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
A Vision Come True HAL-001-103 12/8/2020 10A NCAC 13F .0601 (a) Management Of Facilities; G.S. 131D-21(4) Declaration of Resident's Rights A2 $1,500.00 8/31/2021 Paid in Full
A Vision Come True HAL-001-103 12/8/2020 10A NCAC 13F .1801 (a) (b) Infection Prevention & Control Program (Emer); G.S. 131D-21(4) Declaration of Resident's Rights A2 $1,000.00 8/31/2021 Paid in Full
Above and Beyond Family Care II (Closed) FCL-001-139 4/1/2019 10A NCAC 13G .0901(b) Personal Care and Supervision; G.S. 131D-21(4) Declaration of Resident's Rights A2 $1,000.00 7/21/2021 Not Paid - Referred to Controller's Office
Above and Beyond Family Care II (Closed) FCL-001-139 4/1/2019 10A NCAC 13G .1701 (c) Infection Prevention & Control Program (temp); G.S. 131D-21(4) Declaration of Resident's Rights A1 $2,000.00 7/21/2021 Not Paid - Referred to Controller's Office
Above and Beyond Family Care II (Closed) FCL-001-139 4/1/2019 10A NCAC 13G .1206 Health Care Personnel Registry; G.S. 131D-21(4) Declaration of Resident's Rights A2 $1,000.00 7/21/2021 Not Paid - Referred to Controller's Office
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 Appealed
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
Bountiful Blessings FCH (Closed) FCL-001-146 9/9/2019 10A NCAC 13G .0317(d) Building Service Equipment; G.S. 131D-21(2) Declaration of Resident's Rights A2 $500.00 8/24/2020 Not Paid - Referred to Controller's Office
Bountiful Blessings FCH (Closed) FCL-001-146 9/9/2019 10A NCAC 13G .0601 (c-2) Mangement And Other Staff; G.S. 131D-21(2) Declaration of Resident's Rights A2 $3,000.00 8/24/2020 Not Paid - Referred to Controller's Office
Golden Years Assisted Living 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
Moher Family Care (Closed) FCL-001-107 8/14/2020 10A NCAC 13G .0902(b) Health Care; G.S. 131D-21(4) Declaration of Resident's Rights A2 $3,500.00 7/7/2021 Not Paid - Referred to Controller's Office
Moher Family Care (Closed) FCL-001-107 8/14/2020 10A NCAC 13G .0901(b) Personal Care and Supervision; G.S. 131D-21(2) Declaration of Resident's Rights A1 $7,000.00 7/7/2021 Not Paid - Referred to Controller's Office
Moher Family Care (Closed) FCL-001-107 8/14/2020 10A NCAC 13G .0601(a) Management and Other Staff; G.S. 131D-21(2) Declaration of Resident's Rights A1 $7,000.00 7/7/2021 Not Paid - Referred to Controller's Office
Moher Family Care (Closed) FCL-001-107 8/14/2020 10A NCAC 13G .0909 Residents' Rights; G.S. 131D-21(4) Declaration of Resident's Rights A2 $3,500.00 7/7/2021 Not Paid - Referred to Controller's Office

Alexander County

Facility Facility License Inspection Date & Nature of Validation Rules Areas Cited Level Cited Penalty Amount Date Penalty Imposed Current Status
A New Outlook of Taylorsville HAL-002-007 9/11/2020 10A NCAC 13F .0909 Resident Rights; G.S. 131D-21(2) Declaration of Resident's Rights A2 $12,000.00 8/31/2021 Settlement Agreement

Anson County

Facility Facility License Inspection Date & Nature of Validation Rules Areas Cited Level Cited Penalty Amount Date Penalty Imposed Current Status
Meadowview Terrace of Wadesboro HAL-004-003 7/26/2019 G.S. § 131D-25 Implementation; G.S. 131D-21(2) Declaration of Resident's Rights A2 $2,000.00 9/14/2020 Settlement Agreement
Meadowview Terrace of Wadesboro HAL-004-003 7/26/2019 10A NCAC 13F .1004(a) Medication Administration; G.S. 131D-21(2) Declaration of Resident's Rights A2 $2,000.00 9/14/2020 Settlement Agreement
Meadowview Terrace of Wadesboro HAL-004-003 8/11/2020 10A NCAC 13F .0901(b) Personal Care and Supervision; G.S. 131D-21(4) Declaration of Resident's Rights A1 $12,000.00 8/31/2021 Settlement Agreement

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 11/17/2020 10A NCAC 13F .1801 (a) (b) Infection Prevention & Control Program (Emer); G.S. 131D-21(2) Declaration of Resident's Rights A2 $2,000.00 8/31/2021 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-007-015 8/26/2020 10A NCAC 13F .0601 (a) Management Of Facilities; G.S. 131D-21(4) Declaration of Resident's Rights A2 $4,000.00 8/31/2021 Settlement Agreement
Pantego Rest Home HAL-007-015 8/26/2020 10A NCAC 13F .0909 Resident Rights; G.S. 131D-21(2) Declaration of Resident's Rights A2 $4,000.00 8/31/2021 Settlement Agreement

