Hill Rest Home #5	HAL-011-372	6/1/2021	10A NCAC 13F .1004(a) Medication Administration; G.S. 131D-21(2) Declaration of Resident's Rights	A2	$2,000.00	6/10/2022	Settlement Agreement
Richmond Hill Rest Home #5	HAL-011-372	8/25/2021	G.S. 131D-4.4A (b) ACH Infection Prevention Requirements; G.S. 131D-21(2) Declaration of Resident's Rights	Unabated B	$36,000.00	6/10/2022	Settlement Agreement
Richmond Hill Rest Home #5	HAL-011-372	10/8/2021	10A NCAC 13F .1004(a) Medication Administration; G.S. 131D-21(2) Declaration of Resident's Rights	Unabated B	$20,000.00	9/21/2022	Settlement Agreement
Richmond Hill Rest Home #5	HAL-011-372	4/5/2022	10A NCAC 13F .0901(c) Personal Care and Supervision; G.S. 131D-21(4) Declaration of Resident's Rights	A1	$5,500.00	12/21/2022	Settlement Agreement
Richmond Hill Rest Home #5	HAL-011-372	4/5/2022	10A NCAC 13F .0902(b) Health Care; G.S. 131D-21(4) Declaration of Resident's Rights	A1	$5,500.00	12/21/2022	Settlement Agreement
Richmond Hill Rest Home #5	HAL-011-372	4/5/2022	10A NCAC 13F .1004(a) Medication Administration; G.S. 131D-21(4) Declaration of Resident's Rights	A1	$5,500.00	12/21/2022	Settlement Agreement
St. Mary Rosa's Family Care Home	FCL-011-326	1/5/2022	10A NCAC 13G .1701 (c) Infection Prevention & Control Program (temp); G.S. 131D-21(4) Declaration of Resident's Rights	A1	$3,000.00	8/31/2022	Settlement Agreement
Wilham Ridge	HAL-011-377	5/9/2024	10A NCAC 13F .0403(a) Qualifications Of Medication Staff	A2	$7,000.00	9/18/2024
Wilham Ridge	HAL-011-377	5/9/2024	10A NCAC 13F .0505 Training On Care Of Diabetic Resident	A2	$4,000.00	9/18/2024
Wilham Ridge	HAL-011-377	5/9/2024	10A NCAC 13F .0602 (b) Management Of Facilities with a Capacity of	A1	$12,000.00	9/18/2024
Wilham Ridge	HAL-011-377	5/9/2024	10A NCAC 13F .0902(b) Health Care	A2	$4,000.00	9/18/2024
Wilham Ridge	HAL-011-377	5/9/2024	10A NCAC 13F .0909 Resident Rights	A2	$7,000.00	9/18/2024
Wilham Ridge	HAL-011-377	5/9/2024	10A NCAC 13F .1004(a) Medication Administration	A2	$4,000.00	9/18/2024

Burke County

Facility	Facility License	Inspection Date & Nature of Validation	Rules Areas Cited	Level Cited	Penalty Amount	Date Penalty Imposed	Current Status
Clara's Cottage #1	FCL-012-042	11/24/2020	10A NCAC 13G .1701 (a) (b) Infection Prevention & Control Program (emer); G.S. 131D-21(2) Declaration of Resident's Rights	A2	$1,000.00	12/17/2021	Paid in Full
Morganton Long Term Care, Southview Facility	HAL-012-007	3/3/2022	10A NCAC 13F .0604(e) Personal Care And Other Staffing; G.S. 131D-21(4) Declaration of Resident's Rights	A2	$7,000.00	12/21/2022	Paid in Full
Morganton Long Term Care, Southview Facility	HAL-012-007	10/27/2021	G.S. 131D-21(1) Declaration of Resident's Rights	Unabated B	$2,700.00	4/20/2022	Paid in Full
Morganton Long Term Care, Southview Facility	HAL-012-007	10/27/2021	10A NCAC 13F .0407(a)(7) Other Staff Qualifications; G.S. 131D-21(2) Declaration of Resident's Rights	Unabated B	$3,700.00	4/20/2022	Paid in Full
Morganton Long Term Care, Southview Facility	HAL-012-007	10/27/2021	10A NCAC 13F .0909 Resident Rights; G.S. 131D-21(4) Declaration of Resident's Rights	Unabated B	$2,325.00	4/20/2022	Paid in Full

Cabarrus County

Facility	Facility License	Inspection Date & Nature of Validation	Rules Areas Cited	Level Cited	Penalty Amount	Date Penalty Imposed	Current Status
Concord Place (Closed)	HAL-013-045	10/13/2022	10A NCAC 13F .0901(c) Personal Care and Supervision	A1	$3,500.00	2/15/2023	Paid in Full

Carteret County

Facility	Facility License	Inspection Date & Nature of Validation	Rules Areas Cited	Level Cited	Penalty Amount	Date Penalty Imposed	Current Status
Carteret House	HAL-016-018	1/29/2021	10A NCAC 13F .0604(e)(1)(E) Personal Care and Other Staffing; G.S. 131D-21(4) Declaration of Resident's Rights	A2	$1,000.00	3/16/2022	Paid in Full
Carteret House	HAL-016-018	1/29/2021	10A NCAC 13F .0901(a) Personal Care and Supervision; G.S. 131D-21(4) Declaration of Resident's Rights	A2	$1,000.00	3/16/2022	Paid in Full
Carteret House	HAL-016-018	5/17/2021	10A NCAC 13F .0902(b) Health Care; G.S. 131D-21(2) Declaration of Resident's Rights	A2	$2,000.00	3/16/2022	Paid in Full
Carteret House	HAL-016-018	4/20/2023	10A NCAC 13F .0902(b) Health Care	A2	$4,000.00	8/2/2023	Paid in Full

Caswell County

Facility	Facility License	Inspection Date & Nature of Validation	Rules Areas Cited	Level Cited	Penalty Amount	Date Penalty Imposed	Current Status
Higher Standard Assisted Living	FCL-017-061	7/25/2023	10A NCAC 13G .1004(a) Medication Administration	Unabated B	$10,800.00	1/31/2024	Appealed
Higher Standard Assisted Living	FCL-017-061	1/26/2024	10A NCAC 13G .0904 (d-d) Nutrition And Food Service	A2	$500.00	6/12/2024	Paid in Full
Humphrey Family Care Home	FCL-017-052	10/8/2021	10A NCAC 13G .0902(b) Health Care; G.S. 131D-21(2) Declaration of Resident's Rights	Unabated B	$5,300.00	6/10/2022	Paid in Full
Humphrey Family Care Home	FCL-017-052	10/8/2021	10A NCAC 13G .1004(a) Medication Administration; G.S. 131D-21(2) Declaration of Resident's Rights	Unabated B	$5,300.00	6/10/2022	Paid in Full
Caswell House	HAL-017-054	3/13/2023	10A NCAC 13F .0902(b) Health Care	A1	$7,000.00	7/7/2023	Settlement Agreement
Caswell House	HAL-017-054	6/8/2023	10A NCAC 13F .0902(b) Health Care	Unabated A1	$85,000.00	3/27/2024	Appealed
Caswell House	HAL-017-054	6/8/2023	10A NCAC 13F .1004(a) Medication Administration	Unabated B	$21,800.00	3/27/2024	Appealed
Caswell House	HAL-017-054	6/8/2023	10A NCAC 13F .1205 Health Care Personnel Registry	Unabated B	$21,800.00	3/27/2024	Appealed
Taylor Family Care Home #2 (closed)	FCL-017-058	7/2/2021	10A NCAC 13G .0902(c)(3)(4) Health Care; G.S. 131D-21(2) Declaration of Resident's Rights	Unabated B	$6,700.00	6/10/2022	Settlement Agreement
Taylor Family Care Home #2 (closed)	FCL-017-058	7/2/2021	10A NCAC 13G .1004(a) Medication Administration; G.S. 131D-21(2) Declaration of Resident's Rights	Unabated B	$6,700.00	6/10/2022	Settlement Agreement
Taylor Family Care Home #2 (closed)	FCL-017-058	7/2/2021	G.S. § 131D-4.5B (b) ACH Medication Aides;Training and Competency; G.S. 131D-21(2) Declaration of Resident's Rights	Unabated B	$5,025.00	6/10/2022	Settlement Agreement
Taylor Family Care Home #2 (closed)	FCL-017-058	8/21/2023	10A NCAC 13G .0601 (b)(1) Management And Other Staff	A1	$4,000.00	1/31/2024	Not Paid - Referred to Controller's Office
Taylor Family Care Home #2 (closed)	FCL-017-058	8/21/2023	10A NCAC 13G .0601(a) Management and Other Staff	A1	$8,000.00	1/31/2024	Not Paid - Referred to Controller's Office
Taylor Family Care Home #2 (closed)	FCL-017-058	8/21/2023	10A NCAC 13G .0904 (c-7) Nutrition And Food Service	A1	$7,000.00	1/31/2024	Not Paid - Referred to Controller's Office
Taylor Family Care Home #2 (closed)	FCL-017-058	8/21/2023	10A NCAC 13G .1004(a) Medication Administration	A2	$3,500.00	1/31/2024	Not Paid - Referred to Controller's Office

Catawba County

Facility	Facility License	Inspection Date & Nature of Validation	Rules Areas Cited	Level Cited	Penalty Amount	Date Penalty Imposed	Current Status
Austin Adult Care	HAL-018-023	2/26/2021	10A NCAC 13F .0702 (f) Discharge Of Residents; G.S. 131D-21(2) Declaration of Resident's Rights	A2	$1,500.00	3/16/2022	Paid in Full
Springs of Catawba	HAL-018-032	2/10/2023	10A NCAC 13F .0902(b) Health Care	A2	$1,000.00	5/31/2023	Paid in Full
TerraBella Newton	HAL-018-036	4/22/2022	10A NCAC 13F .0901(b) Personal Care and Supervision G.S. 131D-21(4) Declaration of Resident's Rights	A1	$5,250.00	2/15/2023	Paid in Full
TerraBella Newton	HAL-018-036	4/22/2022	10A NCAC 13F .0902(b) Health Care G.S. 131D-21(4) Declaration of Resident's Rights	A2	$750.00	2/15/2023	Paid in Full
TerraBella Newton	HAL-018-036	4/22/2022	10A NCAC 13F .1004(a) Medication Administration G.S. 131D-21(2) Declaration of Resident's Rights	A2	$750.00	2/15/2023	Paid in Full

Chatham County

Facility	Facility License	Inspection Date & Nature of Validation	Rules Areas Cited	Level Cited	Penalty Amount	Date Penalty Imposed	Current Status
Chatham Ridge Assisted Living (CHOW)	HAL-019-021	3/12/2021	10A NCAC 13F .0909 Resident Rights; G.S. 131D-21(4) Declaration of Resident's Rights	A1	$4,000.00	2/4/2022	Paid in Full

Cherokee County

Facility	Facility License	Inspection Date & Nature of Validation	Rules Areas Cited	Level Cited	Penalty Amount	Date Penalty Imposed	Current Status
Elaine's Care #2	FCL-020-016	5/3/2021	10A NCAC 13G .0902(b) Health Care; G.S. 131D-21(4) Declaration of Resident's Rights	A2	$3,500.00	2/4/2022	Paid in Full
L and N Family Care Home	FCL-020-011	10/28/2021	10A NCAC 13G .1701 (c) Infection Prevention & Control Program (temp); G.S. 131D-21(4) Declaration of Resident's Rights	A1	$6,000.00	8/5/2022	Paid in Full

Cleveland County

Facility	Facility License	Inspection Date & Nature of Validation	Rules Areas Cited	Level Cited	Penalty Amount	Date Penalty Imposed	Current Status
Serenity Living #4	FCL-023-052	5/7/2021	10A NCAC 13G .0902(b) Health Care; G.S. 131D-21(2) Declaration of Resident's Rights	A2	$500.00	3/16/2022	Paid in Full
TerraBella Shelby	HAL-023-048	7/13/2023	10A NCAC 13F .0901(b) Personal Care and Supervision	A1	$4,000.00	3/27/2024	Paid in Full

Columbus County

Facility	Facility License	Inspection Date & Nature of Validation	Rules Areas Cited	Level Cited	Penalty Amount	Date Penalty Imposed	Current Status
Robin's Nest Family Care Home	FCL-024-017	2/14/2023	10A NCAC 13G .0315(a)(5) Housekeeping and Furnishings	A2	$2,000.00	5/26/2023	Paid in Full
Robin's Nest Family Care Home	FCL-024-017	2/14/2023	10A NCAC 13G .0317(d) Building Service Equipment	A2	$2,000.00	5/26/2023	Paid in Full
Robin's Nest Family Care Home	FCL-024-017	2/14/2023	10A NCAC 13G .0601(a) Management and Other Staff	A2	$2,000.00	5/26/2023	Paid in Full
Robin's Nest Family Care Home	FCL-024-017	2/14/2023	10A NCAC 13G .0902(b) Health Care	A2	$2,000.00	5/26/2023	Paid in Full

Craven County

Facility	Facility License	Inspection Date & Nature of Validation	Rules Areas Cited	Level Cited	Penalty Amount	Date Penalty Imposed	Current Status
Croatan Village	HAL-025-037	9/16/2022	10A NCAC 13F .0901(b) Personal Care and Supervision G.S. 131D-21(4) Declaration of Resident's Rights	A2	$1,500.00	2/15/2023	Paid in Full
Croatan Village	HAL-025-037	12/15/2022	10A NCAC 13F .0909 Resident Rights	A1	$7,000.00	5/31/2023	Settlement Agreement
Croatan Village	HAL-025-037	12/15/2022	10A NCAC 13F .1004 (i) Medication Administration	Unabated B	$30,000.00	5/31/2023	Settlement Agreement
Croatan Village	HAL-025-037	12/15/2022	10A NCAC 13F .1004(a) Medication Administration	Unabated B	$100,400.00	5/31/2023	Settlement Agreement
Croatan Village	HAL-025-037	2/24/2023	10A NCAC 13F .0901(b) Personal Care and Supervision	A2	$4,000.00	5/31/2023	Settlement Agreement
Croatan Village	HAL-025-037	2/24/2023	10A NCAC 13F .0909 Resident Rights	A2	$4,000.00	5/31/2023	Settlement Agreement
Croatan Village	HAL-025-037	2/24/2023	10A NCAC 13F .1004(a) Medication Administration	A1	$12,000.00	5/31/2023	Settlement Agreement
Croatan Village	HAL-025-037	5/10/2024	10A NCAC 13F .0902(b) Health Care	A2	$10,500.00	9/18/2024
The Gardens of Trent	HAL-025-035	1/6/2023	10A NCAC 13F .0901(b) Personal Care and Supervision	A2	$1,000.00	7/7/2023	Paid in Full
The Gardens of Trent	HAL-025-035	6/16/2023	10A NCAC 13F .0901(b) Personal Care and Supervision	A1	$4,000.00	5/10/2024	Paid in Full
Truewood by Merrill New Bern MC	HAL-025-040	4/21/2022	10A NCAC 13F .0901(b) Personal Care and Supervision; G.S. 131D-21(2) Declaration of Resident's Rights	A2	$500.00	12/21/2022	Paid in Full

Cumberland County

Facility	Facility License	Inspection Date & Nature of Validation	Rules Areas Cited	Level Cited	Penalty Amount	Date Penalty Imposed	Current Status
Cardinal Care of Hope Mills	HAL-026-069	2/1/2023	10A NCAC 13F .0901(b) Personal Care and Supervision	A2	$1,000.00	7/7/2023	Paid in Full
Cumberland Village Assisted Living (Closed)	HAL-026-062	2/17/2023	10A NCAC 13F .0901(b) Personal Care and Supervision	A2	$2,000.00	5/26/2023	Paid in Full
Fayetteville Manor	HAL-026-054	2/24/2021	10A NCAC 13F .0901(b) Personal Care and Supervision; G.S. 131D-21(2) Declaration of Resident's Rights	A2	$1,000.00	2/4/2022	Paid in Full
McLeod Family Care Center of Fayetteville (Closed)	FCL-026-008	1/31/2024	10A NCAC 13G .0902(b) Health Care	A1	$3,500.00	5/17/2024	Not Paid - Referred to Controller's Office
Morning Star Special Care Unit	HAL-026-066	3/13/2024	10A NCAC 13F .0909 Resident Rights	A2	$750.00	6/12/2024	Not Paid - Referred to Controller's Office
The Addison of Fayetteville	HAL-026-068	12/15/2021	10A NCAC 13F .1004(a) Medication Administration; G.S. 131D-21(2) Declaration of Resident's Rights	Unabated B	$9,400.00	8/31/2022	Settlement Agreement

Currituck County

Facility	Facility License	Inspection Date & Nature of Validation	Rules Areas Cited	Level Cited	Penalty Amount	Date Penalty Imposed	Current Status
Currituck House	HAL-027-003	1/6/2022	10A NCAC 13F .0602 Management Of Facilities WIth A Capacity Or;	A1	$4,000.00	8/31/2022	Settlement Agreement
Currituck House	HAL-027-003	1/6/2022	10A NCAC 13F .0901(b) Personal Care and Supervision;	A1	$3,500.00	8/31/2022	Settlement Agreement
Currituck House	HAL-027-003	1/6/2022	10A NCAC 13F .0902(b) Health Care;	A2	$2,000.00	8/31/2022	Settlement Agreement
Currituck House	HAL-027-003	1/6/2022	G.S. 131D-21(1) Declaration of Residents' Rights;	A2	$2,000.00	8/31/2022	Settlement Agreement
Currituck House	HAL-027-003	1/6/2022	G.S. 131D-21(4) Declaration of Residents' Rights;	A2	$2,000.00	8/31/2022	Settlement Agreement
Currituck House	HAL-027-003	7/20/2023	10A NCAC 13F .0901(b) Personal Care and Supervision	A2	$7,000.00	5/17/2024	Appealed
Currituck House	HAL-027-003	7/20/2023	10A NCAC 13F .1004(a) Medication Administration	A2	$7,000.00	5/17/2024	Appealed
Currituck House	HAL-027-003	1/6/2022	10A NCAC 13F .1004(a) Medication Administration; G.S. 131D-21(2) Declaration of Resident's Rights	Unabated B	$8,300.00	8/31/2022	Settlement Agreement

Davidson County

Facility	Facility License	Inspection Date & Nature of Validation	Rules Areas Cited	Level Cited	Penalty Amount	Date Penalty Imposed	Current Status
Grayson Creek of Welcome	HAL-029-010	3/18/2021	10A NCAC 13F .0902(b) Health Care; G.S. 131D-21(2) Declaration of Resident's Rights	A1	$16,000.00	2/4/2022	Settlement Agreement
The Clinard House (Closed)	FCL-029-012	11/5/2020	10A NCAC 13G .0507 Training on Cardio-Pulmonary Resuscitation; G.S. 131D-21(2) Declaration of Resident's Rights	Unabated B	$4,300.00	12/17/2021	Not Paid - Referred to Controller's Office
The Clinard House (Closed)	FCL-029-012	11/5/2020	10A NCAC 13G .0601(a) Management and Other Staff; G.S. 131D-21(4) Declaration of Resident's Rights	A2	$2,000.00	12/17/2021	Not Paid - Referred to Controller's Office
The Clinard House (Closed)	FCL-029-012	11/5/2020	10A NCAC 13G .0909 Residents' Rights; G.S. 131D-21(4) Declaration of Resident's Rights	Unabated B	$4,300.00	12/17/2021	Not Paid - Referred to Controller's Office
The Clinard House (Closed)	FCL-029-012	11/5/2020	10A NCAC 13G .1701 (a) (b) Infection Prevention & Control Program (emer); G.S. 131D-21(4) Declaration of Resident's Rights	A2	$2,000.00	12/17/2021	Not Paid - Referred to Controller's Office
The Clinard House (Closed)	FCL-029-012	2/11/2021	10A NCAC 13G .0601(a) Management and Other Staff; G.S. 131D-21(2) Declaration of Resident's Rights	Unabated A2	$33,375.00	12/17/2021	Not Paid - Referred to Controller's Office
The Clinard House (Closed)	FCL-029-012	2/11/2021	10A NCAC 13G .1701 (c) Infection Prevention & Control Program (temp); G.S. 131D-21(2) Declaration of Resident's Rights	Unabated A2	$33,375.00	12/17/2021	Not Paid - Referred to Controller's Office
The Clinard House (Closed)	FCL-029-012	3/4/2021	10A NCAC 13G .0601(a) Management and Other Staff; G.S. 131D-21(4) Declaration of Resident's Rights	A2	$8,000.00	12/17/2021	Not Paid - Referred to Controller's Office
The Clinard House (Closed)	FCL-029-012	3/4/2021	10A NCAC 13G .0902(b) Health Care; G.S. 131D-21(2) Declaration of Resident's Rights	A2	$8,000.00	12/17/2021	Not Paid - Referred to Controller's Office
The Lyman House (Closed)	FCL-029-011	2/19/2021	10A NCAC 13G .0601(a) Management and Other Staff; G.S. 131D-21(2) Declaration of Resident's Rights	A1	$8,000.00	12/17/2021	Not Paid - Referred to Controller's Office
The Lyman House (Closed)	FCL-029-011	2/19/2021	10A NCAC 13G .0601(a) Management and Other Staff; G.S. 131D-21(4) Declaration of Resident's Rights	A1	$8,000.00	12/17/2021	Not Paid - Referred to Controller's Office
The Lyman House (Closed)	FCL-029-011	2/19/2021	10A NCAC 13G .0902(b) Health Care; G.S. 131D-21(2) Declaration of Resident's Rights	A1	$10,000.00	12/17/2021	Not Paid - Referred to Controller's Office
The Lyman House (Closed)	FCL-029-011	2/19/2021	10A NCAC 13G .1004(a) Medication Administration; G.S. 131D-21(4) Declaration of Resident's Rights	Continued Unabated Type B	$13,100.00	12/17/2021	Not Paid - Referred to Controller's Office
The Lyman House (Closed)	FCL-029-011	2/19/2021	10A NCAC 13G .1701 (a) (b) Infection Prevention & Control Program (emer); G.S. 131D-21(4) Declaration of Resident's Rights	Unabated A2	$33,375.00	12/17/2021	Not Paid - Referred to Controller's Office
The Lyman House (Closed)	FCL-029-011	3/4/2021	10A NCAC 13G .0909 Residents' Rights; G.S. 131D-21(4) Declaration of Resident's Rights	A1	$8,000.00	12/17/2021	Not Paid - Referred to Controller's Office