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

Bladen County

Facility Facility License Inspection Date & Nature of Validation Rules Areas Cited Level Cited Penalty Amount Date Penalty Imposed Current Status
Comfort Living Family Care Home FCL-009-022 3/5/2020 10A NCAC 13G .0901(b) Personal Care and Supervision; G.S. 131D-21(2) Declaration of Resident's Rights A2 $375.00 5/4/2021 Paid in Full
Oak Grove Family Care Home FCL-009-028 6/6/2019 10A NCAC 13G .0312(g) Outside Entrance And Exits; G.S. 131D-21(2) Declaration of Resident's Rights Unabated B $15,600.00 7/21/2021 Settlement Agreement
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

Brunswick County

Facility Facility License Inspection Date & Nature of Validation Rules Areas Cited Level Cited Penalty Amount Date Penalty Imposed Current Status
Ocean Isle Operations HAL-010-011 8/2/2020 10A NCAC 13F .0901(c) Personal Care and Supervision; G.S. 131D-21(4) Declaration of Resident's Rights A2 $1,000.00 8/26/2021 Paid in Full
Shallotte Assisted Living HAL-010-008 10/18/2019 10A NCAC 13F .1104(b) Accounting For Resident's Personal Funds; G.S. 131D-21(2) Declaration of Resident's Rights Unabated B $34,000.00 8/24/2020 Settlement Agreement
Shallotte Assisted Living HAL-010-008 2/25/2020 10A NCAC 13F .1205 Health Care Personnel Registry; G.S. 131D-21(4) Declaration of Resident's Rights A2 $14,000.00 8/24/2020 Settlement Agreement
Shallotte Assisted Living HAL-010-008 2/25/2020 10A NCAC 13F .1008(a) Controlled Substances; G.S. 131D-21(2) Declaration of Resident's Rights A1 $12,000.00 8/24/2020 Settlement Agreement
Shallotte Assisted Living HAL-010-008 2/25/2020 G.S. § 131D-25 Implementation; G.S. 131D-21(4) Declaration of Resident's Rights A1 $16,000.00 8/24/2020 Settlement Agreement
Shallotte Assisted Living HAL-010-008 2/25/2020 10A NCAC 13F .0902(b) Health Care; G.S. 131D-21(4) Declaration of Resident's Rights A1 $16,000.00 8/24/2020 Settlement Agreement
Shallotte Assisted Living HAL-010-008 2/25/2020 10A NCAC 13F .1004(a) Medication Administration; G.S. 131D-21(4) Declaration of Resident's Rights A2 $12,000.00 8/24/2020 Settlement Agreement
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
The Bluefields (formerly named Leland House) HAL-010-007 5/29/2019 10A NCAC 13F .0406(a) Test For Tuberculosis; G.S. 131D-21(4) Declaration of Resident's Rights Unabated B $6,900.00 10/1/2020 Settlement Agreement
The Bluefields (formerly named Leland House) HAL-010-007 8/6/2019 10A NCAC 13F .0902(b) Health Care; G.S. 131D-21(2) Declaration of Resident's Rights A1 $14,000.00 10/1/2020 Settlement Agreement
The Bluefields (formerly named Leland House) HAL-010-007 8/6/2019 10A NCAC 13F .1004(a) Medication Administration; G.S. 131D-21(4) Declaration of Resident's Rights A1 $14,000.00 10/1/2020 Settlement Agreement
The Bluefields (formerly named Leland House) HAL-010-007 8/6/2019 G.S. § 131D-25 Implementation; G.S. 131D-21(4) Declaration of Resident's Rights A1 $4,000.00 10/1/2020 Settlement Agreement
The Bluefields (formerly named Leland House) HAL-010-007 10/15/2020 10A NCAC 13F .0902(b) Health Care; G.S. 131D-21(4) Declaration of Resident's Rights A1 $13,000.00 8/31/2021 Settlement Agreement
The Bluefields (formerly named Leland House) HAL-010-007 10/15/2020 10A NCAC 13F .0801(c)(1) Resident Assessment; G.S. 131D-21(4) Declaration of Resident's Rights A2 $9,000.00 8/31/2021 Settlement Agreement
The Bluefields (formerly named Leland House) HAL-010-007 10/15/2020 10A NCAC 13F .0901(a) Personal Care and Supervision; G.S. 131D-21(4) Declaration of Resident's Rights A2 $9,000.00 8/31/2021 Settlement Agreement
The Bluefields (formerly named Leland House) HAL-010-007 10/15/2020 10A NCAC 13F .0901(c) Personal Care and Supervision; G.S. 131D-21(4) Declaration of Resident's Rights A1 $13,000.00 8/31/2021 Settlement Agreement
The Bluefields (formerly named Leland House) HAL-010-007 10/15/2020 10A NCAC 13F .1308(a) Special Care Unit Staff; G.S. 131D-21(2) Declaration of Resident's Rights A2 $9,000.00 8/31/2021 Settlement Agreement
The Bluefields (formerly named Leland House) HAL-010-007 10/15/2020 10A NCAC 13F .1308(b) Special Care Unit Staffing; G.S. 131D-21(2) Declaration of Resident's Rights A2 $9,000.00 8/31/2021 Settlement Agreement
The Bluefields (formerly named Leland House) HAL-010-007 10/15/2020 10A NCAC 13F .0909 Resident Rights; G.S. 131D-21(4) Declaration of Resident's Rights A1 $13,000.00 8/31/2021 Settlement Agreement
The Bluefields (formerly named Leland House) HAL-010-007 10/15/2020 G.S. § 131D-25 Implementation; G.S. 131D-21(2) Declaration of Resident's Rights A1 $13,000.00 8/31/2021 Settlement Agreement
The Bluefields (formerly named Leland House) HAL-010-007 7/26/2021 10A NCAC 13F .0909 Resident Rights; G.S. 131D-21(4) Declaration of Resident's Rights A2 $20,000.00 8/31/2022 Appealed
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 Appealed