Davie County

Facility	Facility License	Inspection Date & Nature of Validation	Rules Areas Cited	Level Cited	Penalty Amount	Date Penalty Imposed	Current Status
Mocksville Senior Living and Memory Care	HAL-030-009	2/3/2021	10A NCAC 13F .0901(b) Personal Care and Supervision; G.S. 131D-21(2) Declaration of Resident's Rights	A2	$1,000.00	2/4/2022	Paid in Full
PS Senior Living of Mocksville	HAL-030-010	5/10/2023	10A NCAC 13F .1004(a) Medication Administration	A2	$2,000.00	8/2/2023	Paid in Full
PS Senior Living of Mocksville	HAL-030-010	9/15/2023	10A NCAC 13F .0901(b) Personal Care and Supervision	A2	$2,000.00	3/27/2024	Paid in Full
PS Senior Living of Mocksville	HAL-030-010	9/15/2023	10A NCAC 13F .0902(b) Health Care	A2	$2,000.00	3/27/2024	Paid in Full
Somerset Court of Mocksville	HAL-030-008	10/27/2022	10A NCAC 13F .1004(a) Medication Administration	A1	$1,750.00	5/31/2023	Paid in Full

Duplin County

Facility	Facility License	Inspection Date & Nature of Validation	Rules Areas Cited	Level Cited	Penalty Amount	Date Penalty Imposed	Current Status
Autumn Village	HAL-031-018	12/6/2022	10A NCAC 13F .0901(b) Personal Care and Supervision	A1	$4,000.00	5/12/2023	Settlement Agreement
Autumn Village	HAL-031-018	12/6/2022	10A NCAC 13F .1004(a) Medication Administration	A2	$2,000.00	5/12/2023	Settlement Agreement
Autumn Village	HAL-031-018	12/6/2022	G.S. § 131D-25 Implementation	A1	$4,000.00	5/12/2023	Settlement Agreement
Wallace Gardens	HAL-031-016	5/18/2022	10A NCAC 13F .0305(h)(4) Physical Environment G.S. 131D-21(2) Declaration of Resident's Rights	A2	$1,000.00	2/15/2023	Paid in Full

Durham County

Facility	Facility License	Inspection Date & Nature of Validation	Rules Areas Cited	Level Cited	Penalty Amount	Date Penalty Imposed	Current Status
Pleasant Living Family Care (closed)	FCL-032-150	5/11/2023	10A NCAC 13G .0302 (b) Design And Construction	Unabated B	$5,400.00	9/27/2023	Appealed
Pleasant Living Family Care (Closed)	FCL-032-150	11/22/2023	10A NCAC 13G .0202 The License	A2	$1,000.00	4/30/2024	Not Paid - Referred to Controller's Office
Pleasant Living Family Care (Closed)	FCL-032-150	11/22/2023	10A NCAC 13G .0909 Residents' Rights	A2	$1,000.00	4/30/2024	Not Paid - Referred to Controller's Office
Seasons at Southpoint	HAL-032-109	9/29/2023	10A NCAC 13F .0901(c) Personal Care and Supervision	A1	$5,250.00	3/27/2024	Paid in Full
Seasons at Southpoint	HAL-032-109	3/21/2024	10A NCAC 13F .1004(a) Medication Administration	A2	$2,000.00	6/12/2024	Paid in Full
B.J.'s Family Care Home	FCL-032-062	9/30/2021	10A NCAC 13G .1004(a) Medication Administration; G.S. 131D-21(2) Declaration of Resident's Rights	Unabated B	$5,700.00	9/21/2022	Paid in Full
Brookdale Durham	HAL-032-065	12/2/2022	10A NCAC 13F .1004(a) Medication Administration	Unabated B	$23,200.00	5/26/2023	Settlement Agreement
Camellia Gardens	HAL-032-071	1/24/2022	10A NCAC 13F .0305(h)(4) Physical Environment; G.S. 131D-21(2) Declaration of Resident's Rights	A1	$10,500.00	8/5/2022	Paid in Full
Carolina Care Homes (Closed)	FCL-032-170	12/21/2021	10A NCAC 13G .0601(d) Management and Other Staff; G.S. 131D-21(2) Declaration of Resident's Rights	A2	$375.00	6/10/2022	Paid in Full
Durham Ridge Assisted Living	HAL-032-091	2/25/2021	10A NCAC 13F .1004(a) Medication Administration; G.S. 131D-21(4) Declaration of Resident's Rights	A2	$4,000.00	2/4/2022	Paid in Full
Durham Ridge Assisted Living	HAL-032-091	2/1/2024	10A NCAC 13F .0902(b) Health Care	A2	$1,500.00	6/12/2024	Not Paid - Referred to Controller's Office
Durham Ridge Assisted Living	HAL-032-091	2/2/2024	10A NCAC 13F .0901(c) Personal Care and Supervision	A1	$13,500.00	6/12/2024	Not Paid - Referred to Controller's Office
Elsie-Doris Family Care (Closed)	FCL-032-088	4/30/2021	10A NCAC 13G .1004(a) Medication Administration; G.S. 131D-21(4) Declaration of Resident's Rights	A2	$500.00	3/16/2022	Paid in Full
Eno Pointe Assisted Living	HAL-032-001	8/25/2022	10A NCAC 13F .1004(a) Medication Administration	A1	$2,000.00	3/8/2023	Paid in Full
Our Promise Care Homes	FCL-032-178	4/18/2023	10A NCAC 13G .0302 (b) Design And Construction	A2	$800.00	7/7/2023	Paid in Full

Edgecombe County

Facility	Facility License	Inspection Date & Nature of Validation	Rules Areas Cited	Level Cited	Penalty Amount	Date Penalty Imposed	Current Status
Almarch Family Care	FCL-033-018	11/22/2022	10A NCAC 13G .1006 (g) Medication Storage	A2	$2,000.00	4/5/2023	Paid in Full
Almarch Family Care	FCL-033-018	2/8/2023	10A NCAC 13G .0403(a) Qualifications of Medication Staff	Unabated B	$5,200.00	5/26/2023	Paid in Full
Almarch Family Care	FCL-033-018	2/8/2023	10A NCAC 13G .0507 Training on Cardio-Pulmonary Resuscitation	A1	$3,500.00	5/26/2023	Paid in Full
Almarch Family Care	FCL-033-018	2/8/2023	10A NCAC 13G .0902(b) Health Care	A1	$6,000.00	5/26/2023	Paid in Full
Guiding Star Health Care Two	FCL-033-014	9/19/2023	10A NCAC 13G .0705 (f) Discharge Of Residents	A2	$500.00	3/27/2024
Guiding Star Health Care Two	FCL-033-014	9/19/2023	10A NCAC 13G .0901(b) Personal Care and Supervision	A1	$2,000.00	3/27/2024
Guiding Star Health Care Two	FCL-033-014	9/19/2023	10A NCAC 13G .0906 (f)(1)-(4) Other Resident Services	A2	$500.00	3/27/2024
Guiding Star Health Care Two	FCL-033-014	9/19/2023	10A NCAC 13G .0909 Residents' Rights	A1	$3,500.00	3/27/2024
Guiding Star Health Care Two	FCL-033-014	9/19/2023	10A NCAC 13G .1004(a) Medication Administration	A2	$1,000.00	3/27/2024
Guiding Star Health Care Two	FCL-033-014	11/8/2023	10A NCAC 13G .0906 (f)(1)-(4) Other Resident Services	Unabated A2	$6,375.00	5/17/2024	Not Paid - Referred to Controller's Office
Heritage Care of Rocky Mount	HAL-033-005	9/1/2022	10A NCAC 13F .0901(c) Personal Care and Supervision	A1	$8,000.00	3/8/2023	Settlement Agreement
The Bridges of Hendricks Creek	HAL-033-006	12/8/2022	10A NCAC 13F .0901(b) Personal Care and Supervision	A1	$2,000.00	5/12/2023	Paid in Full
The Bridges of Hendricks Creek	HAL-033-006	6/1/2023	10A NCAC 13F .1004(a) Medication Administration	A1	$2,000.00	11/21/2023	Paid in Full
The Bridges of Hendricks Creek	HAL-033-006	8/30/2023	10A NCAC 13F .1004(a) Medication Administration	A2	$4,000.00	5/10/2024	Paid in Full

Forsyth County

Facility	Facility License	Inspection Date & Nature of Validation	Rules Areas Cited	Level Cited	Penalty Amount	Date Penalty Imposed	Current Status
C.R.T. Golden Lamb	HAL-034-019	5/31/2022	10A NCAC 13F .0901(b) Personal Care and Supervision	A2	$2,000.00	3/8/2023	Paid in Full
Forest Heights Senior Living Community	HAL-034-087	8/31/2023	10A NCAC 13F .1004(a) Medication Administration	Unabated B	$21,000.00	1/31/2024	Appealed
Grand Villa Assisted Living at Winston (Formerly Salem Terrace Assisted Living and Memory Care)	HAL-034-116	5/3/2023	10A NCAC 13F .1004(a) Medication Administration	A2	$1,500.00	9/27/2023	Paid in Full
Harmony at Brookberry Farm	HAL-034-112	2/23/2023	10A NCAC 13F .0901(b) Personal Care and Supervision	A2	$500.00	5/26/2023	Paid in Full
Harmony at Brookberry Farm	HAL-034-112	4/25/2024	10A NCAC 13F .0901(b) Personal Care and Supervision	A1	$16,000.00	9/4/2024	Appealed
Salem Terrace (Closed)	HAL-034-098	10/18/2019	10A NCAC 13F .0901(b) Personal Care and Supervision; G.S. 131D-21(2) Declaration of Resident's Rights	A1	$14,000.00	2/4/2022	Paid in Full
Salem Terrace (Closed)	HAL-034-098	8/5/2022	10A NCAC 13F .0902(b) Health Care	Unabated B	$25,200.00	5/31/2023	Paid in Full
Shuler Health Care/Record Villa	HAL-034-108	5/24/2023	10A NCAC 13F .0902(b) Health Care	A2	$2,000.00	9/27/2023	Appealed
Shuler Health Care/Record Villa	HAL-034-108	5/24/2023	10A NCAC 13F .1004(a) Medication Administration	A2	$2,000.00	9/27/2023	Appealed
Shuler Health Care/Storey Villa	HAL-034-107	2/17/2023	10A NCAC 13F .1004(a) Medication Administration	A2	$1,500.00	5/31/2023	Paid in Full
Shuler Health Care/Storey Villa	HAL-034-107	5/25/2023	10A NCAC 13F .1004(a) Medication Administration	Unabated A2	$60,187.50	3/27/2024	Appealed
The Bradford Village of Kernersville - West	HAL-034-069	3/19/2021	10A NCAC 13F .1004(a) Medication Administration; G.S. 131D-21(2) Declaration of Resident's Rights	Unabated A2	$24,800.00	2/4/2022	Paid in Full
The Bradford Village of Kernersville - West	HAL-034-069	10/12/2021	G.S. 131D-4.4A (b) ACH Infection Prevention Requirements; G.S. 131D-21(2) Declaration of Resident's Rights	Unabated B	$16,800.00	8/31/2022	Settlement Agreement
The Bradford Village of Kernersville - West	HAL-034-069	4/7/2022	10A NCAC 13F .0902(b) Health Care; G.S. 131D-21(2) Declaration of Resident's Rights	A2	$12,000.00	12/21/2022	Paid in Full
The Bradford Village of Kernersville - West	HAL-034-069	7/8/2022	10A NCAC 13F .1004(a) Medication Administration G.S. 131D-21(2) Declaration of Resident's Rights	Unabated B	$13,200.00	2/15/2023	Settlement Agreement
The Ivy at Clemmons (Closed)	HAL-034-105	1/13/2021	10A NCAC 13F .0909 Resident Rights; G.S. 131D-21(4) Declaration of Resident's Rights	A1	$20,000.00	3/16/2022	Settlement Agreement
The Ivy at Clemmons (Closed)	HAL-034-105	4/20/2021	10A NCAC 13F .0901(b) Personal Care and Supervision; G.S. 131D-21(2) Declaration of Resident's Rights	A2	$18,000.00	4/20/2022	Settlement Agreement
The Ivy at Clemmons (Closed)	HAL-034-105	4/20/2021	10A NCAC 13F .1004(a) Medication Administration; G.S. 131D-21(2) Declaration of Resident's Rights	A2	$13,500.00	4/20/2022	Settlement Agreement
The Ivy at Clemmons (Closed)	HAL-034-105	4/20/2021	G.S. § 131D-25 Implementation; G.S. 131D-21(2) Declaration of Resident's Rights	A2	$18,000.00	4/20/2022	Settlement Agreement
The Ivy at Clemmons (Closed)	HAL-034-105	5/17/2022	10A NCAC 13F .0901(a) Personal Care and Supervision; G.S. 131D-21(4) Declaration of Resident's Rights	A2	$15,000.00	12/21/2022	Settlement Agreement
The Ivy at Clemmons (Closed)	HAL-034-105	5/17/2022	10A NCAC 13F .0901(b) Personal Care and Supervision; G.S. 131D-21(4) Declaration of Resident's Rights	A1	$15,000.00	12/21/2022	Settlement Agreement
The Ivy at Clemmons (Closed)	HAL-034-105	5/17/2022	10A NCAC 13F .0902(b) Health Care; G.S. 131D-21(4) Declaration of Resident's Rights	A1	$15,000.00	12/21/2022	Settlement Agreement
The Ivy at Clemmons (Closed)	HAL-034-105	5/17/2022	10A NCAC 13F .0902(c)(3-4) Health Care; G.S. 131D-21(4) Declaration of Resident's Rights	A2	$15,000.00	12/21/2022	Settlement Agreement
The Ivy at Clemmons (Closed)	HAL-034-105	5/17/2022	10A NCAC 13F .1004(a) Medication Administration; G.S. 131D-21(2) Declaration of Resident's Rights	A2	$15,000.00	12/21/2022	Settlement Agreement
Tranquility Care	HAL-034-104	5/17/2022	10A NCAC 13F .0901(b) Personal Care and Supervision	A1	$8,000.00	3/8/2023	Settlement Agreement

Franklin County

Facility	Facility License	Inspection Date & Nature of Validation	Rules Areas Cited	Level Cited	Penalty Amount	Date Penalty Imposed	Current Status
Alston Family Care Home	FCL-035-008	10/20/2022	10A NCAC 13G .0302 (b) Design And Construction	Unabated B	$900.00	2/15/2023	Paid in Full
Franklin Manor Assisted Living Center	HAL-035-024	12/8/2021	10A NCAC 13F .0901(b) Personal Care and Supervision; G.S. 131D-21(2) Declaration of Resident's Rights	Unabated A2	$22,000.00	8/5/2022	Settlement Agreement
Louisburg Healthcare & Rehabilitation Center	NH0264		10A NCAC 13G .0904 (c-7) Nutrition And Food Service;	A1	$20,000.00	7/15/2022	Paid in Full
Southern Living for Seniors of Louisburg, NC (Closed)	HAL-035-031	8/14/2020	10A NCAC 13F .0909 Resident Rights; G.S. 131D-21(4) Declaration of Resident's Rights	A2	$2,000.00	12/10/2021	Paid in Full
Southern Living for Seniors of Louisburg, NC (Closed)	HAL-035-031	8/4/2021	10A NCAC 13F .0909 Resident Rights; G.S. 131D-21(2) Declaration of Resident's Rights	A2	$12,000.00	5/16/2022	Paid in Full
Southern Living for Seniors of Louisburg, NC (Closed)	HAL-035-031	4/29/2022	10A NCAC 13F .0901(b) Personal Care and Supervision; G.S. 131D-21(4) Declaration of Resident's Rights	A2	$2,000.00	12/21/2022	Not Paid - Referred to Controller's Office
Southern Living for Seniors of Louisburg, NC (Closed)	HAL-035-031	12/8/2022	10A NCAC 13F .0904(a)(4) Nutrition And Food Service	A1	$14,000.00	5/12/2023	Not Paid - Referred to Controller's Office
Southern Living for Seniors of Louisburg, NC (Closed)	HAL-035-031	2/10/2023	10A NCAC 13F .0904(a)(4) Nutrition And Food Service	Unabated A1	$5,100.00	5/31/2023	Not Paid - Referred to Controller's Office
Southern Living for Seniors of Louisburg, NC (Closed)	HAL-035-031	2/10/2023	10A NCAC 13F .0904(c)(3) Nutrition And Food Service	Unabated B	$7,400.00	5/31/2023	Not Paid - Referred to Controller's Office
Southern Living for Seniors of Louisburg, NC (Closed)	HAL-035-031	2/10/2023	10A NCAC 13F .0904(d)(1) Nutrition And Food Service	Unabated B	$7,400.00	5/31/2023	Not Paid - Referred to Controller's Office
Southern Living for Seniors of Louisburg, NC (Closed)	HAL-035-031	2/10/2023	10A NCAC 13F .1104 (f) Accounting For Resident's Personal Funds	Unabated B	$7,400.00	5/31/2023	Not Paid - Referred to Controller's Office
Southern Living for Seniors of Louisburg, NC (closed)	HAL-035-031	10/12/2023	10A NCAC 13F .0901(a) Personal Care and Supervision	A1	$16,000.00	3/27/2024	Not Paid - Referred to Controller's Office
Southern Living for Seniors of Louisburg, NC (closed)	HAL-035-031	10/12/2023	10A NCAC 13F .0902(b) Health Care	A1	$16,000.00	3/27/2024	Not Paid - Referred to Controller's Office
Southern Living for Seniors of Louisburg, NC (closed)	HAL-035-031	10/12/2023	10A NCAC 13F .1004(a) Medication Administration	A1	$16,000.00	3/27/2024	Not Paid - Referred to Controller's Office

Gaston County

Facility	Facility License	Inspection Date & Nature of Validation	Rules Areas Cited	Level Cited	Penalty Amount	Date Penalty Imposed	Current Status
Brookdale Robinwood	HAL-036-015	1/5/2024	10A NCAC 13F .0901(b) Personal Care and Supervision	A1	$7,000.00	7/12/2024	Appealed
Brookdale Robinwood	HAL-036-015	1/5/2024	10A NCAC 13F .0901(c) Personal Care and Supervision	A1	$7,000.00	7/12/2024	Appealed
Brookdale Robinwood	HAL-036-015	1/5/2024	10A NCAC 13F .0902(b) Health Care	A1	$7,000.00	7/12/2024	Appealed
Magnolia Gardens (Closed)	HAL-036-036	1/17/2023	10A NCAC 13F .0602 Management Of Facilities WIth A Capacity Or	A1	$14,000.00	5/26/2023	Settlement Agreement
Magnolia Gardens (Closed)	HAL-036-036	1/17/2023	10A NCAC 13F .0606 Staffing Chart	A2	$14,000.00	5/26/2023	Settlement Agreement
Magnolia Gardens (Closed)	HAL-036-036	1/17/2023	10A NCAC 13F .0902(b) Health Care	A1	$7,000.00	5/26/2023	Settlement Agreement
Magnolia Gardens (Closed)	HAL-036-036	1/17/2023	10A NCAC 13F .0909 Resident Rights	A2	$7,000.00	5/26/2023	Settlement Agreement
Magnolia Gardens (Closed)	HAL-036-036	3/23/2023	10A NCAC 13F .0904(e)(4) Nutrition and Food Service	Unabated Type B	$21,600.00	8/2/2023	Settlement Agreement
Rosewood Assisted Living	HAL-036-004	9/7/2022	10A NCAC 13F .0305(h)(3) Physical Environment G.S. 131D-21(4) Declaration of Resident's Rights	A2	$1,500.00	2/15/2023	Paid in Full
TerraBella Cramer Mountain	HAL-036-039	7/7/2022	10A NCAC 13F .0904(e)(4) Nutrition and Food Service	Unabated B	$13,800.00	3/8/2023	Paid in Full
Terrace Ridge Assisted Living	HAL-036-023	3/13/2024	10A NCAC 13F .0901(b) Personal Care and Supervision	A2	$2,000.00	7/31/2024	Paid in Full
Wellington House	HAL-036-031	11/1/2023	10A NCAC 13F .0901(b) Personal Care and Supervision	A2	$2,000.00	5/17/2024	Paid in Full
Woodlawn Haven	HAL-036-006	1/17/2024	10A NCAC 13F .0901(b) Personal Care and Supervision	A1	$14,000.00	5/17/2024	Appealed

Gates County

Facility	Facility License	Inspection Date & Nature of Validation	Rules Areas Cited	Level Cited	Penalty Amount	Date Penalty Imposed	Current Status
Gates House	HAL-037-001	2/10/2023	10A NCAC 13F .0902(b) Health Care	A2	$2,000.00	7/7/2023	Paid in Full
Gates House	HAL-037-001	2/10/2023	10A NCAC 13F .0904(e)(4) Nutrition and Food Service	A2	$1,000.00	7/7/2023	Paid in Full

Granville County

Facility	Facility License	Inspection Date & Nature of Validation	Rules Areas Cited	Level Cited	Penalty Amount	Date Penalty Imposed	Current Status
Toney Rest Home	HAL-039-017	6/17/2021	G.S. 131D-4.4A (b) ACH Infection Prevention Requirements; G.S. 131D-21(2) Declaration of Resident's Rights	Unabated B	$9,000.00	4/20/2022	Paid in Full

Greene County

Facility	Facility License	Inspection Date & Nature of Validation	Rules Areas Cited	Level Cited	Penalty Amount	Date Penalty Imposed	Current Status
A Safe Place (Closed)	FCL-040-011	2/18/2022	10A NCAC 13G .0901(a) Personal Care and Supervision; G.S. 131D-21(4) Declaration of Resident's Rights	A1	$2,000.00	8/5/2022	Not Paid - Referred to Controller's Office
A Safe Place (Closed)	FCL-040-011	2/18/2022	10A NCAC 13G .0902(b) Health Care; G.S. 131D-21(4) Declaration of Resident's Rights	A2	$2,000.00	8/5/2022	Not Paid - Referred to Controller's Office

Guilford County

Facility	Facility License	Inspection Date & Nature of Validation	Rules Areas Cited	Level Cited	Penalty Amount	Date Penalty Imposed	Current Status
Agape Care Family Homes #1	FCL-041-084	6/28/2023	10A NCAC 13G .0909 Residents' Rights	A1	$2,000.00	1/31/2024	Paid in Full
Agape Care Family Homes #2	FCL-041-085	6/26/2023	10A NCAC 13G .0909 Residents' Rights	A1	$2,000.00	1/31/2024	Paid in Full
Brookdale High Point	HAL-041-030	9/16/2022	10A NCAC 13F .0902(b) Health Care	A2	$1,000.00	3/8/2023	Paid in Full
Brookdale High Point North	HAL-041-033	10/20/2022	10A NCAC 13F .0901(b) Personal Care and Supervision	A2	$1,000.00	2/15/2023	Paid in Full
Brookdale Lawndale Park	HAL-041-062	11/7/2022	10A NCAC 13F .0904(e)(4) Nutrition and Food Service	A1	$14,000.00	3/8/2023	Not Paid - Referred to Controller's Office
Carriage House Senior Living Community	HAL-041-065	7/20/2021	10A NCAC 13F .0901(b) Personal Care and Supervision; G.S. 131D-21(2) Declaration of Resident's Rights	A1	$12,000.00	6/10/2022	Paid in Full
Carriage House Senior Living Community	HAL-041-065	7/20/2021	10A NCAC 13F .0902(b) Health Care; G.S. 131D-21(2) Declaration of Resident's Rights	A1	$7,000.00	6/10/2022	Paid in Full
Carriage House Senior Living Community	HAL-041-065	1/17/2023	10A NCAC 13F .0901(c) Personal Care and Supervision	A2	$2,000.00	5/31/2023	Paid in Full
Carriage House Senior Living Community	HAL-041-065	3/17/2023	10A NCAC 13F .1004(a) Medication Administration	A2	$4,000.00	7/7/2023	Paid in Full
Guilford House	HAL-041-077	8/11/2021	10A NCAC 13F .0901(b) Personal Care and Supervision; G.S. 131D-21(4) Declaration of Resident's Rights	A1	$16,000.00	6/10/2022	Settlement Agreement
Harmony at Greensboro	HAL-041-086	11/17/2023	10A NCAC 13F .0902(b) Health Care	A2	$1,000.00	5/17/2024	Paid in Full
Harmony at Greensboro	HAL-041-086	1/31/2024	10A NCAC 13F .0901(c) Personal Care and Supervision	A1	$1,000.00	6/12/2024	Paid in Full
Harmony at Greensboro	HAL-041-086	1/31/2024	10A NCAC 13F .1211 (b) Written Policies And Procedures	A1	$2,000.00	6/12/2024	Paid in Full
Liggins Family Care Woodmere Center (CLOSED)	FCL-041-071	3/29/2019	10A NCAC 13G .0507 Training on Cardio-Pulmonary Resuscitation; G.S. 131D-21(2) Declaration of Resident's Rights	Unabated B	$30,800.00	2/4/2022	Settlement Agreement
Liggins Family Care Woodmere Center (CLOSED)	FCL-041-071	3/29/2019	10A NCAC 13G .0909 Residents' Rights; G.S. 131D-21(4) Declaration of Resident's Rights	Unabated B	$14,200.00	2/4/2022	Settlement Agreement
Liggins Family Care Woodmere Center (CLOSED)	FCL-041-071	3/29/2019	G.S. § 131D-4.5B (b) ACH Medication Aides;Training and Competency; G.S. 131D-21(2) Declaration of Resident's Rights	Unabated B	$30,800.00	2/4/2022	Settlement Agreement
Morningview at Irving Park	HAL-041-052	2/21/2022	10A NCAC 13F .0901(b) Personal Care and Supervision; G.S. 131D-21(2) Declaration of Resident's Rights	A2	$2,000.00	8/31/2022	Paid in Full
Morningview at Irving Park	HAL-041-052	2/21/2022	10A NCAC 13F .1004(a) Medication Administration; G.S. 131D-21(2) Declaration of Resident's Rights	Unabated B	$13,400.00	8/31/2022	Paid in Full
Piedmont Christian Home	HAL-041-010	3/4/2022	10A NCAC 13F .0901(b) Personal Care and Supervision; G.S. 131D-21(2) Declaration of Resident's Rights	A2	$1,000.00	9/21/2022	Paid in Full
Piedmont Christian Home	HAL-041-010	3/4/2022	10A NCAC 13F .1004(a) Medication Administration; G.S. 131D-21(2) Declaration of Resident's Rights	A2	$2,000.00	9/21/2022	Paid in Full
St. Gales Estates (Closed)	HAL-041-023	3/16/2022	10A NCAC 13F .1004(a) Medication Administration; G.S. 131D-21(2) Declaration of Resident's Rights	A2	$4,000.00	8/5/2022	Settlement Agreement
St. Gales Estates (Closed)	HAL-041-023	3/16/2022	10A NCAC 13F .1008(a) Controlled Substances; G.S. 131D-21(2) Declaration of Resident's Rights	A2	$4,000.00	8/5/2022	Settlement Agreement
St. Gales Estates (Closed)	HAL-041-023	7/28/2022	10A NCAC 13F .0902(b) Health Care ; G.S. 131D-21(2) Declaration of Resident's Rights	Unabated B	$22,400.00	2/7/2023	Settlement Agreement
St. Gales Estates (Closed)	HAL-041-023	7/28/2022	10A NCAC 13F .0904(e)(4) Nutrition and Food Service; G.S. 131D-21(2) Declaration of Resident's Rights	Unabated B	$22,400.00	2/7/2023	Settlement Agreement
St. Gales Estates (Closed)	HAL-041-023	7/28/2022	10A NCAC 13F .1004(a) Medication Administration; G.S. 131D-21(4) Declaration of Resident's Rights	Unabated A2	$129,000.00	2/7/2023	Settlement Agreement
St. Gales Estates (Closed)	HAL-041-023	9/13/2022	10A NCAC 13F .0604(e) Personal Care And Other Staffing ; G.S. 131D-21(4) Declaration of Resident's Rights	A2	$12,000.00	2/7/2023	Settlement Agreement
St. Gales Estates (Closed)	HAL-041-023	9/13/2022	10A NCAC 13F .0901(b) Personal Care and Supervision ; G.S. 131D-21(4) Declaration of Resident's Rights	A2	$7,000.00	2/7/2023	Settlement Agreement
St. Gales Estates (Closed)	HAL-041-023	9/13/2022	10A NCAC 13F .0901(c) Personal Care and Supervision ; G.S. 131D-21(4) Declaration of Resident's Rights	A1	$20,000.00	2/7/2023	Settlement Agreement
St. Gales Estates (Closed)	HAL-041-023	11/23/2022	10A NCAC 13F .0702 (f) Discharge Of Residents	A2	$16,000.00	2/7/2023	Settlement Agreement
Wellington Oaks	HAL-041-072	8/19/2022	10A NCAC 13F .0901(b) Personal Care and Supervision	A1	$2,000.00	3/8/2023	Paid in Full

Halifax County

Facility	Facility License	Inspection Date & Nature of Validation	Rules Areas Cited	Level Cited	Penalty Amount	Date Penalty Imposed	Current Status
Carolina Rest Home	HAL-042-005	6/24/2022	10A NCAC 13F .0909 Resident Rights	A1	$7,000.00	3/8/2023	Settlement Agreement
Carolina Rest Home	HAL-042-005	6/24/2022	10A NCAC 13F .1205 Health Care Personnel Registry	A2	$3,500.00	3/8/2023	Settlement Agreement
Carolina Rest Home	HAL-042-005	6/24/2022	G.S. § 131D-25 Implementation	A1	$7,000.00	3/8/2023	Settlement Agreement

Harnett County

Facility	Facility License	Inspection Date & Nature of Validation	Rules Areas Cited	Level Cited	Penalty Amount	Date Penalty Imposed	Current Status
Arc of Dunn (Closed)	HAL-043-033	8/23/2021	10A NCAC 13F .0901(b) Personal Care and Supervision; G.S. 131D-21(4) Declaration of Resident's Rights	A1	$7,000.00	5/11/2022	Not Paid - Referred to Controller's Office
Arc of Dunn (Closed)	HAL-043-033	11/19/2021	10A NCAC 13F .0909 Resident Rights; G.S. 131D-21(4) Declaration of Resident's Rights	A1	$7,000.00	5/11/2022	Not Paid - Referred to Controller's Office
Arc of Dunn (Closed)	HAL-043-033	11/23/2021	10A NCAC 13F .0306(a)(5) Housekeeping and Furnishings; G.S. 131D-21(2) Declaration of Resident's Rights	Unabated B	$6,000.00	5/11/2022	Not Paid - Referred to Controller's Office
Green Leaf Care Center	HAL-043-027	1/15/2021	10A NCAC 13F .0902(b) Health Care; G.S. 131D-21(4) Declaration of Resident's Rights	A1	$3,000.00	12/17/2021	Paid in Full
Johnson Better Care (Closed)	HAL-043-003	11/25/2019	10A NCAC 13F .1004(a) Medication Administration; G.S. 131D-21(2) Declaration of Resident's Rights	A2	$4,000.00	12/17/2021	Paid in Full
Johnson Better Care (Closed)	HAL-043-003	11/25/2019	G.S. § 131D-25 Implementation; G.S. 131D-21(2) Declaration of Resident's Rights	A2	$4,000.00	12/17/2021	Paid in Full
Oak Hill Living Center	HAL-043-015	1/22/2021	10A NCAC 13F .0901(b) Personal Care and Supervision; G.S. 131D-21(4) Declaration of Resident's Rights	A1	$7,000.00	3/16/2022	Settlement Agreement

Haywood County

Facility	Facility License	Inspection Date & Nature of Validation	Rules Areas Cited	Level Cited	Penalty Amount	Date Penalty Imposed	Current Status
Spicewood Cottages Elms	HAL-044-039	10/20/2023	10A NCAC 13F .0909 Resident Rights	A1	$4,000.00	5/17/2024	Paid in Full
Haywood House	HAL-044-042	3/16/2023	10A NCAC 13F .0602 (b) Management Of Facilities with a Capacity of	A1	$12,000.00	6/16/2023	Appealed
Haywood House	HAL-044-042	3/16/2023	10A NCAC 13F .0901(b) Personal Care and Supervision	A1	$7,000.00	6/16/2023	Appealed
Haywood House	HAL-044-042	3/16/2023	10A NCAC 13F .0901(c) Personal Care and Supervision	A2	$2,000.00	6/16/2023	Appealed
Haywood House	HAL-044-042	3/16/2023	10A NCAC 13F .0902(b) Health Care	A2	$2,000.00	6/16/2023	Appealed
Haywood House	HAL-044-042	3/16/2023	10A NCAC 13F .0909 Resident Rights	A1	$12,000.00	6/16/2023	Appealed
Haywood House	HAL-044-042	3/16/2023	10A NCAC 13F .1205 Health Care Personnel Registry	A2	$4,000.00	6/16/2023	Appealed
Haywood Lodge and Retirment Center	HAL-044-009	7/20/2023	10A NCAC 13F .0909 Resident Rights	A1	$2,000.00	11/21/2023	Paid in Full
McCracken Rest Home (Closed)	HAL-044-046	2/2/2021	10A NCAC 13F .0311(b) Other Requirements; G.S. 131D-21(2) Declaration of Resident's Rights	A2	$2,000.00	5/16/2022	Paid in Full
McCracken Rest Home (Closed)	HAL-044-046	6/2/2023	10A NCAC 13F .0909 Resident Rights	A1	$7,000.00	9/27/2023	Not Paid - Referred to Controller's Office
McCracken Rest Home (Closed)	HAL-044-046	6/2/2023	10A NCAC 13F .1104(b) Accounting For Resident's Personal Funds	A1	$7,000.00	9/27/2023	Not Paid - Referred to Controller's Office
Spicewood Cottages Elms	HAL-044-039	10/20/2023	10A NCAC 13F .1205 Health Care Personnel Registry	A1	$4,000.00	5/17/2024	Paid in Full
Spicewood Cottages Oaks	HAL-044-040	11/30/2022	10A NCAC 13F .0604 (d) Personal Care And Other Staffing	Unabated B	$23,400.00	5/31/2023	Paid in Full
Spicewood Cottages Oaks	HAL-044-040	7/7/2021	10A NCAC 13F .0901(b) Personal Care and Supervision; G.S. 131D-21(2) Declaration of Resident's Rights	A1	$2,000.00	5/16/2022	Paid in Full
Spicewood Cottages Willows	HAL-044-041	11/17/2022	10A NCAC 13F .0604 (d) Personal Care And Other Staffing	Unabated B	$19,400.00	5/31/2023	Paid in Full

Henderson County

Facility	Facility License	Inspection Date & Nature of Validation	Rules Areas Cited	Level Cited	Penalty Amount	Date Penalty Imposed	Current Status
McCullough's Rest Home	HAL-045-005	10/6/2023	10A NCAC 13F .0909 Resident Rights	A1	$4,000.00	3/27/2024	Paid in Full
Carolina Reserve of Hendersonville	HAL-045-125	5/13/2022	10A NCAC 13F .0901(c) Personal Care and Supervision	A1	$12,000.00	3/8/2023	Paid in Full
TerraBella Hendersonville	HAL-045-130	9/1/2023	10A NCAC 13F .0901(b) Personal Care and Supervision	A1	$7,000.00	3/27/2024	Paid in Full
TerraBella Hendersonville	HAL-045-130	11/1/2023	10A NCAC 13F .0901(c) Personal Care and Supervision	A1	$7,000.00	5/17/2024	Paid in Full
Terrabella Hendersonville	HAL-045-130	3/25/2024	10A NCAC 13F .0902(b) Health Care	A2	$3,000.00	7/31/2024	Paid in Full
The Gardens of Hendersonville	HAL-045-129	5/14/2021	10A NCAC 13F .0306(a)(5) Housekeeping and Furnishings; G.S. 131D-21(2) Declaration of Resident's Rights	A1	$1,000.00	3/16/2022	Paid in Full
Tore's Home #22	FCL-045-127	12/6/2023	10A NCAC 13G .0909 Residents' Rights	A1	$1,000.00	7/12/2024	Paid in Full

Hertford County

Facility	Facility License	Inspection Date & Nature of Validation	Rules Areas Cited	Level Cited	Penalty Amount	Date Penalty Imposed	Current Status
Ahoskie Assisted Living	HAL-046-020	1/19/2024	10A NCAC 13F .0902(b) Health Care	A1	$2,000.00	6/12/2024	Paid in Full
Carver Manor (Closed)	FCL-046-002	4/28/2021	10A NCAC 13G .0302 (b) Design And Construction; G.S. 131D-21(2) Declaration of Resident's Rights	Unabated B	$2,500.00	3/16/2022	Not Paid - Referred to Controller's Office
Carver Manor (Closed)	FCL-046-002	6/30/2021	10A NCAC 13G .0601(d) Management and Other Staff; G.S. 131D-21(2) Declaration of Resident's Rights	A2	$4,000.00	3/16/2022	Not Paid - Referred to Controller's Office
Twin Oaks and Twins Adult Home (closed)	HAL-046-018	2/12/2020	10A NCAC 13F .0901(b) Personal Care and Supervision; G.S. 131D-21(4) Declaration of Resident's Rights	A1	$7,000.00	3/16/2022	Not Paid - Referred to Controller's Office
Twin Oaks and Twins Adult Home (closed)	HAL-046-018	2/12/2020	10A NCAC 13F .0902(b) Health Care; G.S. 131D-21(4) Declaration of Resident's Rights	A1	$7,000.00	3/16/2022	Not Paid - Referred to Controller's Office
Twin Oaks and Twins Adult Home (closed)	HAL-046-018	2/12/2020	10A NCAC 13F .0909 Resident Rights; G.S. 131D-21(4) Declaration of Resident's Rights	A1	$7,000.00	3/16/2022	Paid in Full
Weaver's Pineview Home	FCL-046-013	8/11/2023	10A NCAC 13G .0315(a)(5) Housekeeping and Furnishings	A2	$1,000.00	1/31/2024	Not Paid - Referred to Controller's Office
Weaver's Pineview Home	FCL-046-013	8/11/2023	10A NCAC 13G .0904(a)(2) Nutrition and Food Service	A2	$1,000.00	1/31/2024	Not Paid - Referred to Controller's Office
Weaver's Pineview Home	FCL-046-013	8/11/2023	10A NCAC 13G .0909 Residents' Rights	A1	$2,000.00	1/31/2024	Not Paid - Referred to Controller's Office
Weaver's Pineview Home	FCL-046-013	10/19/2023	10A NCAC 13G .1004(a) Medication Administration	A2	$2,000.00	1/31/2024	Not Paid - Referred to Controller's Office
Weaver's Pineview Home	FCL-046-013	12/4/2023	10A NCAC 13G .0904(a)(2) Nutrition and Food Service	Unabated B	$4,500.00	5/17/2024	Appealed