Buncombe County

Facility Facility License Inspection Date & Nature of Validation Rules Areas Cited Level Cited Penalty Amount Date Penalty Imposed Current Status
Becky's Rest Home #1 HAL-011-002 9/13/2019 10A NCAC 13F .0909 Resident Rights; G.S. 131D-21(4) Declaration of Resident's Rights A2 $2,000.00 8/7/2020 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 11/14/2019 10A NCAC 13F .0901(c) Personal Care and Supervision; G.S. 131D-21(4) Declaration of Resident's Rights Unabated B $16,400.00 8/7/2020 Settlement Agreement
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(2) 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 .0901(b) Personal Care and Supervision; G.S. 131D-21(4) 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 .0601(a) Management and Other Staff; G.S. 131D-21(4) 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 .0902(b) Health Care; G.S. 131D-21(2) 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 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 FCL-011-023 6/22/2021 10A NCAC 13G .1004(a) Medication Administration; 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 #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
Heather Glen at Ardenwoods HAL-011-371 8/20/2020 10A NCAC 13F .0901(b) Personal Care and Supervision; G.S. 131D-21(2) Declaration of Resident's Rights A1 $4,500.00 8/26/2021 Paid in Full
Richmond Hill Rest Home #1 HAL-011-376 6/2/2021 10A NCAC 13F .0601 (a) Management Of Facilities; G.S. 131D-21(2) Declaration of Resident's Rights A1 $4,000.00 5/16/2022 Appealed
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 Appealed
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(4) Declaration of Resident's Rights Unabated B $21,200.00 9/21/2022 Appealed
Richmond Hill Rest Home #2 HAL-011-375 6/2/2021 10A NCAC 13F .0601 (a) Management Of Facilities; G.S. 131D-21(2) Declaration of Resident's Rights A1 $4,000.00 5/16/2022 Appealed
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 Appealed
Richmond Hill Rest Home #2 HAL-011-375 4/1/2022 10A NCAC 13F .0902(b) Health Care; G.S. 131D-21(2) Declaration of Resident's Rights A1 $12,000.00 12/21/2022 Appealed
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 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 Appealed
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 Appealed
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 Appealed
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 Appealed
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 Appealed
Richmond Hill Rest Home #5 HAL-011-372 6/1/2021 10A NCAC 13F .1004(a) Medication Administration; G.S. 131D-21(4) Declaration of Resident's Rights A2 $2,000.00 6/10/2022 Appealed
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(4) Declaration of Resident's Rights Unabated B $36,000.00 6/10/2022 Appealed
Richmond Hill Rest Home #5 HAL-011-372 10/8/2021 10A NCAC 13F .1004(a) Medication Administration; G.S. 131D-21(4) Declaration of Resident's Rights Unabated B $20,000.00 9/21/2022 Appealed
Richmond Hill Rest Home #5 HAL-011-372 4/5/2022 10A NCAC 13F .0901(c) Personal Care and Supervision; G.S. 131D-21(1) Declaration of Resident's Rights A1 $5,500.00 12/21/2022 Appealed
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 Appealed
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 Appealed
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(2) Declaration of Resident's Rights A1 $3,000.00 8/31/2022 Appealed

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(2) Declaration of Resident's Rights A2 $7,000.00 12/21/2022
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
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