Hoke County

Facility	Facility License	Inspection Date & Nature of Validation	Rules Areas Cited	Level Cited	Penalty Amount	Date Penalty Imposed	Current Status
Open Arms Retirement Center	HAL-047-014	6/14/2021	10A NCAC 13F .0902(b) Health Care; G.S. 131D-21(4) Declaration of Resident's Rights	A2	$1,000.00	5/16/2022	Paid in Full
Open Arms Retirement Center	HAL-047-014	8/25/2023	10A NCAC 13F .0901(b) Personal Care and Supervision	A1	$3,500.00	5/10/2024	Paid in Full
Wickshire Creek Crossing	HAL-047-015	5/30/2023	10A NCAC 13F .0901(b) Personal Care and Supervision	A2	$2,000.00	9/27/2023	Paid in Full
Wickshire Creek Crossing	HAL-047-015	8/29/2023	10A NCAC 13F .0901(c) Personal Care and Supervision	A1	$12,000.00	1/31/2024	Appealed
Wickshire Creek Crossing	HAL-047-015	9/8/2023	10A NCAC 13F .1212(g) Reporting of Accidents and Incidents	A2	$7,000.00	1/31/2024	Appealed
Wickshire Creek Crossing	HAL-047-015	11/2/2023	10A NCAC 13F .0901(b) Personal Care and Supervision	A1	$12,000.00	7/31/2024	Appealed
Wickshire Creek Crossing	HAL-047-015	3/6/2024	10A NCAC 13F .1004(a) Medication Administration	A2	$12,000.00	7/31/2024	Appealed
Wickshire Creek Crossing	HAL-047-015	5/8/2024	10A NCAC 13F .1004(a) Medication Administration	A1	$14,000.00	7/31/2024	Appealed
Wickshire Creek Crossing	HAL-047-015	5/8/2024	10A NCAC 13F .1008 (a) Controlled Substances	A1	$14,000.00	7/31/2024	Appealed
Wickshire Creeks Crossing (Formerly The Crossings at Wayside)	HAL-047-015	3/4/2022	10A NCAC 13F .0901(b) Personal Care and Supervision; G.S. 131D-21(2) Declaration of Resident's Rights	A2	$750.00	8/5/2022	Paid in Full

Iredell County

Facility	Facility License	Inspection Date & Nature of Validation	Rules Areas Cited	Level Cited	Penalty Amount	Date Penalty Imposed	Current Status
Meadow Lakes of Statesville	HAL-049-036	5/17/2024	10A NCAC 13F .0901(b) Personal Care and Supervision	A1	$9,000.00	9/18/2024	Appealed
Meadow Lakes of Statesville	HAL-049-036	5/17/2024	10A NCAC 13F .0902(b) Health Care	A2	$3,000.00	9/18/2024	Appealed
Meadow Lakes of Statesville	HAL-049-036	5/17/2024	10A NCAC 13F .1308(a) Special Care Unit Staff	A1	$14,000.00	9/18/2024	Appealed
Meadow Lakes of Statesville (formerly Heritage Place)	HAL-049-036	6/21/2023	10A NCAC 13F .0909 Resident Rights	A1	$8,000.00	11/21/2023	Settlement Agreement
Mill Creek Manor	HAL-049-033	12/1/2023	10A NCAC 13F .0902(b) Health Care	A1	$4,000.00	6/14/2024	Paid in Full

Jackson County

Facility	Facility License	Inspection Date & Nature of Validation	Rules Areas Cited	Level Cited	Penalty Amount	Date Penalty Imposed	Current Status
Morningstar Assisted Living	HAL-050-016	2/1/2022	10A NCAC 13F .1801 (c) Infection Prevention & Control Program (temp); G.S. 131D-21(2) Declaration of Resident's Rights	A2	$2,000.00	9/21/2022	Settlement Agreement
Morningstar Assisted Living	HAL-050-016	6/23/2022	10A NCAC 13F .0902(b) Health Care G.S. 131D-21(2) Declaration of Resident's Rights	A2	$500.00	2/15/2023	Paid in Full
The Hermitage	HAL-050-017	3/29/2022	10A NCAC 13F .0902(b) Health Care; G.S. 131D-21(2) Declaration of Resident's Rights	A1	$4,000.00	12/21/2022	Settlement Agreement
The Hermitage	HAL-050-017	9/28/2022	10A NCAC 13F .0902(b) Health Care	A2	$1,500.00	3/8/2023	Paid in Full

Johnston County

Facility	Facility License	Inspection Date & Nature of Validation	Rules Areas Cited	Level Cited	Penalty Amount	Date Penalty Imposed	Current Status
Americares Adult Care Home #2	HAL-051-072	11/21/2023	10A NCAC 13F .1004(a) Medication Administration	A2	$2,000.00	7/12/2024	Paid in Full
Classic Care #1 (Closed)	HAL-051-062	10/30/2023	10A NCAC 13F .0909 Resident Rights	A2	$1,000.00	6/12/2024	Not Paid - Referred to Controller's Office
Classic Care Homes #1 (Closed)	HAL-051-062	6/15/2023	10A NCAC 13F .1004(a) Medication Administration	A1	$4,000.00	11/21/2023	Not Paid - Referred to Controller's Office
Classic Care Homes #2 (Closed)	HAL-051-064	6/22/2023	10A NCAC 13F .1004(a) Medication Administration	A2	$2,000.00	11/21/2023	Not Paid - Referred to Controller's Office
Clayton House	HAL-051-041	4/1/2021	10A NCAC 13F .0901(b) Personal Care and Supervision; G.S. 131D-21(2) Declaration of Resident's Rights	A2	$1,000.00	3/16/2022	Paid in Full
Clayton House	HAL-051-041	10/26/2022	10A NCAC 13F .0901(b) Personal Care and Supervision	A2	$1,500.00	5/26/2023	Paid in Full
Four Oaks Senior Living	HAL-051-060	5/11/2023	10A NCAC 13F .0901(c) Personal Care and Supervision	A2	$2,000.00	9/27/2023	Paid in Full
Four Oaks Senior Living	HAL-051-060	12/1/2023	10A NCAC 13F .0901(a) Personal Care and Supervision	A2	$3,000.00	6/12/2024	Paid in Full
Four Oaks Senior Living	HAL-051-060	12/1/2023	10A NCAC 13F .0901(b) Personal Care and Supervision	A2	$2,000.00	6/12/2024	Paid in Full
Freedom Care Services #1 (closed)	FCL-051-070	7/2/2020	10A NCAC 13G .0601(a) Management and Other Staff; G.S. 131D-21(4) Declaration of Resident's Rights	A2	$2,000.00	12/17/2021	Paid in Full
Freedom Care Services #1 (closed)	FCL-051-070	7/2/2020	10A NCAC 13G .0909 Residents' Rights; G.S. 131D-21(4) Declaration of Resident's Rights	A2	$2,000.00	12/17/2021	Paid in Full
Shining Star Adult Care Home (Closed)	FCL-051-082	3/10/2023	10A NCAC 13G .0202 The License	A2	$500.00	8/2/2023	Not Paid - Referred to Controller's Office
The Enclave at Eagle Point	FCL-051-073	8/11/2023	10A NCAC 13G .0901(a) Personal Care and Supervision	A2	$1,000.00	5/17/2024	Paid in Full
The Villas at Benson VI (Closed)	FCL-051-079	7/22/2022	10A NCAC 13G .0312(g) Outside Entrance And Exits G.S. 131D-21(2) Declaration of Resident's Rights	A2	$750.00	2/15/2023	Paid in Full
The Villas at Benson VI (Closed)	FCL-051-079	7/22/2022	10A NCAC 13G .0901(b) Personal Care and Supervision G.S. 131D-21(4) Declaration of Resident's Rights	A2	$750.00	2/15/2023	Paid in Full
The Villas at Benson VI (Closed)	FCL-051-079	7/22/2022	10A NCAC 13G .0902(b) Health Care G.S. 131D-21(4) Declaration of Resident's Rights	A2	$750.00	2/15/2023	Paid in Full

Lee County

Facility	Facility License	Inspection Date & Nature of Validation	Rules Areas Cited	Level Cited	Penalty Amount	Date Penalty Imposed	Current Status
Sanford Manor	HAL-053-030	10/26/2021	10A NCAC 13F .0901(c) Personal Care and Supervision; G.S. 131D-21(4) Declaration of Resident's Rights	A1	$8,000.00	8/17/2022	Paid in Full
Sanford Senior Living	HAL-053-031	5/5/2022	10A NCAC 13F .0601 (a) Management Of Facilities	A1	$7,000.00	3/8/2023	Settlement Agreement
Sanford Senior Living	HAL-053-031	5/5/2022	10A NCAC 13F .0901(a) Personal Care and Supervision	A2	$2,000.00	3/8/2023	Settlement Agreement
Sanford Senior Living	HAL-053-031	5/5/2022	10A NCAC 13F .0901(b) Personal Care and Supervision	A1	$4,000.00	3/8/2023	Settlement Agreement
Sanford Senior Living	HAL-053-031	5/5/2022	10A NCAC 13F .0902(b) Health Care	A2	$2,000.00	3/8/2023	Settlement Agreement
Sanford Senior Living	HAL-053-031	8/11/2022	10A NCAC 13F .0601 (a) Management Of Facilities	A2	$3,500.00	3/8/2023	Settlement Agreement
Sanford Senior Living	HAL-053-031	8/11/2022	10A NCAC 13F .0901(a) Personal Care and Supervision	Unabated A2	$38,250.00	3/8/2023	Settlement Agreement
Sanford Senior Living	HAL-053-031	8/11/2022	10A NCAC 13F .0902(b) Health Care	Unabated A2	$38,250.00	3/8/2023	Settlement Agreement

Lenoir County

Facility	Facility License	Inspection Date & Nature of Validation	Rules Areas Cited	Level Cited	Penalty Amount	Date Penalty Imposed	Current Status
Lenoir Assisted Living	HAL-054-068	2/1/2023	10A NCAC 13F .0306(a)(5) Housekeeping and Furnishings	Unabated B	$12,300.00	7/7/2023	Settlement Agreement
Lenoir Assisted Living	HAL-054-068	2/1/2023	10A NCAC 13F .0902(b) Health Care	Unabated B	$12,300.00	7/7/2023	Settlement Agreement
The Village of Kinston	HAL-054-067	4/18/2024	10A NCAC 13F .0901(b) Personal Care and Supervision	A1	$12,000.00	9/18/2024	Appealed

Lincoln County

Facility	Facility License	Inspection Date & Nature of Validation	Rules Areas Cited	Level Cited	Penalty Amount	Date Penalty Imposed	Current Status
Heath House	HAL-055-013	2/4/2022	10A NCAC 13F .0902(b) Health Care; G.S. 131D-21(2) Declaration of Resident's Rights	A2	$1,000.00	8/31/2022	Paid in Full
The Addison of Lincolnton	HAL-055-009	11/5/2021	10A NCAC 13F .1004(a) Medication Administration; G.S. 131D-21(2) Declaration of Resident's Rights	A2	$3,000.00	8/17/2022	Paid in Full

Macon County

Facility	Facility License	Inspection Date & Nature of Validation	Rules Areas Cited	Level Cited	Penalty Amount	Date Penalty Imposed	Current Status
Grandview Manor	HAL-056-001	1/8/2024	10A NCAC 13F .0309 (d) Plan For Evacuation	A1	$7,000.00	7/12/2024	Paid in Full
Grandview Manor	HAL-056-001	1/8/2024	10A NCAC 13F .0909 Resident Rights	A1	$5,250.00	7/12/2024	Paid in Full
Grandview Manor	HAL-056-001	1/8/2024	G.S. § 131D-25 Implementation	A1	$7,000.00	7/12/2024	Paid in Full
Franklin House	HAL-056-006	8/24/2021	10A NCAC 13F .0306(a)(5) Housekeeping and Furnishings; G.S. 131D-21(2) Declaration of Resident's Rights	Unabated B	$4,800.00	5/16/2022	Settlement Agreement
Franklin House	HAL-056-006	12/12/2023	10A NCAC 13F .1004(a) Medication Administration	Unabated B	$11,400.00	5/17/2024	Appealed

Madison County

Facility	Facility License	Inspection Date & Nature of Validation	Rules Areas Cited	Level Cited	Penalty Amount	Date Penalty Imposed	Current Status
Mars Hill Retirement Community	HAL-057-010	9/13/2023	10A NCAC 13F .0902(c)(3-4) Health Care	A1	$3,000.00	3/27/2024	Paid in Full

Martin County

Facility	Facility License	Inspection Date & Nature of Validation	Rules Areas Cited	Level Cited	Penalty Amount	Date Penalty Imposed	Current Status
Fields Foundation	FCL-058-008	5/8/2023	10A NCAC 13G .1004(a) Medication Administration	A2	$1,000.00	8/2/2023	Paid in Full
Vintage Inn Retirement Community	HAL-058-010	3/5/2021	10A NCAC 13F .0902(b) Health Care; G.S. 131D-21(2) Declaration of Resident's Rights	A1	$15,000.00	2/4/2022	Settlement Agreement
Vintage Inn Retirement Community	HAL-058-010	4/8/2022	10A NCAC 13F .0901(a) Personal Care and Supervision; G.S. 131D-21(2) Declaration of Resident's Rights	A2	$8,000.00	12/21/2022	Settlement Agreement
Vintage Inn Retirement Community	HAL-058-010	4/8/2022	10A NCAC 13F .0901(b) Personal Care and Supervision; G.S. 131D-21(2) Declaration of Resident's Rights	A2	$5,250.00	12/21/2022	Settlement Agreement
Vintage Inn Retirement Community	HAL-058-010	4/8/2022	10A NCAC 13F .1004(a) Medication Administration; G.S. 131D-21(4) Declaration of Resident's Rights	A1	$7,000.00	12/21/2022	Settlement Agreement
Vintage Inn Retirement Community	HAL-058-010	5/11/2023	10A NCAC 13F .0901(b) Personal Care and Supervision	A1	$12,000.00	8/2/2023	Appealed
Vintage Inn Retirement Community	HAL-058-010	5/11/2023	10A NCAC 13F .0902(b) Health Care	A1	$15,000.00	8/2/2023	Appealed
Vintage Inn Retirement Community	HAL-058-010	8/2/2023	10A NCAC 13F .0901(b) Personal Care and Supervision	Unabated A1	$83,000.00	3/27/2024	Appealed
Vintage Inn Retirement Community	HAL-058-010	11/17/2023	10A NCAC 13F .0306(a)(5) Housekeeping and Furnishings	A2	$12,000.00	5/17/2024	Appealed
Vintage Inn Retirement Community	HAL-058-010	11/17/2023	10A NCAC 13F .0407(a)(2) Other Staff Qualifications	A2	$12,000.00	5/17/2024	Appealed
Vintage Inn Retirement Community	HAL-058-010	11/17/2023	10A NCAC 13F .0901(b) Personal Care and Supervision	A1	$16,000.00	5/17/2024	Appealed
Vintage Inn Retirement Community	HAL-058-010	1/26/2024	10A NCAC 13F .0901(b) Personal Care and Supervision	Unabated A1	$56,800.00	9/18/2024	Appealed
Vintage Inn Retirement Community	HAL-058-010	1/26/2024	10A NCAC 13F .0909 Resident Rights	Unabated B	$8,640.00	9/18/2024	Appealed
Vintage Inn Retirement Community	HAL-058-010	5/8/2024	10A NCAC 13F .0902(b) Health Care	A1	$16,000.00	9/18/2024	Appealed
Vintage Inn Retirement Community	HAL-058-010	5/8/2024	10A NCAC 13F .0903 (d) Licensed Health Professional Support	A1	$16,000.00	9/18/2024	Appealed
Vintage Inn Retirement Community	HAL-058-010	5/8/2024	10A NCAC 13F .0903(c) Licensed Health Professional Support	A2	$14,400.00	9/18/2024	Appealed
Williamston House	HAL-058-011	5/26/2022	10A NCAC 13F .0902(b) Health Care	A1	$7,000.00	3/8/2023	Settlement Agreement
Williamston House	HAL-058-011	5/26/2022	10A NCAC 13F .1004(a) Medication Administration	A1	$7,000.00	3/8/2023	Settlement Agreement

McDowell County

Facility	Facility License	Inspection Date & Nature of Validation	Rules Areas Cited	Level Cited	Penalty Amount	Date Penalty Imposed	Current Status
Cedarbrook Residential Facility	HAL-059-021	8/12/2022	10A NCAC 13F .0901(b) Personal Care and Supervision	A2	$2,000.00	3/8/2023	Not Paid - Referred to Controller's Office
Cedarbrook Residential Facility	HAL-059-021	8/12/2022	10A NCAC 13F .0902(b) Health Care	A1	$7,000.00	3/8/2023	Not Paid - Referred to Controller's Office
Cedarbrook Residential Facility	HAL-059-021	8/12/2022	10A NCAC 13F .1212(g) Reporting of Accidents and Incidents	A2	$2,000.00	3/8/2023	Not Paid - Referred to Controller's Office
Cedarbrook Residential Facility	HAL-059-021	1/26/2024	10A NCAC 13F .1212(g) Reporting of Accidents and Incidents	A1	$7,000.00	5/17/2024	Appealed