Cabarrus County

Facility Facility License Inspection Date & Nature of Validation Rules Areas Cited Level Cited Penalty Amount Date Penalty Imposed Current Status
The Living Center of Concord HAL-013-044 9/30/2020 10A NCAC 13F .0901(a) Personal Care and Supervision; G.S. 131D-21(4) Declaration of Resident's Rights A1 $12,000.00 8/31/2021 Settlement Agreement
The Living Center of Concord HAL-013-044 9/30/2020 10A NCAC 13F .0902(b) Health Care; G.S. 131D-21(4) Declaration of Resident's Rights A1 $12,000.00 8/31/2021 Settlement Agreement
The Living Center of Concord HAL-013-044 9/30/2020 10A NCAC 13F .0909 Resident Rights; G.S. 131D-21(2) Declaration of Resident's Rights A2 $7,000.00 8/31/2021 Settlement Agreement
The Living Center of Concord HAL-013-044 9/30/2020 10A NCAC 13F .1004(a) Medication Administration; G.S. 131D-21(2) Declaration of Resident's Rights A2 $4,000.00 8/31/2021 Settlement Agreement
The Living Center of Concord HAL-013-044 9/30/2020 G.S. § 131D-25 Implementation; G.S. 131D-21(4) Declaration of Resident's Rights A1 $12,000.00 8/31/2021 Settlement Agreement

Caldwell County

Facility Facility License Inspection Date & Nature of Validation Rules Areas Cited Level Cited Penalty Amount Date Penalty Imposed Current Status
Brockford Inn HAL-014-014 2/13/2020 10A NCAC 13F .0902(b) Health Care; G.S. 131D-21(4) Declaration of Resident's Rights A1 $12,000.00 10/19/2021 Paid in Full
Brockford Inn HAL-014-014 7/9/2020 10A NCAC 13F .0909 Resident Rights; G.S. 131D-21(1) Declaration of Resident's Rights A2 $3,000.00 8/26/2021 Paid in Full
Grandview Villa Assisted Living HAL-014-015 7/16/2020 10A NCAC 13F .0909 Resident Rights; G.S. 131D-21(2) Declaration of Resident's Rights A2 $1,000.00 8/26/2021 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 Landing HAL-016-023 6/29/2020 10A NCAC 13F .0306(a)(5) Housekeeping and Furnishings; G.S. 131D-21(2) Declaration of Resident's Rights A1 $500.00 8/26/2021 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
Caswell House HAL-017-054 9/19/2019 10A NCAC 13F .0901(a) Personal Care and Supervision; G.S. 131D-21(2) Declaration of Resident's Rights Unabated B $10,200.00 10/1/2020 Settlement Agreement
Caswell House HAL-017-054 9/19/2019 10A NCAC 13F .1004(a) Medication Administration; G.S. 131D-21(4) Declaration of Resident's Rights Unabated B $10,200.00 10/1/2020 Settlement Agreement
Humphrey Family Care Home FCL-017-052 10/8/2021 10A NCAC 13G .0902(b) Health Care; G.S. 131D-21(4) 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(4) Declaration of Resident's Rights Unabated B $5,300.00 6/10/2022 Paid in Full
Poole's Rest Home (Closed) HAL-017-006 7/30/2019 10A NCAC 13F .1004(a) Medication Administration; G.S. 131D-21(2) Declaration of Resident's Rights Unabated A2 $24,000.00 10/1/2020 Not Paid - Referred to Controller's Office
Poole's Rest Home (Closed) HAL-017-006 7/30/2019 10A NCAC 13F .0601 (a) Management Of Facilities; G.S. 131D-21(2) Declaration of Resident's Rights Unabated A2 $24,000.00 10/1/2020 Not Paid - Referred to Controller's Office
Taylor Family Care Home #2 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 Appealed
Taylor Family Care Home #2 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 Appealed
Taylor Family Care Home #2 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 Appealed

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

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(2) 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
Carolina Care Home #2 HAL-020-002 5/12/2021 10A NCAC 13F .0402 Qualifications Of Administrator-In-Charge; G.S. 131D-21(2) Declaration of Resident's Rights A1 $6,000.00 9/30/2021 Settlement Agreement
Carolina Care Home #2 HAL-020-002 5/12/2021 10A NCAC 13F .0601 (b) Management Of Facilities With A Capacity Or; G.S. 131D-21(2) Declaration of Resident's Rights A1 $6,000.00 9/30/2021 Settlement Agreement
Carolina Care Home #2 HAL-020-002 5/12/2021 10A NCAC 13F .0909 Resident Rights; G.S. 131D-21(2) Declaration of Resident's Rights A1 $3,500.00 9/30/2021 Settlement Agreement
Carolina Care Home #2 HAL-020-002 5/12/2021 10A NCAC 13F .1004(a) Medication Administration; G.S. 131D-21(2) Declaration of Resident's Rights A2 $2,000.00 9/30/2021 Settlement Agreement
Carolina Care Home #2 HAL-020-002 5/12/2021 10A NCAC 13F .1205 Health Care Personnel Registry; G.S. 131D-21(2) Declaration of Resident's Rights A2 $2,000.00 9/30/2021 Settlement Agreement
Elaine's Care #2 FCL-020-016 5/3/2021 10A NCAC 13G .0902(b) Health Care; G.S. 131D-21(2) 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
Cleveland House HAL-023-045 11/25/2019 10A NCAC 13F .0902(b) Health Care; G.S. 131D-21(4) Declaration of Resident's Rights A1 $7,000.00 10/1/2020 Settlement Agreement
Cleveland House HAL-023-045 11/25/2019 10A NCAC 13F .0901(b) Personal Care and Supervision; G.S. 131D-21(4) Declaration of Resident's Rights A1 $5,250.00 10/1/2020 Settlement Agreement
Cleveland House HAL-023-045 1/31/2020 10A NCAC 13F .0902(b) Health Care; G.S. 131D-21(4) Declaration of Resident's Rights A2 $4,000.00 8/31/2021 Settlement Agreement
Cleveland House HAL-023-045 1/31/2020 10A NCAC 13F .0901(a) Personal Care and Supervision; G.S. 131D-21(2) Declaration of Resident's Rights A1 $18,000.00 8/31/2021 Settlement Agreement
Cleveland House HAL-023-045 1/31/2020 10A NCAC 13F .0909 Resident Rights; G.S. 131D-21(2) Declaration of Resident's Rights Unabated B $8,400.00 8/31/2021 Settlement Agreement
Lean's 3 Family Care Home (Closed) FCL-023-049 9/4/2020 10A NCAC 13G .0909 Residents' Rights; G.S. 131D-21(4) Declaration of Resident's Rights A2 $2,000.00 8/31/2021 Not Paid - Referred to Controller's Office
Serenity Living #4 FCL-023-052 5/7/2021 10A NCAC 13G .0902(b) Health Care; G.S. 131D-21(4) Declaration of Resident's Rights A2 $500.00 3/16/2022 Paid in Full
Cleveland House HAL-023-045 1/31/2020 G.S. § 131D-25 Implementation; G.S. 131D-21(4) Declaration of Resident's Rights A1 $7,000.00 8/31/2021 Settlement Agreement
Cleveland House HAL-023-045 1/31/2020 G.S. 131D-4.4A (b) ACH Infection Prevention Requirements; G.S. 131D-21(2) Declaration of Resident's Rights A2 $4,000.00 8/31/2021 Settlement Agreement
TerraBella Shelby (Formerly named Elmcroft of Shelby) HAL-023-048 9/14/2020 10A NCAC 13F .0902(b) Health Care; G.S. 131D-21(2) Declaration of Resident's Rights A1 $7,000.00 8/31/2021 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
Liberty Hill Family Care (Closed) FCL-024-012 4/22/2019 10A NCAC 13G .0315(a)(5) Housekeeping and Furnishings; G.S. 131D-21(2) Declaration of Resident's Rights Unabated B $14,300.00 8/24/2020 Not Paid - Referred to Controller's Office

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 7/17/2019 10A NCAC 13F .0309 (d) Plan For Evacuation; G.S. 131D-21(2) Declaration of Resident's Rights A1 $2,000.00 5/3/2021 Paid in Full
Good Shepard Home for the Aged HAL-025-023 11/19/2019 10A NCAC 13F .0909 Resident Rights; G.S. 131D-21(2) Declaration of Resident's Rights A1 $12,000.00 9/8/2021 Settlement Agreement
Riverstone HAL-025-026 2/5/2021 10A NCAC 13F .0902(b) Health Care; G.S. 131D-21(2) Declaration of Resident's Rights A2 $750.00 9/8/2021 Paid in Full
The Gardens of Trent HAL-025-035 10/16/2019 10A NCAC 13F .0306(a)(5) Housekeeping and Furnishings; G.S. 131D-21(4) Declaration of Resident's Rights Unabated B $24,800.00 7/21/2021 Settlement Agreement
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(4) Declaration of Resident's Rights A2 $500.00 12/21/2022