Mecklenburg County

Facility	Facility License	Inspection Date & Nature of Validation	Rules Areas Cited	Level Cited	Penalty Amount	Date Penalty Imposed	Current Status
Arbor Ridge at Huntersville	HAL-060-170	8/23/2022	10A NCAC 13F .0901(b) Personal Care and Supervision G.S. 131D-21(4) Declaration of Resident's Rights	A2	$1,500.00	2/15/2023	Settlement Agreement
Brookdale Carriage Club Providence I	HAL-060-016	11/18/2022	10A NCAC 13F .0901(c) Personal Care and Supervision		$10,500.00	3/8/2023	Settlement Agreement
Brookdale Carriage Club Providence II	HAL-060-049	5/14/2021	10A NCAC 13F .0901(b) Personal Care and Supervision; G.S. 131D-21(2) Declaration of Resident's Rights	A2	$2,000.00	3/16/2022	Paid in Full
Brookdale Carriage Club Providence II	HAL-060-049	4/1/2022	10A NCAC 13F .0901(a) Personal Care and Supervision; G.S. 131D-21(4) Declaration of Resident's Rights	A1	$2,000.00	12/21/2022	Paid in Full
Brookdale Carriage Club Providence II	HAL-060-049	4/1/2022	10A NCAC 13F .0902(b) Health Care; G.S. 131D-21(4) Declaration of Resident's Rights	A2	$7,000.00	12/21/2022	Paid in Full
Brookdale South Charlotte	HAL-060-101	6/3/2021	10A NCAC 13F .0901(b) Personal Care and Supervision; G.S. 131D-21(2) Declaration of Resident's Rights	A2	$1,000.00	3/16/2022	Paid in Full
Brookdale South Charlotte	HAL-060-101	6/3/2021	10A NCAC 13F .0902(b) Health Care; G.S. 131D-21(2) Declaration of Resident's Rights	A1	$2,000.00	3/16/2022	Paid in Full
Brookdale Weddington Park	HAL-060-042	10/20/2022	10A NCAC 13F .0901(b) Personal Care and Supervision	A2	$750.00	3/8/2023	Paid in Full
Cadence Huntersville	HAL-060-160	5/20/2022	10A NCAC 13F .1004(a) Medication Administration G.S. 131D-21(4) Declaration of Resident's Rights	A2	$2,000.00	2/15/2023	Paid in Full
Cadence Senior Living at Mint Hill	HAL-060-159	10/8/2021	10A NCAC 13F .0901(b) Personal Care and Supervision; G.S. 131D-21(2) Declaration of Resident's Rights	A2	$1,000.00	8/5/2022	Paid in Full
Cadence Senior Living at Mint Hill	HAL-060-159	2/21/2022	10A NCAC 13F .0901(b) Personal Care and Supervision	A2	$2,000.00	3/8/2023	Paid in Full
Charter Senior Living of Charlotte	HAL-060-171	3/17/2023	10A NCAC 13F .0902(c)(3-4) Health Care	A2	$2,000.00	5/26/2023	Paid in Full
Charter Senior Living of Charlotte	HAL-060-171	8/3/2023	10A NCAC 13F .0902(b) Health Care	A1	$8,000.00	1/31/2024	Paid in Full
Cuthbertson Village at Aldersgate	HAL-060-059	2/10/2023	10A NCAC 13F .0902(b) Health Care	A2	$1,000.00	8/2/2023	Paid in Full
East Towne	HAL-060-149	7/15/2020	10A NCAC 13F .0901(c) Personal Care and Supervision; G.S. 131D-21(2) Declaration of Resident's Rights	A2	$15,000.00	2/4/2022	Settlement Agreement
East Towne	HAL-060-149	7/15/2020	10A NCAC 13F .0901(c) Personal Care and Supervision; G.S. 131D-21(2) Declaration of Resident's Rights	A1	$15,000.00	2/4/2022	Settlement Agreement
East Towne	HAL-060-149	7/15/2020	10A NCAC 13F .0909 Resident Rights; G.S. 131D-21(4) Declaration of Resident's Rights	A1	$20,000.00	2/4/2022	Settlement Agreement
East Towne	HAL-060-149	7/15/2020	10A NCAC 13F .1004(a) Medication Administration; G.S. 131D-21(2) Declaration of Resident's Rights	A2	$15,000.00	2/4/2022	Settlement Agreement
East Towne	HAL-060-149	9/22/2022	10A NCAC 13F .0902(b) Health Care G.S. 131D-21(4) Declaration of Resident's Rights	A2	$3,000.00	2/15/2023	Paid in Full
East Towne	HAL-060-149	8/14/2023	10A NCAC 13F .0906(f)(4) Other Resident Care and Services	A2	$4,000.00	5/10/2024	Paid in Full
House of Peace	FCL-060-153	4/6/2022	10A NCAC 13G .0902(b) Health Care; G.S. 131D-21(2) Declaration of Resident's Rights	A1	$2,000.00	12/21/2022	Paid in Full
Legacy Heights Senior Living Community	HAL-060-152	11/22/2021	10A NCAC 13F .0901(b) Personal Care and Supervision; G.S. 131D-21(2) Declaration of Resident's Rights	A2	$500.00	8/5/2022	Paid in Full
Merrywood on Park	HAL-060-155	2/23/2023	10A NCAC 13F .0604 (a-b-c) Personal Care And Other Staffing SA - paid in full	A1	$7,000.00	5/26/2023	Settlement Agreement
Merrywood on Park	HAL-060-155	2/23/2023	10A NCAC 13F .0901(a) Personal Care and Supervision SA - paid in full	A1	$4,000.00	5/26/2023	Settlement Agreement
Merrywood on Park	HAL-060-155	2/23/2023	10A NCAC 13F .0901(b) Personal Care and Supervision SA - paid in full	A1	$4,000.00	5/26/2023	Settlement Agreement
Ranson Ridge Assisted Living & Memory Care	HAL-060-172	10/26/2023	10A NCAC 13F .0909 Resident Rights	A2	$1,000.00	5/17/2024	Paid in Full
Senior Retreat at Stonehaven	FCL-060-159	5/11/2021	10A NCAC 13G .0901(b) Personal Care and Supervision; G.S. 131D-21(2) Declaration of Resident's Rights	A2	$500.00	3/16/2022	Paid in Full
Summit Place of Southpark	HAL-060-116	1/3/2024	10A NCAC 13F .0901(b) Personal Care and Supervision	A2	$1,000.00	5/17/2024	Paid in Full
TerraBella Little Avenue	HAL-060-156	8/3/2023	10A NCAC 13F .0901(b) Personal Care and Supervision	A2	$1,000.00	3/27/2024	Paid in Full
The Charlotte Assisted Living	HAL-060-158	6/24/2022	10A NCAC 13F .0305 (d) Physical Environment	A1	$12,000.00	3/8/2023	Paid in Full
The Charlotte Assisted Living	HAL-060-158	6/24/2022	10A NCAC 13F .0909 Resident Rights	A1	$12,000.00	3/8/2023	Paid in Full
The Crossings at Steele Creek (Closed)	HAL-060-130	8/13/2020	10A NCAC 13F .0901(b) Personal Care and Supervision; G.S. 131D-21(4) Declaration of Resident's Rights	A2	$2,000.00	12/17/2021	Paid in Full
The Haven in Highland Creek	HAL-060-162	5/14/2021	10A NCAC 13F .0901(b) Personal Care and Supervision; G.S. 131D-21(2) Declaration of Resident's Rights	A2	$750.00	3/16/2022	Paid in Full
The Laurels in Highland Creek	HAL-060-161	8/23/2023	10A NCAC 13F .0901(c) Personal Care and Supervision	A1	$7,000.00	1/31/2024	Paid in Full
The Parc at Sharon Amity	HAL-060-125	1/19/2022	10A NCAC 13F .0901(b) Personal Care and Supervision; G.S. 131D-21(2) Declaration of Resident's Rights	A2	$5,250.00	8/31/2022	Paid in Full
The Parc at Sharon Amity	HAL-060-125	1/2/2024	10A NCAC 13F .0909 Resident Rights	A1	$7,000.00	5/17/2024	Appealed
The Pines on Carmel Senior Living	HAL-060-168	6/28/2023	10A NCAC 13F .0901(b) Personal Care and Supervision	A2	$2,000.00	9/27/2023	Paid in Full
The Pines on Carmel Senior Living	HAL-060-168	9/19/2023	10A NCAC 13F .0901(b) Personal Care and Supervision	Unabated A2	$28,875.00	5/10/2024	Paid in Full
The Post at Providence	FCL-060-165	8/31/2022	10A NCAC 13G .0317(d) Building Service Equipment G.S. 131D-21(4) Declaration of Resident's Rights	A2	$750.00	2/15/2023	Paid in Full
The Social at Cotswold (Closed)	HAL-060-132	7/13/2021	10A NCAC 13F .0901(a) Personal Care and Supervision; G.S. 131D-21(2) Declaration of Resident's Rights	A2	$1,000.00	6/10/2022	Paid in Full
The Social at Cotswold (Closed)	HAL-060-132	7/13/2021	10A NCAC 13F .0901(b) Personal Care and Supervision; G.S. 131D-21(4) Declaration of Resident's Rights	A1	$2,000.00	6/10/2022	Paid in Full
The Social at Cotswold (Closed)	HAL-060-132	7/13/2021	10A NCAC 13F .0902(b) Health Care; G.S. 131D-21(4) Declaration of Resident's Rights	A1	$2,000.00	6/10/2022	Paid in Full
The Social at Cotswold (Closed)	HAL-060-132	7/13/2021	10A NCAC 13F .0909 Resident Rights; G.S. 131D-21(4) Declaration of Resident's Rights	A2	$1,000.00	6/10/2022	Paid in Full
The Social at Cotswold (Closed)	HAL-060-132	7/13/2021	10A NCAC 13F .1004(a) Medication Administration; G.S. 131D-21(4) Declaration of Resident's Rights	A1	$2,000.00	6/10/2022	Paid in Full
The Social at Cotswold (Closed)	HAL-060-132	7/13/2021	G.S. § 131D-25 Implementation; G.S. 131D-21(4) Declaration of Resident's Rights	A1	$2,000.00	6/10/2022	Paid in Full
Waltonwood Cotswold	HAL-060-148	1/19/2024	10A NCAC 13F .0902(b) Health Care	A1	$4,000.00	7/12/2024	Paid in Full
Wickshire Steele Creek	HAL-060-166	5/13/2022	10A NCAC 13F .0902(b) Health Care G.S. 131D-21(4) Declaration of Resident's Rights	A1	$9,000.00	2/15/2023	Paid in Full
Wickshire Steele Creek	HAL-060-166	5/13/2022	10A NCAC 13F .1004(a) Medication Administration G.S. 131D-21(4) Declaration of Resident's Rights	A1	$9,000.00	2/15/2023	Paid in Full
Wickshire Steele Creek	HAL-060-166	8/3/2023	10A NCAC 13F .0901(b) Personal Care and Supervision	A1	$18,000.00	1/31/2024	Appealed
Wickshire Steele Creek	HAL-060-166	9/11/2023	10A NCAC 13F .0901(b) Personal Care and Supervision	A1	$14,000.00	1/31/2024	Appealed
Wickshire Steele Creek	HAL-060-166	9/11/2023	10A NCAC 13F .0902(b) Health Care	A2	$7,000.00	1/31/2024	Appealed
Wickshire Steele Creek	HAL-060-166	9/11/2023	10A NCAC 13F .0906(f)(4) Other Resident Care and Services	A2	$7,000.00	1/31/2024	Appealed
Wickshire Steele Creek	HAL-060-166	9/11/2023	10A NCAC 13F .0909 Resident Rights	A1	$12,000.00	1/31/2024	Appealed
Wickshire Steele Creek	HAL-060-166	11/20/2023	10A NCAC 13F .0505 Training On Care Of Diabetic Resident	Unabated B	$14,600.00	6/12/2024	Appealed
Wickshire Steele Creek	HAL-060-166	11/20/2023	10A NCAC 13F .0901(c) Personal Care and Supervision	A2	$16,000.00	6/12/2024	Appealed
Wickshire Steele Creek	HAL-060-166	11/20/2023	10A NCAC 13F .0902(b) Health Care	A1	$20,000.00	6/12/2024	Appealed
Wickshire Steele Creek	HAL-060-166	11/20/2023	10A NCAC 13F .1004(a) Medication Administration	A2	$16,000.00	6/12/2024	Appealed
Wickshire Steele Creek	HAL-060-166	11/20/2023	10A NCAC 13F .1004(g) Medication Administration	Unabated B	$14,600.00	6/12/2024	Appealed
Wickshire Steele Creek	HAL-060-166	11/20/2023	10A NCAC 13F .1309 Special Care Unit Staff Orientation And Train	Unabated B	$146,000.00	6/12/2024	Appealed
Wickshire Steele Creek	HAL-060-166	2/12/2024	10A NCAC 13F .0902(c)(3-4) Health Care	A1	$20,000.00	6/12/2024	Appealed
Wickshire Steele Creek	HAL-060-166	2/12/2024	10A NCAC 13F .0909 Resident Rights	A1	$20,000.00	6/12/2024	Appealed
Wickshire Steele Creek	HAL-060-166	2/12/2024	10A NCAC 13F .1004(a) Medication Administration	A1	$20,000.00	6/12/2024	Appealed
Wickshire Steele Creek	HAL-060-166	2/12/2024	10A NCAC 13F .1205 Health Care Personnel Registry	A1	$20,000.00	6/12/2024	Appealed
Wickshire Steele Creek	HAL-060-166	2/12/2024	10A NCAC 13F .1212(d) Reporting of Accidents and Incidents	A1	$20,000.00	6/12/2024	Appealed
Wickshire Steele Creek	HAL-060-166	2/12/2024	G.S. § 131D-25 Implementation	A1	$20,000.00	6/12/2024	Appealed
Wickshire Steele Creek	HAL-060-166	5/21/2024	10A NCAC 13F .0311(a) Other Requirements	A2	$20,000.00	7/12/2024	Appealed
Wickshire Steele Creek	HAL-060-166	5/21/2024	10A NCAC 13F .0901(b) Personal Care and Supervision	A1	$16,000.00	7/12/2024	Appealed
Wickshire Steele Creek	HAL-060-166	5/21/2024	10A NCAC 13F .1308(a) Special Care Unit Staff	A2	$20,000.00	7/12/2024	Appealed
Willow Ridge Assisted Living	HAL-060-111	1/11/2021	10A NCAC 13F .0901(b) Personal Care and Supervision; G.S. 131D-21(2) Declaration of Resident's Rights	A2	$1,500.00	12/17/2021	Settlement Agreement
Willow Ridge Assisted Living	HAL-060-111	1/11/2021	10A NCAC 13F .0902(b) Health Care; G.S. 131D-21(2) Declaration of Resident's Rights	A2	$2,000.00	12/17/2021	Settlement Agreement
Willow Ridge Assisted Living	HAL-060-111	6/23/2021	10A NCAC 13F .0902(b) Health Care; G.S. 131D-21(2) Declaration of Resident's Rights	A2	$2,000.00	5/16/2022	Paid in Full
Willow Ridge Assisted Living	HAL-060-111	10/13/2021	10A NCAC 13F .0901(b) Personal Care and Supervision; G.S. 131D-21(4) Declaration of Resident's Rights	A1	$9,000.00	8/17/2022	Settlement Agreement
Willow Ridge Assisted Living	HAL-060-111	2/24/2022	10A NCAC 13F .0902(b) Health Care; G.S. 131D-21(4) Declaration of Resident's Rights	A2	$5,250.00	8/31/2022	Settlement Agreement
Sunrise on Providence	HAL-060-165	1/15/2021	10A NCAC 13F .0901(b) Personal Care and Supervision; G.S. 131D-21(2) Declaration of Resident's Rights	A2	$2,000.00	3/16/2022	Paid in Full

Mitchell County

Facility	Facility License	Inspection Date & Nature of Validation	Rules Areas Cited	Level Cited	Penalty Amount	Date Penalty Imposed	Current Status
B & L Family Care Home	FCL-061-008	7/31/2020	10A NCAC 13G .0909 Residents' Rights; G.S. 131D-21(2) Declaration of Resident's Rights	A2	$1,000.00	12/17/2021	Paid in Full
Mitchell House	HAL-061-011	11/24/2021	10A NCAC 13F .0902(b) Health Care; G.S. 131D-21(2) Declaration of Resident's Rights	Unabated B	$8,000.00	6/10/2022	Settlement Agreement
Mitchell House	HAL-061-011	6/12/2023	10A NCAC 13F .0901(b) Personal Care and Supervision	A2	$2,000.00	11/21/2023	Settlement Agreement
Mitchell House	HAL-061-011	8/14/2023	10A NCAC 13F .0901(b) Personal Care and Supervision	Unabated A2	$18,562.50	11/21/2023	Settlement Agreement
Mitchell House	HAL-061-011	8/14/2023	10A NCAC 13F .0902(b) Health Care	A2	$3,000.00	11/21/2023	Settlement Agreement
Mitchell House	HAL-061-011	8/14/2023	10A NCAC 13F .0909 Resident Rights	A1	$7,000.00	11/21/2023	Settlement Agreement
Mitchell House	HAL-061-011	8/14/2023	10A NCAC 13F .1004(a) Medication Administration	A2	$2,000.00	11/21/2023	Settlement Agreement
Mitchell House	HAL-061-011	8/14/2023	10A NCAC 13F .1205 Health Care Personnel Registry	A2	$7,000.00	11/21/2023	Settlement Agreement

Moore County

Facility	Facility License	Inspection Date & Nature of Validation	Rules Areas Cited	Level Cited	Penalty Amount	Date Penalty Imposed	Current Status
Tara Plantation of Carthage	HAL-063-011	2/22/2024	10A NCAC 13F .1004(a) Medication Administration	A2	$1,000.00	9/4/2024	Paid in Full
Brookdale Pinehurst	HAL-063-024	2/18/2022	10A NCAC 13F .0902(c)(3-4) Health Care; G.S. 131D-21(4) Declaration of Resident's Rights	A2	$2,000.00	9/21/2022	Paid in Full
Seven Lakes Assisted Living and Memory Care	HAL-063-023	10/5/2022	10A NCAC 13F .0909 Resident Rights	A2	$1,000.00	5/31/2023	Paid in Full
The Coventry	HAL-063-016	9/1/2022	10A NCAC 13F .0901(b) Personal Care and Supervision	A2	$1,500.00	3/8/2023	Paid in Full

Nash County

Facility	Facility License	Inspection Date & Nature of Validation	Rules Areas Cited	Level Cited	Penalty Amount	Date Penalty Imposed	Current Status
Brekenridge Retirement Center	HAL-064-004	3/24/2022	10A NCAC 13F .0901(b) Personal Care and Supervision; G.S. 131D-21(2) Declaration of Resident's Rights	A1	$500.00	8/17/2022	Paid in Full
Hunter Hill Senior Living	HAL-064-035	6/26/2023	10A NCAC 13F .0902(b) Health Care	A1	$4,000.00	9/27/2023	Paid in Full
Hunter Hill Senior Living (Closed)	HAL-064-032	6/3/2022	10A NCAC 13F .0902(b) Health Care	A1	$2,000.00	3/8/2023	Paid in Full
Hunter Hill Senior Living (Closed)	HAL-064-032	6/3/2022	10A NCAC 13F .1004(a) Medication Administration	A2	$1,000.00	3/8/2023	Paid in Full
Trinity Retirement Villas #1 (CLOSED)	HAL-064-014	3/1/2021	G.S.§ 131D-4.5B(b) ACH Medication Aides; Training and Competency; G.S. 131D-21(2) Declaration of Resident's Rights	Unabated B	$11,800.00	2/4/2022	Settlement Agreement

New Hanover County

Facility	Facility License	Inspection Date & Nature of Validation	Rules Areas Cited	Level Cited	Penalty Amount	Date Penalty Imposed	Current Status
Brookdale Wilmington	HAL-065-019	8/6/2021	10A NCAC 13F .0901(a) Personal Care and Supervision; G.S. 131D-21(4) Declaration of Resident's Rights	A1	$4,000.00	6/10/2022	Paid in Full
Castle Creek Memory Care	HAL-065-034	3/18/2021	10A NCAC 13F .0901(b) Personal Care and Supervision; G.S. 131D-21(4) Declaration of Resident's Rights	A1	$3,000.00	8/17/2022	Settlement Agreement
Castle Creek Memory Care	HAL-065-034	3/18/2021	10A NCAC 13F .0902(b) Health Care; G.S. 131D-21(4) Declaration of Resident's Rights	A1	$7,000.00	8/17/2022	Settlement Agreement
Castle Creek Memory Care	HAL-065-034	3/18/2021	10A NCAC 13F .1004(a) Medication Administration; G.S. 131D-21(4) Declaration of Resident's Rights	A1	$12,000.00	8/17/2022	Settlement Agreement
Cedar Cove Assisted Living	HAL-065-035	7/24/2023	10A NCAC 13F .0901(b) Personal Care and Supervision	A2	$2,000.00	3/27/2024	Appealed
Cedar Cove Assisted Living	HAL-065-035	7/24/2023	10A NCAC 13F .0902(b) Health Care	A1	$7,000.00	3/27/2024	Appealed
Cedar Cove Assisted Living	HAL-065-035	7/24/2023	10A NCAC 13F .0909 Resident Rights	A1	$18,000.00	3/27/2024	Appealed
Cedar Cove Assisted Living	HAL-065-035	7/24/2023	10A NCAC 13F .1004(a) Medication Administration	A2	$2,000.00	3/27/2024	Appealed
Cedar Cove Assisted Living	HAL-065-035	7/24/2023	10A NCAC 13F .1205 Health Care Personnel Registry	A1	$12,000.00	3/27/2024	Appealed
Champions Assisted Living	HAL-065-020	11/6/2023	10A NCAC 13F .0901(b) Personal Care and Supervision	A2	$2,000.00	6/12/2024	Paid in Full
Coastal Cove of Wilmington (closed)	FCL-065-046	9/16/2020	10A NCAC 13G .0909 Residents' Rights; G.S. 131D-21(4) Declaration of Resident's Rights	A2	$2,000.00	12/17/2021	Paid in Full
Coastal Cove of Wilmington (closed)	FCL-065-046	9/13/2022	10A NCAC 13G .0904(c)(4) Nutrition and Food Service	A2	$7,000.00	5/26/2023	Not Paid - Referred to Controller's Office
Morningside of Wilmington	HAL-065-045	7/2/2021	10A NCAC 13F .0306(a)(5) Housekeeping and Furnishings; G.S. 131D-21(4) Declaration of Resident's Rights	A1	$7,000.00	8/17/2022	Paid in Full
Morningside of Wilmington	HAL-065-045	7/2/2021	10A NCAC 13F .0901(b) Personal Care and Supervision; G.S. 131D-21(4) Declaration of Resident's Rights	A1	$12,000.00	8/17/2022	Paid in Full
Morningside of Wilmington	HAL-065-045	9/15/2021	10A NCAC 13F .0902(b) Health Care; G.S. 131D-21(4) Declaration of Resident's Rights	A2	$1,000.00	8/17/2022	Paid in Full
Morningside of Wilmington	HAL-065-045	9/15/2021	G.S. § 131D-25 Implementation; G.S. 131D-21(4) Declaration of Resident's Rights	A2	$1,000.00	8/17/2022	Paid in Full
Morningside of Wilmington	HAL-065-045	10/19/2023	10A NCAC 13F .0901(b) Personal Care and Supervision	A1	$14,000.00	3/27/2024	Appealed
Morningside of Wilmington	HAL-065-045	1/5/2024	10A NCAC 13F .1002(a) Medication Orders	A2	$12,000.00	7/12/2024	Appealed
Morningside of Wilmington	HAL-065-045	1/5/2024	10A NCAC 13F .1004(a) Medication Administration	A2	$12,000.00	7/12/2024	Appealed
Morningside of Wilmington	HAL-065-045	1/5/2024	G.S. § 131D-25 Implementation	A2	$12,000.00	7/12/2024	Appealed
Morningside of Wilmington	HAL-065-045	3/15/2024	10A NCAC 13F .0902(b) Health Care	A1	$18,000.00	7/12/2024	Appealed
Morningside of Wilmington	HAL-065-045	3/15/2024	10A NCAC 13F .0909 Resident Rights	Unabated B	$16,800.00	7/12/2024	Appealed
Spring Arbor of Wilmington (Closed)	HAL-065-014	12/6/2022	10A NCAC 13F .0901(b) Personal Care and Supervision	A2	$1,500.00	2/15/2023	Paid in Full

Onslow County

Facility	Facility License	Inspection Date & Nature of Validation	Rules Areas Cited	Level Cited	Penalty Amount	Date Penalty Imposed	Current Status
Pearl's Family Care Home #3	FCL-067-020	11/6/2019	10A NCAC 13G .1206 Health Care Personnel Registry;	A2	$500.00	12/17/2021	Paid in Full
Pearl's Family Care Home #3	FCL-067-020	11/6/2019	G.S. 131D-21(4) Declaration of Resident's Rights	A1	$1,500.00	12/17/2021	Paid in Full

Orange County

Facility	Facility License	Inspection Date & Nature of Validation	Rules Areas Cited	Level Cited	Penalty Amount	Date Penalty Imposed	Current Status
Carlisle at Carborro	HAL-068-036	9/23/2022	10A NCAC 13F .0906(f)(4) Other Resident Care and Services	A1	$14,000.00	3/8/2023	Paid in Full
Carlisle at Carborro	HAL-068-036	1/19/2023	10A NCAC 13F .0901(b) Personal Care and Supervision	A2	$750.00	7/7/2023	Paid in Full

Pasquotank County

Facility	Facility License	Inspection Date & Nature of Validation	Rules Areas Cited	Level Cited	Penalty Amount	Date Penalty Imposed	Current Status
Brookdale Elizabeth City	HAL-070-005	6/16/2022	10A NCAC 13F .0901(b) Personal Care and Supervision	A2	$1,500.00	3/8/2023	Paid in Full
Brookdale Elizabeth City	HAL-070-005	9/8/2023	10A NCAC 13F .0901(b) Personal Care and Supervision	A2	$2,000.00	3/27/2024	Paid in Full
Waterbrooke of Elizabeth City	HAL-070-008	1/14/2020	10A NCAC 13F .0901(c) Personal Care and Supervision G.S. 131D-21(4) Declaration of Resident's Rights	A1	$500.00	3/8/2023	Settlement Agreement
Waterbrooke of Elizabeth City	HAL-070-008	2/4/2022	10A NCAC 13F .0702 (f) Discharge Of Residents	A1	$6,000.00	3/8/2023	Settlement Agreement
Waterbrooke of Elizabeth City	HAL-070-008	2/4/2022	10A NCAC 13F .0901(b) Personal Care and Supervision	A2	$5,750.00	3/8/2023	Settlement Agreement
Waterbrooke of Elizabeth City	HAL-070-008	2/4/2022	10A NCAC 13F .0902(b) Health Care	B	$4,250.00	3/8/2023	Settlement Agreement
Waterbrooke of Elizabeth City	HAL-070-008	4/11/2022	10A NCAC 13F .0901(c) Personal Care and Supervision	A1	$8,000.00	3/8/2023	Settlement Agreement
Waterbrooke of Elizabeth City	HAL-070-008	1/6/2023	10A NCAC 13F .0901(a) Personal Care and Supervision	A2	$4,250.00	8/2/2023	Settlement Agreement
Waterbrooke of Elizabeth City	HAL-070-008	1/6/2023	10A NCAC 13F .0902(b) Health Care	A2	$7,000.00	8/2/2023	Settlement Agreement

Perquimans County

Facility	Facility License	Inspection Date & Nature of Validation	Rules Areas Cited	Level Cited	Penalty Amount	Date Penalty Imposed	Current Status
Hertford Manor (Closed)	HAL-072-013	9/10/2020	10A NCAC 13F .0909 Resident Rights; G.S. 131D-21(4) Declaration of Resident's Rights	A2	$4,000.00	2/4/2022	Settlement Agreement

Person County

Facility	Facility License	Inspection Date & Nature of Validation	Rules Areas Cited	Level Cited	Penalty Amount	Date Penalty Imposed	Current Status
Maple Heights Assisted Living	HAL-073-010	2/19/2021	10A NCAC 13F .0902(b) Health Care; G.S. 131D-21(2) Declaration of Resident's Rights	A2	$2,000.00	2/4/2022	Settlement Agreement
Maple Heights Assisted Living	HAL-073-010	2/19/2021	10A NCAC 13F .0909 Resident Rights; G.S. 131D-21(4) Declaration of Resident's Rights	A1	$4,000.00	2/4/2022	Settlement Agreement
Maple Heights Assisted Living	HAL-073-010	2/19/2021	10A NCAC 13F .1004(a) Medication Administration; G.S. 131D-21(2) Declaration of Resident's Rights	A2	$2,000.00	2/4/2022	Settlement Agreement
Maple Heights Assisted Living	HAL-073-010	2/19/2021	10A NCAC 13F .1205 Health Care Personnel Registry; G.S. 131D-21(4) Declaration of Resident's Rights	A2	$4,000.00	2/4/2022	Settlement Agreement
Maple Heights Assisted Living	HAL-073-010	2/19/2021	G.S. § 131D-25 Implementation; G.S. 131D-21(4) Declaration of Resident's Rights	A2	$2,000.00	2/4/2022	Settlement Agreement
Roxboro Assisted Living OPCP LLC	HAL-073-019	5/3/2024	10A NCAC 13F .0305(h)(4) Physical Environment	A2	$4,000.00	9/4/2024	Appealed
Roxboro Assisted Living OPCP LLC	HAL-073-019	5/3/2024	10A NCAC 13F .0403(a) Qualifications Of Medication Staff	A2	$4,000.00	9/4/2024	Appealed
Roxboro Assisted Living OPCP LLC	HAL-073-019	5/3/2024	10A NCAC 13F .0505 Training On Care Of Diabetic Resident	A2	$4,000.00	9/4/2024	Appealed
Roxboro Assisted Living OPCP LLC	HAL-073-019	5/3/2024	10A NCAC 13F .0901(b) Personal Care and Supervision	A1	$7,000.00	9/4/2024	Appealed
Roxboro Assisted Living OPCP LLC	HAL-073-019	5/3/2024	10A NCAC 13F .0902(b) Health Care	A2	$4,000.00	9/4/2024	Appealed
Roxboro Assisted Living OPCP LLC	HAL-073-019	5/3/2024	10A NCAC 13F .0902(c)(3-4) Health Care	A1	$7,000.00	9/4/2024	Appealed
Roxboro Assisted Living OPCP LLC	HAL-073-019	5/3/2024	10A NCAC 13F .1002(a) Medication Orders	A2	$2,000.00	9/4/2024	Appealed
Roxboro Assisted Living OPCP LLC	HAL-073-019	5/3/2024	10A NCAC 13F .1004(a) Medication Administration	A1	$12,000.00	9/4/2024	Appealed
Roxboro Assisted Living OPCP LLC	HAL-073-019	5/28/2024	10A NCAC 13F .0604 (e)(1)(A)(B)(C) Personal Care And Other Staffing	A2	$16,000.00	9/18/2024	Appealed
Roxboro Assisted Living OPCP LLC	HAL-073-019	5/28/2024	10A NCAC 13F .0701 Admission Of Residents	A1	$16,000.00	9/18/2024	Appealed
Roxboro Assisted Living OPCP LLC	HAL-073-019	5/28/2024	10A NCAC 13F .0909 Resident Rights	A1	$18,000.00	9/18/2024	Appealed
Roxboro Assisted Living OPCP LLC	HAL-073-019	5/28/2024	10A NCAC 13F .1004(a) Medication Administration	A1	$20,000.00	9/18/2024	Appealed

Pitt County

Facility	Facility License	Inspection Date & Nature of Validation	Rules Areas Cited	Level Cited	Penalty Amount	Date Penalty Imposed	Current Status
Alpha Care One Assisted Living	HAL-074-046	8/4/2023	10A NCAC 13F .0504(a & b) Competency Eval & Validation For LHPS Tasks	A2	$500.00	5/10/2024	Paid in Full
Alpha Care One Assisted Living	HAL-074-046	8/4/2023	10A NCAC 13F .0902(b) Health Care	A1	$7,000.00	5/10/2024	Appealed
Alpha Care One Assisted Living	HAL-074-046	8/4/2023	10A NCAC 13F .0902(c)(3-4) Health Care	A1	$3,500.00	5/10/2024	Appealed
Alpha Care One Assisted Living	HAL-074-046	12/15/2023	10A NCAC 13F .0902(b) Health Care	Unabated B	$6,200.00	5/17/2024	Appealed
Brookdale Dickinson Avenue	HAL-074-011	10/7/2021	10A NCAC 13F .0902(b) Health Care; G.S. 131D-21(2) Declaration of Resident's Rights	A2	$2,000.00	6/10/2022	Paid in Full
Care One Assisted Living of Greenville (Closed)	HAL-074-044	6/11/2021	10A NCAC 13F .0901(b) Personal Care and Supervision; G.S. 131D-21(4) Declaration of Resident's Rights	A1	$7,000.00	3/16/2022	Paid in Full
Care One Assisted Living of Greenville (Closed)	HAL-074-044	6/11/2021	10A NCAC 13F .0906(f)(4) Other Resident Care and Services; G.S. 131D-21(4) Declaration of Resident's Rights	A1	$7,000.00	3/16/2022	Paid in Full
Clemmie's Family Care Home II	FCL-074-041	10/6/2023	10A NCAC 13G .0902(b) Health Care	Unabated B	$6,000.00	6/12/2024	Appealed
Clemmie's Family Care Home II	FCL-074-041	12/13/2023	10A NCAC 13G .0902(c)(3)(4) Health Care	Unabated B	$3,900.00	6/12/2024	Appealed
Cypress Glen Retirement Community Memory Care Cottage	HAL-074-042	3/19/2021	10A NCAC 13F .0901(b) Personal Care and Supervision; G.S. 131D-21(4) Declaration of Resident's Rights	A1	$1,000.00	3/16/2022	Paid in Full
L and C Family Care Home	FCL-074-050	2/9/2024	10A NCAC 13G .0902(b) Health Care	A2	$1,000.00	6/12/2024	Paid in Full
L and C Family Care Home	FCL-074-050	2/9/2024	10A NCAC 13G .1004(a) Medication Administration	A2	$1,000.00	6/12/2024	Paid in Full

Randolph County

Facility	Facility License	Inspection Date & Nature of Validation	Rules Areas Cited	Level Cited	Penalty Amount	Date Penalty Imposed	Current Status
Brookstone Haven	HAL-076-034	1/19/2022	10A NCAC 13F .0901(b) Personal Care and Supervision; G.S. 131D-21(4) Declaration of Resident's Rights	A1	$2,000.00	9/16/2022	Settlement Agreement
Brookstone Haven	HAL-076-034	1/19/2022	10A NCAC 13F .0909 Resident Rights; G.S. 131D-21(4) Declaration of Resident's Rights	A2	$7,000.00	9/16/2022	Settlement Agreement
Brookstone Haven	HAL-076-034	1/19/2022	10A NCAC 13F .1205 Health Care Personnel Registry; G.S. 131D-21(4) Declaration of Resident's Rights	A2	$2,000.00	9/16/2022	Settlement Agreement
North Pointe	HAL-076-027	2/7/2022	10A NCAC 13F .0901(b) Personal Care and Supervision; G.S. 131D-21(4) Declaration of Resident's Rights	A1	$16,000.00	8/5/2022	Settlement Agreement
North Pointe Assisted Living Of Archdale	HAL-076-032	6/11/2021	10A NCAC 13F .0909 Resident Rights; G.S. 131D-21(2) Declaration of Resident's Rights	A2	$1,000.00	4/20/2022	Settlement Agreement

Richmond County

Facility	Facility License	Inspection Date & Nature of Validation	Rules Areas Cited	Level Cited	Penalty Amount	Date Penalty Imposed	Current Status
Hamlet House	HAL-077-010	2/18/2022	10A NCAC 13F .0902(b) Health Care; G.S. 131D-21(4) Declaration of Resident's Rights	A2	$2,000.00	8/31/2022	Paid in Full
Hamlet House	HAL-077-010	5/18/2022	10A NCAC 13F .0902(b) Health Care	Unabated A2	$50,063.00	3/8/2023	Settlement Agreement
Hamlet House	HAL-077-010	5/18/2022	10A NCAC 13F .1004(a) Medication Administration	A2	$1,500.00	3/8/2023	Settlement Agreement
Hamlet House	HAL-077-010	8/1/2022	10A NCAC 13F .0901(c) Personal Care and Supervision	A1	$12,000.00	3/8/2023	Settlement Agreement
Hermitage Retirement Center	HAL-077-012	12/3/2021	10A NCAC 13F .0901(b) Personal Care and Supervision; G.S. 131D-21(2) Declaration of Resident's Rights	A2	$1,000.00	8/31/2022	Paid in Full
Hermitage Retirement Center	HAL-077-012	12/3/2021	10A NCAC 13F .0901(c) Personal Care and Supervision; G.S. 131D-21(2) Declaration of Resident's Rights	A2	$500.00	8/31/2022	Paid in Full
Hermitage Retirement Center	HAL-077-012	6/6/2023	10A NCAC 13F .0901(b) Personal Care and Supervision	A1	$16,000.00	1/31/2024	Paid in Full
Hermitage Retirement Center	HAL-077-012	6/6/2023	10A NCAC 13F .0901(c) Personal Care and Supervision	A2	$4,000.00	1/31/2024	Paid in Full

Robeson County

Facility	Facility License	Inspection Date & Nature of Validation	Rules Areas Cited	Level Cited	Penalty Amount	Date Penalty Imposed	Current Status
Cromartie Spring Village Rest Home	HAL-078-082	2/16/2024	10A NCAC 13F .0902(b) Health Care	A2	$2,000.00	6/12/2024	Appealed
Dial's Family Care Home #4 (closed)	FCL-078-077	5/1/2019	10A NCAC 13G .0909 Residents' Rights; G.S. 131D-21(4) Declaration of Resident's Rights	A2	$3,500.00	12/20/2021	Not Paid - Referred to Controller's Office
Hope Springs	HAL-078-100	1/25/2024	10A NCAC 13F .1004(a) Medication Administration	A2	$2,000.00	5/17/2024	Paid in Full
Kim's Assisted Living	FCL-078-114	6/2/2023	10A NCAC 13G .1004(a) Medication Administration	A2	$1,000.00	9/27/2023	Paid in Full
Mt. Olive Family Care Home #2	FCL-078-015	7/5/2023	10A NCAC 13G .0906 (f)(1)-(4) Other Resident Services	A2	$250.00	11/21/2023	Paid in Full
Mt. Olive Family Care Home #2	FCL-078-015	7/5/2023	10A NCAC 13G .0906 (f)(1)-(4) Other Resident Services	A2	$250.00	11/21/2023	Paid in Full
Red Springs Assisted Living	HAL-078-083	8/26/2021	10A NCAC 13F .0901(b) Personal Care and Supervision; G.S. 131D-21(2) Declaration of Resident's Rights	A2	$1,000.00	5/16/2022	Settlement Agreement

Rockingham County

Facility	Facility License	Inspection Date & Nature of Validation	Rules Areas Cited	Level Cited	Penalty Amount	Date Penalty Imposed	Current Status
Beverly Rucker's Family Care Home #2	FCL-079-033	5/28/2021	10A NCAC 13G .0901(b) Personal Care and Supervision; G.S. 131D-21(4) Declaration of Resident's Rights	A1	$4,000.00	4/20/2022	Paid in Full
Beverly Rucker's Family Care Home #2	FCL-079-033	5/28/2021	10A NCAC 13G .0906 (f)(1)-(4) Other Resident Services; G.S. 131D-21(4) Declaration of Resident's Rights	A1	$8,000.00	4/20/2022	Paid in Full
Moyer's Agape Assisted Living (Closed)	HAL-079-105	8/25/2022	10A NCAC 13F .0902(b) Health Care G.S. 131D-21(4) Declaration of Resident's Rights	A2	$750.00	2/15/2023	Paid in Full
Moyer's Agape Assisted Living (Closed)	HAL-079-107	3/14/2023	10A NCAC 13F .0909 Resident Rights	A1	$7,000.00	9/27/2023	Paid in Full
Moyer's Agape Assisted Living (Closed)	HAL-079-107	6/14/2023	10A NCAC 13F .0901(b) Personal Care and Supervision	A2	$2,000.00	9/27/2023	Paid in Full
R & D Wilson Home Care (Closed)	FCL-079-075	7/8/2021	10A NCAC 13G .0302 (b) Design And Construction; G.S. 131D-21(2) Declaration of Resident's Rights	Unabated B	$5,700.00	5/16/2022	Paid in Full
The Landings of Rockingham	HAL-079-106	2/13/2024	10A NCAC 13F .0909 Resident Rights	A1	$12,000.00	6/12/2024	Appealed

Rowan County

Facility	Facility License	Inspection Date & Nature of Validation	Rules Areas Cited	Level Cited	Penalty Amount	Date Penalty Imposed	Current Status
Angels at Heart Assisted Living	HAL-080-029	3/31/2021	10A NCAC 13F .0901(c) Personal Care and Supervision; G.S. 131D-21(4) Declaration of Resident's Rights	A2	$7,000.00	2/4/2022	Paid in Full
Angels at Heart Assisted Living	HAL-080-029	3/31/2021	10A NCAC 13F .0902(b) Health Care; G.S. 131D-21(4) Declaration of Resident's Rights	A1	$9,000.00	2/4/2022	Paid in Full
Bethamy Retirement Center	HAL-080-032	3/31/2022	10A NCAC 13F .1004 (i) Medication Administration ; G.S. 131D-21(2) Declaration of Resident's Rights	A2	$1,000.00	2/7/2023	Paid in Full
Bethamy Retirement Center	HAL-080-032	4/13/2023	10A NCAC 13F .0902(b) Health Care	A2	$2,000.00	8/2/2023	Settlement Agreement
Bethamy Retirement Center	HAL-080-032	4/13/2023	10A NCAC 13F .1004(a) Medication Administration	A1	$7,000.00	8/2/2023	Settlement Agreement
Bethamy Retirement Center	HAL-080-032	4/5/2024	10A NCAC 13F .0602 Management Of Facilities WIth A Capacity Or	A2	$2,000.00	6/12/2024	Not Paid - Referred to Controller's Office
Bethamy Retirement Center	HAL-080-032	4/5/2024	10A NCAC 13F .0909 Resident Rights	A1	$4,000.00	6/12/2024	Not Paid - Referred to Controller's Office
Bethamy Retirement Center	HAL-080-032	4/5/2024	G.S. § 131D-25 Implementation	A1	$4,000.00	6/12/2024	Not Paid - Referred to Controller's Office
Bethamy Retreat	FCL-080-034	4/18/2024	10A NCAC 13G .0601(a) Management and Other Staff	A2	$2,000.00	7/31/2024	Not Paid - Referred to Controller's Office
Bethamy Retreat	FCL-080-034	4/18/2024	10A NCAC 13G .0601(d) Management and Other Staff	A2	$2,000.00	7/31/2024	Not Paid - Referred to Controller's Office
Bethamy Retreat	FCL-080-034	4/18/2024	10A NCAC 13G .0909 Residents' Rights	A1	$3,500.00	7/31/2024	Not Paid - Referred to Controller's Office

Rutherford County

Facility	Facility License	Inspection Date & Nature of Validation	Rules Areas Cited	Level Cited	Penalty Amount	Date Penalty Imposed	Current Status
Cedar Creek Living (Closed)	HAL-081-052	1/4/2023	10A NCAC 13F .0601 (a) Management Of Facilities	A2	$4,000.00	5/26/2023	Paid in Full
Cedar Creek Living (Closed)	HAL-081-052	1/4/2023	10A NCAC 13F .0702(b) Discharge Of Residents	A2	$2,000.00	5/26/2023	Paid in Full
Cedar Creek Living (Closed)	HAL-081-052	1/4/2023	10A NCAC 13F .0909 Resident Rights	A2	$2,000.00	5/26/2023	Paid in Full
Sunnyside Retirement Center	HAL-081-042	4/14/2022	10A NCAC 13F .0901(b) Personal Care and Supervision; G.S. 131D-21(4) Declaration of Resident's Rights	A2	$1,000.00	12/21/2022	Paid in Full
Sunnyside Retirement Center	HAL-081-042	4/14/2022	10A NCAC 13F .1004(a) Medication Administration; G.S. 131D-21(4) Declaration of Resident's Rights	A2	$1,000.00	12/21/2022	Paid in Full