Cumberland County

Facility Facility License Inspection Date & Nature of Validation Rules Areas Cited Level Cited Penalty Amount Date Penalty Imposed Current Status
Fayetteville Manor HAL-026-054 2/24/2021 10A NCAC 13F .0901(b) Personal Care and Supervision; G.S. 131D-21(4) Declaration of Resident's Rights A2 $1,000.00 2/4/2022 Paid in Full
Forest Hill Group Home (Closed) FCL-026-031 8/13/2019 10A NCAC 13G .0302 (b) Design And Construction; G.S. 131D-21(2) Declaration of Resident's Rights Unabated B $15,100.00 7/21/2021 Not Paid - Referred to Controller's Office
Harmony at Hope Mills HAL-026-065 6/12/2019 10A NCAC 13F .0901(b) Personal Care and Supervision; G.S. 131D-21(4) Declaration of Resident's Rights A1 $7,000.00 8/7/2020 Settlement Agreement
Leach's Family Care Home (Closed) FCL-026-037 5/8/2020 10A NCAC 13G .0909 Residents' Rights; G.S. 131D-21(4) Declaration of Resident's Rights A1 $3,500.00 7/21/2021 Not Paid - Referred to Controller's Office
Morning Star Special Care Unit HAL-026-066 12/19/2019 10A NCAC 13F .0901(b) Personal Care and Supervision; G.S. 131D-21(4) Declaration of Resident's Rights A2 $1,000.00 8/7/2020 Paid in Full
Morning Star Special Care Unit HAL-026-066 12/19/2019 10A NCAC 13F .0902(b) Health Care; G.S. 131D-21(2) Declaration of Resident's Rights A2 $1,000.00 8/7/2020 Paid in Full
Morning Star Special Care Unit HAL-026-066 12/19/2019 10A NCAC 13F .0902(b) Health Care; G.S. 131D-21(2) Declaration of Resident's Rights A2 $2,000.00 8/7/2020 Paid in Full
Pine Valley Adult Care HAL-026-048 1/8/2021 10A NCAC 13F .0601 (a) Management Of Facilities; G.S. 131D-21(2) Declaration of Resident's Rights A1 $7,000.00 8/26/2021 Settlement Agreement
Pine Valley Adult Care HAL-026-048 1/8/2021 10A NCAC 13F .1801 (a) Infection Prevention & Control Program (temp); G.S. 131D-21(2) Declaration of Resident's Rights A2 $4,000.00 8/26/2021 Settlement Agreement
Pine Valley Adult Care HAL-026-048 1/8/2021 10A NCAC 13F .1802 (b) Report & Notification of a Outbreak (temp); G.S. 131D-21(2) Declaration of Resident's Rights A1 $7,000.00 8/26/2021 Settlement Agreement
The Addison of Fayetteville HAL-026-068 12/15/2021 10A NCAC 13F .1004(a) Medication Administration; G.S. 131D-21(4) Declaration of Resident's Rights Unabated B $9,400.00 8/31/2022 Appealed

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 Appealed
Currituck House HAL-027-003 1/6/2022 10A NCAC 13F .0901(b) Personal Care and Supervision; A1 $3,500.00 8/31/2022 Appealed
Currituck House HAL-027-003 1/6/2022 10A NCAC 13F .0902(b) Health Care; A2 $2,000.00 8/31/2022 Appealed
Currituck House HAL-027-003 1/6/2022 G.S. 131D-21(1) Declaration of Residents' Rights; A2 $2,000.00 8/31/2022 Appealed
Currituck House HAL-027-003 1/6/2022 G.S. 131D-21(4) Declaration of Residents' Rights; A2 $2,000.00 8/31/2022 Appealed
Currituck House HAL-027-003 1/6/2022 10A NCAC 13F .1004(a) Medication Administration; G.S. 131D-21(4) Declaration of Resident's Rights Unabated B $8,300.00 8/31/2022 Appealed
Currituck House HAL-027-003 11/5/2018 10A NCAC 13F .0909 Resident Rights; G.S. 131D-21(4) Declaration of Resident's Rights A2 $2,000.00 7/21/2021 Paid in Full