Stokes County

Facility	Facility License	Inspection Date & Nature of Validation	Rules Areas Cited	Level Cited	Penalty Amount	Date Penalty Imposed	Current Status
Rose Tara Senior Living	HAL-085-008	2/17/2021	10A NCAC 13F .0901(b) Personal Care and Supervision; G.S. 131D-21(2) Declaration of Resident's Rights	A2	$750.00	2/4/2022	Paid in Full

Surry County

Facility	Facility License	Inspection Date & Nature of Validation	Rules Areas Cited	Level Cited	Penalty Amount	Date Penalty Imposed	Current Status
Central Care	HAL-086-001	8/18/2021	G.S.§ 131D-4.5B(b) ACH Medication Aides; Training and Competency; G.S. 131D-21(2) Declaration of Resident's Rights	Unabated B	$2,400.00	5/16/2022	Paid in Full
Central Care	HAL-086-001	11/29/2022	10A NCAC 13F .0306(a)(4) Housekeeping And Furnishings	Unabated B	$8,600.00	7/7/2023	Paid in Full
Central Care	HAL-086-001	5/5/2023	10A NCAC 13F .0601 (a) Management Of Facilities	A1	$14,000.00	8/2/2023	Paid in Full
Central Care	HAL-086-001	5/5/2023	10A NCAC 13F .0901(b) Personal Care and Supervision	A2	$4,000.00	8/2/2023	Paid in Full
Central Care	HAL-086-001	5/5/2023	10A NCAC 13F .1004(a) Medication Administration	A1	$14,000.00	8/2/2023	Paid in Full
Colonial Long Term Care Facility	HAL-086-002	6/28/2023	10A NCAC 13F .0305(h)(4) Physical Environment	A1	$7,000.00	9/27/2023	Paid in Full
Riverwood ALF	HAL-086-014	5/18/2023	10A NCAC 13F .0909 Resident Rights	A2	$2,000.00	9/27/2023	Paid in Full
Twelve Oaks	HAL-086-016	9/23/2022	10A NCAC 13F .0901(b) Personal Care and Supervision G.S. 131D-21(4) Declaration of Resident's Rights	A2	$500.00	6/16/2023	Paid in Full

Transylvania County

Facility	Facility License	Inspection Date & Nature of Validation	Rules Areas Cited	Level Cited	Penalty Amount	Date Penalty Imposed	Current Status
Kingsbridge House	HAL-088-015	1/22/2021	10A NCAC 13F .0902(b) Health Care; G.S. 131D-21(4) Declaration of Resident's Rights	Unabated A2	$30,375.00	6/10/2022	Settlement Agreement
Kingsbridge House	HAL-088-015	1/22/2021	10A NCAC 13F .1004(a) Medication Administration; G.S. 131D-21(4) Declaration of Resident's Rights	Unabated A2	$37,500.00	12/17/2021	Settlement Agreement
Kingsbridge House	HAL-088-015	1/22/2021	10A NCAC 13F .1801 (c) Infection Prevention & Control Program (temp); G.S. 131D-21(4) Declaration of Resident's Rights	A1	$8,000.00	12/17/2021	Settlement Agreement

Tyrrell County

Facility	Facility License	Inspection Date & Nature of Validation	Rules Areas Cited	Level Cited	Penalty Amount	Date Penalty Imposed	Current Status
Tyrrell House	HAL-089-002	1/28/2021	10A NCAC 13F .1004(a) Medication Administration; G.S. 131D-21(2) Declaration of Resident's Rights	Unabated B	$9,000.00	12/17/2021	Paid in Full
Tyrrell House	HAL-089-002	9/1/2022	10A NCAC 13F .0902(b) Health Care	A2	$14,000.00	3/8/2023	Settlement Agreement

Union County

Facility	Facility License	Inspection Date & Nature of Validation	Rules Areas Cited	Level Cited	Penalty Amount	Date Penalty Imposed	Current Status
The Addison of Indian Trail	HAL-090-035	11/5/2021	10A NCAC 13F .0901(c) Personal Care and Supervision; G.S. 131D-21(2) Declaration of Resident's Rights	A1	$3,500.00	8/17/2022	Paid in Full
The Addison of Indian Trail	HAL-090-035	8/4/2023	10A NCAC 13F .0305(h)(4) Physical Environment	A2	$1,000.00	5/17/2024	Paid in Full

Wake County

Facility	Facility License	Inspection Date & Nature of Validation	Rules Areas Cited	Level Cited	Penalty Amount	Date Penalty Imposed	Current Status
Dunmore Senior Living of Zebulon (formerly Coventry House of Zebulon)	HAL-092-212	4/5/2024	10A NCAC 13F .1004(a) Medication Administration	A2	$2,000.00	7/31/2024	Paid in Full
Livewell Cary	FCL-092-305	2/9/2024	10A NCAC 13G .0901(b) Personal Care and Supervision	A2	$500.00	6/12/2024	Paid in Full
The Addison of Fuquay-Varina	HAL-092-219	5/15/2024	10A NCAC 13F .0305(h)(4) Physical Environment	A2	$12,000.00	10/3/2024
The Addison of Fuquay-Varina	HAL-092-219	5/15/2024	10A NCAC 13F .0901(b) Personal Care and Supervision	A2	$14,000.00	10/3/2024
Sunrise at North Hills	HAL-092-218	8/27/2021	10A NCAC 13F .0901(b) Personal Care and Supervision; G.S. 131D-21(2) Declaration of Resident's Rights	A2	$500.00	5/16/2022	Paid in Full
Sunrise of Cary	HAL-092-209	10/4/2022	10A NCAC 13F .0901(b) Personal Care and Supervision	A1	$2,000.00	2/15/2023	Paid in Full
Sunrise of Cary	HAL-092-209	10/4/2022	10A NCAC 13F .1308(a) Special Care Unit Staff	A1	$500.00	2/15/2023	Paid in Full
Sunrise of Cary	HAL-092-209	1/19/2023	10A NCAC 13F .0909 Resident Rights	A2	$4,000.00	5/31/2023	Paid in Full
Sunrise of Raleigh	HAL-092-222	10/14/2022	10A NCAC 13F .0902(c)(1) Health Care	A1	$1,500.00	5/31/2023	Paid in Full
TerraBella Northridge	HAL-092-207	11/9/2023	10A NCAC 13F .0902(b) Health Care	A1	$2,000.00	5/17/2024	Paid in Full
The Addison of Fuquay-Varina	HAL-092-219	11/12/2021	10A NCAC 13F .0902(c)(3-4) Health Care; G.S. 131D-21(2) Declaration of Resident's Rights	A2	$16,000.00	8/17/2022	Paid in Full
The Addison of Fuquay-Varina	HAL-092-219	11/12/2021	10A NCAC 13F .1004(a) Medication Administration; G.S. 131D-21(2) Declaration of Resident's Rights	A1	$20,000.00	8/17/2022	Paid in Full
The Addison of Fuquay-Varina	HAL-092-219	3/14/2024	10A NCAC 13F .0909 Resident Rights	A1	$12,000.00	7/31/2024	Not Paid - Refered to Controller's Office
The Addison of Fuquay-Varina	HAL-092-219	8/6/2021	10A NCAC 13F .0901(b) Personal Care and Supervision; G.S. 131D-21(2) Declaration of Resident's Rights	A2	$1,500.00	5/16/2022	Paid in Full
The Addison of Fuquay-Varina	HAL-092-219	8/6/2021	10A NCAC 13F .0902(b) Health Care; G.S. 131D-21(4) Declaration of Resident's Rights	A2	$1,500.00	5/16/2022	Paid in Full
The Addison of Fuquay-Varina	HAL-092-219	9/3/2021	10A NCAC 13F .0901(b) Personal Care and Supervision; G.S. 131D-21(2) Declaration of Resident's Rights	A2	$1,000.00	8/17/2022	Paid in Full
Avendelle Assisted Living at Heritage (closed)	FCL-092-230	7/11/2022	10A NCAC 13G .0504 (c) Competency Validation For Licensed Health Pro; G.S. 131D-21(2) Declaration of Resident's Rights	A1	$4,000.00	12/21/2022	Paid in Full
Avendelle Assisted Living at Heritage (closed)	FCL-092-230	7/11/2022	10A NCAC 13G .0601(a) Management and Other Staff; G.S. 131D-21(2) Declaration of Resident's Rights	A1	$4,000.00	12/21/2022	Paid in Full
Avendelle Assisted Living on Lazy River	FCL-092-295	5/26/2023	10A NCAC 13G .0902(b) Health Care	A2	$1,000.00	9/27/2023	Paid in Full
Avendelle Assisted Living on Lazy River	FCL-092-295	5/26/2023	10A NCAC 13G .1004(a) Medication Administration	A2	$1,000.00	9/27/2023	Paid in Full
Avendelle Assisted Living on Tryon	FCL-092-272	8/19/2022	10A NCAC 13G .0902(c)(3)(4) Health Care G.S. 131D-21(4) Declaration of Resident's Rights	A2	$500.00	2/15/2023	Paid in Full
Brighton Gardens of Raleigh	HAL-092-024	5/13/2022	10A NCAC 13F .0305(h)(4) Physical Environment	A2	$1,500.00	3/8/2023	Paid in Full
Brighton Gardens of Raleigh	HAL-092-024	10/30/2023	10A NCAC 13F .0901(b) Personal Care and Supervision	A1	$7,000.00	3/27/2024	Paid in Full
Brookdale Cary	HAL-092-023	12/5/2022	10A NCAC 13F .0901(b) Personal Care and Supervision	A2	$1,000.00	5/26/2023	Paid in Full
Brookdale Cary	HAL-092-023	3/23/2023	10A NCAC 13F .0901(b) Personal Care and Supervision	A1	$16,000.00	8/2/2023	Appealed
Brookdale Wake Forest	HAL-092-032	4/13/2022	10A NCAC 13F .0902(b) Health Care	A2	$3,000.00	3/8/2023	Paid in Full
Cadence at Wake Forest	HAL-092-213	12/16/2021	10A NCAC 13F .0901(b) Personal Care and Supervision; G.S. 131D-21(4) Declaration of Resident's Rights	A1	$2,000.00	9/16/2022	Paid in Full
Cadence at Wake Forest	HAL-092-213	12/16/2021	10A NCAC 13F .1308(a) Special Care Unit Staff; G.S. 131D-21(2) Declaration of Resident's Rights	A2	$2,000.00	9/16/2022	Paid in Full
Cadence at Wake Forest	HAL-092-213	12/16/2021	10A NCAC 13F .1801 (c) Infection Prevention & Control Program (temp); G.S. 131D-21(2) Declaration of Resident's Rights	A2	$4,000.00	9/16/2022	Paid in Full
Cadence at Wake Forest	HAL-092-213	3/10/2022	10A NCAC 13F .0901(b) Personal Care and Supervision; G.S. 131D-21(4) Declaration of Resident's Rights	A2	$1,000.00	9/16/2022	Paid in Full
Cadence at Wake Forest	HAL-092-213	5/27/2022	10A NCAC 13F .0901(b) Personal Care and Supervision	A1	$10,500.00	3/8/2023	Paid in Full
Cadence at Wake Forest	HAL-092-213	5/27/2022	10A NCAC 13F .0906(f)(4) Other Resident Care and Services	A2	$3,000.00	3/8/2023	Paid in Full
Cadence Garner	HAL-092-215	3/9/2023	10A NCAC 13F .1005 (b) Self-Administration Of Medications	A2	$4,000.00	5/26/2023	Paid in Full
Cadence North Raleigh	HAL-092-214	4/28/2022	10A NCAC 13F .0901(c) Personal Care and Supervision G.S. 131D-21(2) Declaration of Resident's Rights	A1	$3,500.00	2/15/2023	Paid in Full
Cadence North Raleigh	HAL-092-214	7/28/2022	10A NCAC 13F .0901(b) Personal Care and Supervision	A2	$2,000.00	5/26/2023	Paid in Full
Chatham Commons	HAL-092-203	2/12/2021	10A NCAC 13F .0901(a) Personal Care and Supervision; G.S. 131D-21(4) Declaration of Resident's Rights	A1	$7,000.00	2/4/2022	Settlement Agreement
Chatham Commons	HAL-092-203	2/12/2021	10A NCAC 13F .0902(b) Health Care; G.S. 131D-21(4) Declaration of Resident's Rights	A2	$14,000.00	2/4/2022	Settlement Agreement
Chatham Commons	HAL-092-203	6/2/2021	10A NCAC 13F .0902(b) Health Care; G.S. 131D-21(2) Declaration of Resident's Rights	Unabated A2	$67,500.00	4/20/2022	Settlement Agreement
Destiny Family Care Home #4	FCL-092-290	6/22/2022	10A NCAC 13G .0906 (f)(1)-(4) Other Resident Services G.S. 131D-21(2) Declaration of Resident's Rights	A1	$1,000.00	2/15/2023	Paid in Full
Destiny Family Care Home #4	FCL-092-290	4/12/2024	10A NCAC 13G .0901(b) Personal Care and Supervision	A1	$2,000.00	6/12/2024	Appealed
Falls River Court Memory Care Community	HAL-092-141	11/30/2021	10A NCAC 13F .0901(b) Personal Care and Supervision; G.S. 131D-21(2) Declaration of Resident's Rights	A2	$500.00	8/17/2022	Paid in Full
Falls River Village Assisted Living Community	HAL-092-142	4/14/2022	10A NCAC 13F .0901(b) Personal Care and Supervision; G.S. 131D-21(2) Declaration of Resident's Rights	A2	$1,000.00	12/21/2022	Paid in Full
Heart to Live (Closed)	FCL-092-252	6/17/2021	10A NCAC 13G .0901(c) Personal Care and Supervision; G.S. 131D-21(4) Declaration of Resident's Rights	A1	$875.00	4/20/2022	Paid in Full
LiveWell Cary (Closed)	FCL-092-258	10/31/2022	10A NCAC 13G .0902 (c-2) Health Care	A1	$16,000.00	3/8/2023	Not Paid - Referred to Controller's Office
Morningside of Raleigh	HAL-092-217	3/30/2022	10A NCAC 13F .0901(a) Personal Care and Supervision; G.S. 131D-21(4) Declaration of Resident's Rights	A1	$14,000.00	12/21/2022	Paid in Full
Morningside of Raleigh	HAL-092-217	5/20/2022	10A NCAC 13F .0901(b) Personal Care and Supervision	A1	$12,000.00	3/8/2023	Paid in Full
Morningside of Raleigh	HAL-092-217	5/20/2022	10A NCAC 13F .0902(b) Health Care	A2	$2,000.00	3/8/2023	Paid in Full
Morningside of Raleigh	HAL-092-217	6/10/2022	10A NCAC 13F .0305(h)(4) Physical Environment	A2	$4,000.00	3/8/2023	Paid in Full
Morningside of Raleigh	HAL-092-217	6/10/2022	10A NCAC 13F .0901(b) Personal Care and Supervision	A1	$14,000.00	3/8/2023	Paid in Full
Morningside of Raleigh	HAL-092-217	9/13/2022	10A NCAC 13F .0901(b) Personal Care and Supervision	A1	$15,000.00	4/5/2023	Paid in Full
Morningside of Raleigh	HAL-092-217	9/15/2022	10A NCAC 13F .0901(b) Personal Care and Supervision	A2	$7,000.00	5/26/2023	Paid in Full
Morningside of Raleigh	HAL-092-217	11/18/2022	10A NCAC 13F .0901(b) Personal Care and Supervision	A2	$10,500.00	5/26/2023	Paid in Full
Morningside of Raleigh	HAL-092-217	1/4/2023	10A NCAC 13F .0305(h)(4) Physical Environment	Unabated B	$13,200.00	7/7/2023	Paid in Full
Morningside of Raleigh	HAL-092-217	4/14/2023	10A NCAC 13F .0305(f)(4) Physical Environment	A1	$7,000.00	7/7/2023	Paid in Full
Novelty Healthcare Services	FCL-092-206	3/1/2023	10A NCAC 13G .0317(d) Building Service Equipment	A2	$1,000.00	8/2/2023	Paid in Full
Novelty Healthcare Services II	FCL-092-228	8/3/2021	G.S. 131D 4.4A (b) ACH Infection Prevention Requirements; G.S. 131D-21(2) Declaration of Resident's Rights	Unabated B	$540.00	5/16/2022	Paid in Full
Oliver House	HAL-092-182	8/19/2021	10A NCAC 13F .1004(a) Medication Administration; G.S. 131D-21(2) Declaration of Resident's Rights	Unabated B	$12,000.00	5/16/2022	Settlement Agreement
Phoenix Assisted Care	HAL-092-131	2/16/2021	10A NCAC 13F .0901(a) Personal Care and Supervision; G.S. 131D-21(4) Declaration of Resident's Rights	A1	$2,000.00	2/4/2022	Settlement Agreement
Phoenix Assisted Care	HAL-092-131	2/16/2021	10A NCAC 13F .0901(b) Personal Care and Supervision; G.S. 131D-21(4) Declaration of Resident's Rights	A1	$2,000.00	2/4/2022	Settlement Agreement
Phoenix Assisted Care	HAL-092-131	2/16/2021	10A NCAC 13F .0902(b) Health Care; G.S. 131D-21(4) Declaration of Resident's Rights	A1	$2,000.00	2/4/2022	Settlement Agreement
Phoenix Assisted Care	HAL-092-131	2/16/2021	10A NCAC 13F .1801 (c) Infection Prevention & Control Program (temp); G.S. 131D-21(4) Declaration of Resident's Rights	A2	$1,000.00	2/4/2022	Settlement Agreement
Phoenix Assisted Care	HAL-092-131	2/16/2021	G.S. § 131D-25 Implementation; G.S. 131D-21(4) Declaration of Resident's Rights	A1	$4,000.00	2/4/2022	Settlement Agreement
Phoenix Assisted Care	HAL-092-131	5/14/2021	10A NCAC 13F .0306(a)(5) Housekeeping and Furnishings; G.S. 131D-21(2) Declaration of Resident's Rights	Unabated B	$7,300.00	5/16/2022	Settlement Agreement
Phoenix Assisted Care	HAL-092-131	5/14/2021	10A NCAC 13F .0901(b) Personal Care and Supervision; G.S. 131D-21(2) Declaration of Resident's Rights	A2	$5,250.00	5/16/2022	Settlement Agreement
Phoenix Assisted Care	HAL-092-131	5/14/2021	10A NCAC 13F .0909 Resident Rights; G.S. 131D-21(4) Declaration of Resident's Rights	Unabated B	$7,300.00	5/16/2022	Settlement Agreement
Phoenix Assisted Care	HAL-092-131	5/14/2021	10A NCAC 13F .1004(a) Medication Administration; G.S. 131D-21(2) Declaration of Resident's Rights	A2	$3,500.00	5/16/2022	Settlement Agreement
Phoenix Assisted Care	HAL-092-131	9/11/2023	10A NCAC 13F .0901(b) Personal Care and Supervision	A2	$14,000.00	5/17/2024	Appealed
Spring Arbor of Apex	HAL-092-223	4/10/2024	10A NCAC 13F .0909 Resident Rights	A1	$1,500.00	7/12/2024	Paid in Full
Spring Arbor of Cary (Closed)	HAL-092-204	9/13/2021	10A NCAC 13F .0901(b) Personal Care and Supervision; G.S. 131D-21(2) Declaration of Resident's Rights	A2	$1,000.00	6/10/2022	Paid in Full
The Addison of Fuquay-Varina	HAL-092-219	9/3/2021	10A NCAC 13F .0902(b) Health Care; G.S. 131D-21(2) Declaration of Resident's Rights	A1	$7,000.00	8/17/2022	Paid in Full
The Addison of Fuquay-Varina	HAL-092-219	9/3/2021	10A NCAC 13F .0909 Resident Rights;	A1	$7,000.00	8/17/2022	Paid in Full
The Addison of Fuquay-Varina	HAL-092-219	11/12/2021	10A NCAC 13F .0902(b) Health Care; G.S. 131D-21(2) Declaration of Resident's Rights	Unabated A2	$64,500.00	8/17/2022	Paid in Full
The Addison of Knightdale	HAL-092-220	11/12/2021	10A NCAC 13F .0902(b) Health Care; G.S. 131D-21(2) Declaration of Resident's Rights	A2	$1,500.00	8/17/2022	Paid in Full
The Addison of Knightdale	HAL-092-220	2/8/2022	10A NCAC 13F .0305(h)(4) Physical Environment G.S. 131D-21(2) Declaration of Resident's Rights	Unabated B	$54,000.00	2/15/2023	Paid in Full
The Addison of Knightdale	HAL-092-220	2/8/2022	10A NCAC 13F .0309 (d) Plan For Evacuation; G.S. 131D-21(4) Declaration of Resident's Rights	A2	$4,000.00	8/31/2022	Settlement Agreement
The Addison of Knightdale	HAL-092-220	2/8/2022	10A NCAC 13F .0311(a) Other Requirements; G.S. 131D-21(4) Declaration of Resident's Rights	A2	$4,000.00	8/31/2022	Settlement Agreement
The Addison of Knightdale	HAL-092-220	2/8/2022	10A NCAC 13F .0605 Staffing Of Personal Care Aide Supervisors; G.S. 131D-21(4) Declaration of Resident's Rights	A2	$4,000.00	8/31/2022	Settlement Agreement
The Addison of Knightdale	HAL-092-220	2/8/2022	10A NCAC 13F .0902(b) Health Care; G.S. 131D-21(4) Declaration of Resident's Rights	A1	$7,000.00	8/31/2022	Settlement Agreement
The Addison of Knightdale	HAL-092-220	2/8/2022	10A NCAC 13F .1004(a) Medication Administration; G.S. 131D-21(4) Declaration of Resident's Rights	A2	$2,000.00	8/31/2022	Settlement Agreement
The Addison of Knightdale	HAL-092-220	2/8/2022	G.S. § 131D-25 Implementation; G.S. 131D-21(4) Declaration of Resident's Rights	A1	$12,000.00	8/31/2022	Settlement Agreement
The Covington	HAL-092-181	1/12/2023	10A NCAC 13F .1004(a) Medication Administration	Unabated B	$15,800.00	5/31/2023	Settlement Agreement
The Manor at Edgewater	FCL-092-153	6/30/2022	10A NCAC 13G .0902(b) Health Care G.S. 131D-21(2) Declaration of Resident's Rights	A2	$500.00	2/15/2023	Paid in Full
The Reserve at Mills Farm (Closed)	HAL-092-221	2/3/2023	10A NCAC 13F .0901(b) Personal Care and Supervision	A2	$2,000.00	8/2/2023	Paid in Full
The Reserve at Mills Farm (Closed)	HAL-092-221	2/3/2023	10A NCAC 13F .1004(a) Medication Administration	A2	$2,000.00	8/2/2023	Paid in Full
The Reserve at Mills Farm Villa #3	FCL-092-270	1/24/2023	10A NCAC 13G .1004(a) Medication Administration	Unabated Type B	$12,500.00	7/7/2023	Paid in Full
The Reserve at Mills Farm Villa #3	FCL-092-270	3/27/2023	10A NCAC 13G .1004(a) Medication Administration	A2	$1,000.00	7/7/2023	Paid in Full
Wake Assisted Living	HAL-092-144	3/19/2021	10A NCAC 13F .1004(a) Medication Administration; G.S. 131D-21(2) Declaration of Resident's Rights	A2	$2,000.00	4/20/2022	Paid in Full
Wake Assisted Living	HAL-092-144	7/14/2022	10A NCAC 13F .0902(b) Health Care	A1	$4,000.00	3/8/2023	Paid in Full
Wake Assisted Living	HAL-092-144	12/15/2023	10A NCAC 13F .0909 Resident Rights	A1	$7,000.00	6/12/2024	Paid in Full
Windsor Point Continuing Care Retirement Community	NH0580	10/26/2023	10A NCAC 13F .0909 Resident Rights	A1	$20,000.00	11/8/2023	Paid in Full