Davidson County

Facility Facility License Inspection Date & Nature of Validation Rules Areas Cited Level Cited Penalty Amount Date Penalty Imposed Current Status
Brookstone Retirement Center HAL-029-001 10/28/2019 10A NCAC 13F .0901(b) Personal Care and Supervision; G.S. 131D-21(2) Declaration of Resident's Rights A1 $3,000.00 8/24/2020 Paid in Full
Grayson Creek of Welcome HAL-029-010 7/15/2019 10A NCAC 13F .1004(a) Medication Administration; G.S. 131D-21(2) Declaration of Resident's Rights Unabated B $19,800.00 8/7/2020 Settlement Agreement
Grayson Creek of Welcome HAL-029-010 8/7/2020 10A NCAC 13F .0909 Resident Rights; G.S. 131D-21(4) Declaration of Resident's Rights A2 $2,000.00 7/21/2021 Paid in Full
Grayson Creek of Welcome HAL-029-010 8/7/2020 10A NCAC 13F .0604(e) Personal Care And Other Staffing; G.S. 131D-21(4) Declaration of Resident's Rights A1 $1,000.00 7/21/2021 Paid in Full
Grayson Creek of Welcome HAL-029-010 8/7/2020 10A NCAC 13F .0901(b) Personal Care and Supervision; G.S. 131D-21(2) Declaration of Resident's Rights A1 $8,000.00 7/21/2021 Paid in Full
Grayson Creek of Welcome HAL-029-010 8/7/2020 10A NCAC 13F .1501(a) Use Of Physical Restraints And Alternatives; G.S. 131D-21(4) Declaration of Resident's Rights A1 $8,000.00 7/21/2021 Paid in Full
Grayson Creek of Welcome HAL-029-010 8/7/2020 G.S. § 131D-25 Implementation; G.S. 131D-21(4) Declaration of Resident's Rights A1 $8,000.00 7/21/2021 Paid in Full
Grayson Creek of Welcome HAL-029-010 3/18/2021 10A NCAC 13F .0902(b) Health Care; G.S. 131D-21(4) 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 Appealed
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 Appealed
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 Appealed
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 Appealed
The Clinard House (Closed) FCL-029-012 2/11/2021 10A NCAC 13G .0601(a) Management and Other Staff; G.S. 131D-21(4) Declaration of Resident's Rights Unabated A2 $33,375.00 12/17/2021 Appealed
The Clinard House (Closed) FCL-029-012 2/11/2021 10A NCAC 13G .1701 (c) Infection Prevention & Control Program (temp); G.S. 131D-21(4) Declaration of Resident's Rights Unabated A2 $33,375.00 12/17/2021 Appealed
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 Appealed
The Clinard House (Closed) FCL-029-012 3/4/2021 10A NCAC 13G .0601(a) Management and Other Staff; G.S. 131D-21(2) Declaration of Resident's Rights A2 $8,000.00 12/17/2021 Appealed
The Lyman House (Closed) FCL-029-011 11/5/2020 10A NCAC 13G .0901(b) Personal Care and Supervision; G.S. 131D-21(2) Declaration of Resident's Rights A2 $2,000.00 8/31/2021 Appealed
The Lyman House (Closed) FCL-029-011 11/5/2020 10A NCAC 13G .0507 Training on Cardio-Pulmonary Resuscitation; G.S. 131D-21(4) Declaration of Resident's Rights Unabated B $4,300.00 8/31/2021 Appealed
The Lyman House (Closed) FCL-029-011 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 8/31/2021 Appealed
The Lyman House (Closed) FCL-029-011 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 8/31/2021 Appealed
The Lyman House (Closed) FCL-029-011 2/19/2021 10A NCAC 13G .1004(a) Medication Administration; G.S. 131D-21(2) Declaration of Resident's Rights Continued Unabated Type B $13,100.00 12/17/2021 Appealed
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 Appealed
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 Appealed
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 Appealed
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 Appealed
The Lyman House (Closed) FCL-029-011 3/4/2021 10A NCAC 13G .0909 Residents' Rights; G.S. 131D-21(2) Declaration of Resident's Rights A1 $8,000.00 12/17/2021 Appealed
The Perryman House (Closed) FCL-029-009 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 8/31/2021 Appealed
The Perryman House (Closed) FCL-029-009 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 8/31/2021 Appealed
The Perryman House (Closed) FCL-029-009 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 8/31/2021 Appealed

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 5/1/2020 10A NCAC 13F .0901(b) Personal Care and Supervision; G.S. 131D-21(2) Declaration of Resident's Rights A1 $8,000.00 5/3/2021 Settlement Agreement
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(4) Declaration of Resident's Rights A2 $1,000.00 2/4/2022 Paid in Full
Mocksville Senior Living and Memory Care HAL-030-009 11/9/2020 10A NCAC 13F .0901(b) Personal Care and Supervision; G.S. 131D-21(4) Declaration of Resident's Rights A2 $2,000.00 8/31/2021 Paid in Full
The Heritage of Cedar Rock (Closed) HAL-030-007 12/13/2019 10A NCAC 13F .0902(b) Health Care; G.S. 131D-21(2) Declaration of Resident's Rights A2 $14,000.00 2/15/2021 Not Paid - Referred to Controller's Office
The Heritage of Cedar Rock (Closed) HAL-030-007 12/13/2019 10A NCAC 13F .1004(a) Medication Administration; G.S. 131D-21(4) Declaration of Resident's Rights A1 $14,000.00 2/15/2021 Not Paid - Referred to Controller's Office
The Heritage of Cedar Rock (Closed) HAL-030-007 12/13/2019 G.S. § 131D-25 Implementation; G.S. 131D-21(2) Declaration of Resident's Rights A2 $14,000.00 2/15/2021 Not Paid - Referred to Controller's Office