Warren County

Facility	Facility License	Inspection Date & Nature of Validation	Rules Areas Cited	Level Cited	Penalty Amount	Date Penalty Imposed	Current Status
Alpha Magnolia Garden	HAL-093-010	10/17/2022	10A NCAC 13F .0305(h)(4) Physical Environment	A2	$1,500.00	7/7/2023	Paid in Full
Alpha Magnolia Garden	HAL-093-010	10/17/2022	10A NCAC 13F .0901(b) Personal Care and Supervision	A2	$1,500.00	7/7/2023	Paid in Full
Alpha Magnolia Garden	HAL-093-010	6/23/2023	10A NCAC 13F .0901(b) Personal Care and Supervision	A2	$4,000.00	11/21/2023	Paid in Full
Alpha Magnolia Garden	HAL-093-010	6/23/2023	10A NCAC 13F .0902(b) Health Care	A2	$4,000.00	11/21/2023	Paid in Full
Pivotal Care (Closed)	FCL-093-012	2/5/2021	10A NCAC 13G .1004(a) Medication Administration; G.S. 131D-21(2) Declaration of Resident's Rights	Unabated B	$11,800.00	2/4/2022	Not Paid - Referred to Controller's Office
Pivotal Care (Closed)	FCL-093-012	4/16/2021	10A NCAC 13G .0601(a) Management and Other Staff; G.S. 131D-21(4) Declaration of Resident's Rights	A2	$3,500.00	3/16/2022	Not Paid - Referred to Controller's Office
Pivotal Care (Closed)	FCL-093-012	4/16/2021	10A NCAC 13G .0901(b) Personal Care and Supervision; G.S. 131D-21(4) Declaration of Resident's Rights	A2	$3,500.00	3/16/2022	Not Paid - Referred to Controller's Office
Pivotal Care (Closed)	FCL-093-012	6/4/2021	10A NCAC 13G .0312(g) Outside Entrance And Exits; G.S. 131D-21(2) Declaration of Resident's Rights	Unabated B	$1,600.00	4/20/2022	Not Paid - Referred to Controller's Office
Pivotal Care (Closed)	FCL-093-012	6/4/2021	10A NCAC 13G .0405(a)(b) Test For Tuberculosis; G.S. 131D-21(2) Declaration of Resident's Rights	Unabated B	$1,600.00	4/20/2022	Not Paid - Referred to Controller's Office
Pivotal Care (Closed)	FCL-093-012	6/4/2021	10A NCAC 13G .0601(a) Management and Other Staff; G.S. 131D-21(4) Declaration of Resident's Rights	Unabated A2	$11,625.00	4/20/2022	Not Paid - Referred to Controller's Office
Pivotal Care (Closed)	FCL-093-012	6/4/2021	10A NCAC 13G .0901(b) Personal Care and Supervision; G.S. 131D-21(4) Declaration of Resident's Rights	Unabated A2	$11,625.00	4/20/2022	Not Paid - Referred to Controller's Office
Pivotal Care (Closed)	FCL-093-012	6/4/2021	G.S. § 131D-4.5B (b) ACH Medication Aides;Training and Competency; G.S. 131D-21(2) Declaration of Resident's Rights	Unabated B	$17,900.00	4/20/2022	Not Paid - Referred to Controller's Office
Pivotal Care (Closed)	FCL-093-012	6/4/2021	G.S. 131D 4.4A (b) ACH Infection Prevention Requirements; G.S. 131D-21(2) Declaration of Resident's Rights	A2	$3,500.00	4/20/2022	Not Paid - Referred to Controller's Office

Wayne County

Facility	Facility License	Inspection Date & Nature of Validation	Rules Areas Cited	Level Cited	Penalty Amount	Date Penalty Imposed	Current Status
Countryside Village	HAL-096-049	7/21/2022	10A NCAC 13F .0901(b) Personal Care and Supervision	A1	$16,000.00	3/8/2023	Settlement Agreement
Countryside Village	HAL-096-049	7/21/2022	10A NCAC 13F .0902(b) Health Care	A2	$12,000.00	3/8/2023	Settlement Agreement
Countryside Village	HAL-096-049	7/21/2022	10A NCAC 13F .1004 (i) Medication Administration	A2	$9,000.00	3/8/2023	Settlement Agreement
Countryside Village	HAL-096-049	11/1/2022	10A NCAC 13F .0901(b) Personal Care and Supervision	A2	$12,000.00	4/5/2023	Paid in Full
Countryside Village	HAL-096-049	2/5/2024	10A NCAC 13F .0901(c) Personal Care and Supervision	A1	$14,000.00	9/18/2024
Fremont Rest Center	HAL-096-024	4/16/2021	10A NCAC 13F .0901(b) Personal Care and Supervision; G.S. 131D-21(2) Declaration of Resident's Rights	A2	$5,250.00	4/20/2022	Settlement Agreement
Fremont Rest Center	HAL-096-024	4/16/2021	10A NCAC 13F .0901(c) Personal Care and Supervision; G.S. 131D-21(4) Declaration of Resident's Rights	A1	$2,000.00	4/20/2022	Settlement Agreement
Fremont Rest Center	HAL-096-024	4/16/2021	10A NCAC 13F .0902(b) Health Care; G.S. 131D-21(4) Declaration of Resident's Rights	A1	$6,000.00	4/20/2022	Settlement Agreement
Fremont Rest Center	HAL-096-024	7/11/2022	10A NCAC 13F .0909 Resident Rights	A1	$7,000.00	3/8/2023	Settlement Agreement
Goldsboro Assisted Living & Alzheimer's Care	HAL-096-031	1/9/2020	10A NCAC 13F .0902(b) Health Care; G.S. 131D-21(2) Declaration of Resident's Rights	A2	$500.00	12/17/2021	Paid in Full
Helping Hands Assisted Living (Closed)	HAL-096-052	12/7/2022	10A NCAC 13F .1004(a) Medication Administration	Unabated B	$11,800.00	11/21/2023	Settlement Agreement
Morning Glory Family Care	FCL-096-038	3/15/2023	10A NCAC 13G .0317(d) Building Service Equipment	A2	$1,000.00	7/7/2023	Paid in Full
Somerset Court of Goldsboro	HAL-096-047	12/4/2020	10A NCAC 13F .0306(a)(4) Housekeeping And Furnishings; G.S. 131D-21(2) Declaration of Resident's Rights	A2	$1,000.00	12/10/2021	Paid in Full
Somerset Court of Goldsboro	HAL-096-047	12/4/2020	10A NCAC 13F .0306(a)(5) Housekeeping and Furnishings; G.S. 131D-21(2) Declaration of Resident's Rights	A2	$1,000.00	12/10/2021	Paid in Full
Somerset Court of Goldsboro	HAL-096-047	12/4/2020	10A NCAC 13F .0901(b) Personal Care and Supervision; G.S. 131D-21(2) Declaration of Resident's Rights	A1	$7,000.00	12/10/2021	Settlement Agreement
Somerset Court of Goldsboro	HAL-096-047	12/4/2020	10A NCAC 13F .0901(c) Personal Care and Supervision; G.S. 131D-21(4) Declaration of Resident's Rights	A1	$16,000.00	12/10/2021	Settlement Agreement
Somerset Court of Goldsboro	HAL-096-047	3/1/2021	10A NCAC 13F .0306(a)(5) Housekeeping and Furnishings; G.S. 131D-21(4) Declaration of Resident's Rights	Unabated A2	$80,250.00	9/13/2022	Settlement Agreement
Somerset Court of Goldsboro	HAL-096-047	3/1/2021	10A NCAC 13F .0902(b) Health Care; G.S. 131D-21(4) Declaration of Resident's Rights	A2	$2,000.00	8/17/2022	Settlement Agreement
Somerset Court of Goldsboro	HAL-096-047	9/23/2021	10A NCAC 13F .1004(a) Medication Administration; G.S. 131D-21(2) Declaration of Resident's Rights	Unabated B	$14,500.00	8/17/2022	Settlement Agreement

Wilson County

Facility	Facility License	Inspection Date & Nature of Validation	Rules Areas Cited	Level Cited	Penalty Amount	Date Penalty Imposed	Current Status
Parkwood Village	HAL-098-030	3/22/2024	10A NCAC 13F .1004(a) Medication Administration	A1	$12,000.00	9/4/2024	Paid in Full
Hands that Cares (Closed)	FCL-098-039	4/20/2023	10A NCAC 13G .0902(b) Health Care	A1	$3,500.00	7/7/2023	Not Paid - Referred to Controller's Office
Hands that Cares (Closed)	FCL-098-039	4/20/2023	10A NCAC 13G .1004(a) Medication Administration	A1	$3,500.00	7/7/2023	Not Paid - Referred to Controller's Office
Morning Star Assisted Living #5	HAL-098-031	1/5/2023	10A NCAC 13F .0909 Resident Rights	A2	$500.00	5/26/2023	Paid in Full
Morning Star Assisted Living #5	HAL-098-031	3/22/2023	10A NCAC 13F .0902(c)(3-4) Health Care	A1	$4,000.00	7/7/2023	Paid in Full
Morning Star Assisted Living #5	HAL-098-031	3/22/2023	10A NCAC 13F .1004(a) Medication Administration	A2	$1,000.00	7/7/2023	Paid in Full
Parkwood Village	HAL-098-030	4/4/2023	10A NCAC 13F .0901(a) Personal Care and Supervision	A1	$4,000.00	7/7/2023	Paid in Full
Parkwood Village	HAL-098-030	4/4/2023	10A NCAC 13F .1309 Special Care Unit Staff Orientation And Train	A2	$2,000.00	7/7/2023	Paid in Full
Wilson Assisted Living	HAL-098-027	9/29/2022	10A NCAC 13F .0901(b) Personal Care and Supervision	A1	$9,000.00	3/8/2023	Paid in Full
Wilson House	HAL-098-023	12/22/2021	10A NCAC 13F .1004(a) Medication Administration; G.S. 131D-21(2) Declaration of Resident's Rights	A1	$14,000.00	8/31/2022	Settlement Agreement
Wilson House	HAL-098-023	1/27/2023	10A NCAC 13F .1004(a) Medication Administration	A2	$12,000.00	10/25/2023	Settlement Agreement

Yadkin County

Facility	Facility License	Inspection Date & Nature of Validation	Rules Areas Cited	Level Cited	Penalty Amount	Date Penalty Imposed	Current Status
Pinebrook Residential Center II	HAL-099-016	1/26/2024	10A NCAC 13F .0901(b) Personal Care and Supervision	Unabated A2	$39,937.50	10/3/2024
Pinebrook Residential Center II	HAL-099-016	1/26/2024	10A NCAC 13F .0909 Resident Rights	Unabated A2	$53,250.00	10/3/2024
Patriot Living of Yadkinville	HAL-099-018	6/10/2022	10A NCAC 13F .0902(b) Health Care	A2	$2,000.00	3/8/2023	Paid in Full
Pinebrook Residential Center II	HAL-099-016	10/27/2023	10A NCAC 13F .0901(b) Personal Care and Supervision	A2	$2,000.00	6/12/2024	Not Paid - Referred to Controller's Office
Pinebrook Residential Center II	HAL-099-016	10/27/2023	10A NCAC 13F .0909 Resident Rights	A2	$2,000.00	6/12/2024	Not Paid - Referred to Controller's Office

Yancey County

Facility	Facility License	Inspection Date & Nature of Validation	Rules Areas Cited	Level Cited	Penalty Amount	Date Penalty Imposed	Current Status
Southern Living for Seniors of Burnsville, NC (Closed)	HAL-100-006	2/18/2022	10A NCAC 13F .0601 (a) Management Of Facilities; G.S. 131D-21(4) Declaration of Resident's Rights	A2	$16,000.00	8/17/2022	Not Paid - Refered to Controller's Office
Southern Living for Seniors of Burnsville, NC (Closed)	HAL-100-006	2/18/2022	10A NCAC 13F .0601 (b) Management Of Facilities With A Capacity Or; G.S. 131D-21(4) Declaration of Resident's Rights	A1	$20,000.00	8/17/2022	Not Paid - Refered to Controller's Office
Southern Living for Seniors of Burnsville, NC (Closed)	HAL-100-006	2/18/2022	10A NCAC 13F .0604(e) Personal Care And Other Staffing; G.S. 131D-21(1) Declaration of Resident's Rights	A2	$16,000.00	8/17/2022	Not Paid - Refered to Controller's Office
Southern Living for Seniors of Burnsville, NC (Closed)	HAL-100-006	3/17/2022	10A NCAC 13F .0601 (a) Management Of Facilities; G.S. 131D-21(4) Declaration of Resident's Rights	A1	$20,000.00	8/17/2022	Not Paid - Refered to Controller's Office
Southern Living for Seniors of Burnsville, NC (Closed)	HAL-100-006	3/17/2022	10A NCAC 13F .0601 (b) Management Of Facilities With A Capacity Or; G.S. 131D-21(4) Declaration of Resident's Rights	Unabated A2	$3,750.00	8/17/2022	Not Paid - Refered to Controller's Office
Southern Living for Seniors of Burnsville, NC (Closed)	HAL-100-006	3/17/2022	10A NCAC 13F .0909 Resident Rights; G.S. 131D-21(4) Declaration of Resident's Rights	Unabated A1	$5,000.00	8/17/2022	Not Paid - Refered to Controller's Office
Southern Living for Seniors of Burnsville, NC (Closed)	HAL-100-006	3/17/2022	10A NCAC 13F .1205 Health Care Personnel Registry; G.S. 131D-21(4) Declaration of Resident's Rights	A1	$20,000.00	8/17/2022	Not Paid - Refered to Controller's Office
Southern Living for Seniors of Burnsville, NC (Closed)	HAL-100-006	5/10/2022	10A NCAC 13F .0305(h)(4) Physical Environment; G.S. 131D-21(4) Declaration of Resident's Rights	A1	$20,000.00	8/17/2022	Not Paid - Refered to Controller's Office
Southern Living for Seniors of Burnsville, NC (Closed)	HAL-100-006	5/10/2022	10A NCAC 13F .0407(a)(7) Other Staff Qualifications; G.S. 131D-21(4) Declaration of Resident's Rights	A2	$20,000.00	8/17/2022	Not Paid - Refered to Controller's Office
Southern Living for Seniors of Burnsville, NC (Closed)	HAL-100-006	5/10/2022	10A NCAC 13F .0601 (a) Management Of Facilities; G.S. 131D-21(4) Declaration of Resident's Rights	Unabated A1	$32,000.00	8/17/2022	Not Paid - Refered to Controller's Office
Southern Living for Seniors of Burnsville, NC (Closed)	HAL-100-006	5/10/2022	10A NCAC 13F .0601 (b) Management Of Facilities With A Capacity Or; G.S. 131D-21(4) Declaration of Resident's Rights	Unabated A2	$24,000.00	8/17/2022	Not Paid - Refered to Controller's Office
Southern Living for Seniors of Burnsville, NC (Closed)	HAL-100-006	5/10/2022	10A NCAC 13F .0901(b) Personal Care and Supervision; G.S. 131D-21(4) Declaration of Resident's Rights	A1	$20,000.00	8/17/2022	Not Paid - Refered to Controller's Office
Southern Living for Seniors of Burnsville, NC (Closed)	HAL-100-006	5/10/2022	10A NCAC 13F .0901(c) Personal Care and Supervision; G.S. 131D-21(4) Declaration of Resident's Rights	A1	$20,000.00	8/17/2022	Not Paid - Refered to Controller's Office
Southern Living for Seniors of Burnsville, NC (Closed)	HAL-100-006	5/10/2022	10A NCAC 13F .0909 Resident Rights; G.S. 131D-21(4) Declaration of Resident's Rights	A1	$2,000.00	8/17/2022	Not Paid - Refered to Controller's Office
Southern Living for Seniors of Burnsville, NC (Closed)	HAL-100-006	5/10/2022	10A NCAC 13F .1008 (h) Controlled Substance; G.S. 131D-21(4) Declaration of Resident's Rights	A2	$20,000.00	8/17/2022	Not Paid - Refered to Controller's Office
Southern Living for Seniors of Burnsville, NC (Closed)	HAL-100-006	5/10/2022	10A NCAC 13F .1104(c) Accounting For Resident's Personal Funds; G.S. 131D-21(4) Declaration of Resident's Rights	A1	$20,000.00	8/17/2022	Not Paid - Refered to Controller's Office
Southern Living for Seniors of Burnsville, NC (Closed)	HAL-100-006	5/10/2022	10A NCAC 13F .1205 Health Care Personnel Registry; G.S. 131D-21(4) Declaration of Resident's Rights	A1	$2,000.00	8/17/2022	Not Paid - Refered to Controller's Office
Yancey House	HAL-100-005	2/8/2023	10A NCAC 13F .1004(a) Medication Administration	Unabated B	$9,600.00	6/16/2023	Settlement Agreement

NC Division of Health Service Regulation

Adult Care Licensure Section