Duplin County

Facility Facility License Inspection Date & Nature of Validation Rules Areas Cited Level Cited Penalty Amount Date Penalty Imposed Current Status
Moore Family Care Home #2 (Closed) FCL-031-007 5/23/2018 10A NCAC 13G .0909 Residents' Rights; G.S. 131D-21(4) Declaration of Resident's Rights A2 $750.00 8/7/2020 Paid in Full
Moore Family Care Home #2 (Closed) FCL-031-007 5/23/2018 10A NCAC 13G .1206 Health Care Personnel Registry; G.S. 131D-21(2) Declaration of Resident's Rights A2 $1,000.00 8/7/2020 Paid in Full
Wellington Park HAL-031-006 6/16/2020 10A NCAC 13F .0909 Resident Rights; G.S. 131D-21(2) Declaration of Resident's Rights A1 $12,000.00 8/26/2021 Settlement Agreement
Wellington Park HAL-031-006 6/16/2020 G.S. § 131D-25 Implementation; G.S. 131D-21(4) Declaration of Resident's Rights A1 $8,000.00 8/26/2021 Settlement Agreement
Wellington Park HAL-031-006 6/16/2020 10A NCAC 13F .0902(b) Health Care; G.S. 131D-21(4) Declaration of Resident's Rights A2 $3,500.00 8/26/2021 Settlement Agreement
Wellington Park HAL-031-006 12/21/2020 10A NCAC 13F .0909 Resident Rights; G.S. 131D-21(4) Declaration of Resident's Rights A1 $8,000.00 8/26/2021 Settlement Agreement
Wellington Park HAL-031-006 12/21/2020 10A NCAC 13F .0901(b) Personal Care and Supervision; G.S. 131D-21(4) Declaration of Resident's Rights A1 $16,000.00 8/26/2021 Settlement Agreement

Durham County

Facility Facility License Inspection Date & Nature of Validation Rules Areas Cited Level Cited Penalty Amount Date Penalty Imposed Current Status
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 Not Paid - Referred to Controller's Office
Camellia Gardens HAL-032-071 1/24/2022 10A NCAC 13F .0305(h)(4) Physical Environment; G.S. 131D-21(4) 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(4) Declaration of Resident's Rights A2 $375.00 6/10/2022 Paid in Full
Durham Ridge Assisted Living HAL-032-091 5/20/2020 10A NCAC 13F .0902(b) Health Care; G.S. 131D-21(4) Declaration of Resident's Rights A1 $12,000.00 7/7/2021 Paid in Full
Durham Ridge Assisted Living HAL-032-091 11/17/2020 10A NCAC 13F .0902(b) Health Care; G.S. 131D-21(4) Declaration of Resident's Rights A1 $12,000.00 7/7/2021 Paid in Full
Durham Ridge Assisted Living HAL-032-091 11/17/2020 10A NCAC 13F .0909 Resident Rights; G.S. 131D-21(4) Declaration of Resident's Rights A2 $3,000.00 7/7/2021 Paid in Full
Durham Ridge Assisted Living HAL-032-091 11/17/2020 10A NCAC 13F .1801 (a) (b) Infection Prevention & Control Program (Emer); G.S. 131D-21(4) Declaration of Resident's Rights A2 $3,000.00 7/7/2021 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
Elsie-Doris Family Care FCL-032-088 4/30/2021 10A NCAC 13G .1004(a) Medication Administration; G.S. 131D-21(2) Declaration of Resident's Rights A2 $500.00 3/16/2022 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
Heritage Care of Rocky Mount HAL-033-005 9/4/2020 10A NCAC 13F .0909 Resident Rights; G.S. 131D-21(2) Declaration of Resident's Rights A2 $4,000.00 8/26/2021 Settlement Agreement

Forsyth County

Facility Facility License Inspection Date & Nature of Validation Rules Areas Cited Level Cited Penalty Amount Date Penalty Imposed Current Status
Danby House HAL-034-093 7/26/2019 10A NCAC 13F .0909 Resident Rights; G.S. 131D-21(4) Declaration of Resident's Rights A1 $2,000.00 10/1/2020 Settlement Agreement
Danby House HAL-034-093 11/15/2019 10A NCAC 13F .0901(b) Personal Care and Supervision; G.S. 131D-21(4) Declaration of Resident's Rights A1 $4,000.00 10/1/2020 Settlement Agreement
Danby House HAL-034-093 11/15/2019 10A NCAC 13F .0909 Resident Rights; G.S. 131D-21(4) Declaration of Resident's Rights A2 $1,000.00 10/1/2020 Settlement Agreement
Danby House HAL-034-093 11/15/2019 G.S. § 131D-25 Implementation; G.S. 131D-21(2) Declaration of Resident's Rights A1 $3,500.00 10/1/2020 Settlement Agreement
Danby House HAL-034-093 1/17/2020 10A NCAC 13F .0901(b) Personal Care and Supervision; G.S. 131D-21(4) Declaration of Resident's Rights A1 $14,000.00 10/1/2020 Settlement Agreement
Salem Terrace (Closed) HAL-034-098 7/19/2019 10A NCAC 13F .0901(b) Personal Care and Supervision; G.S. 131D-21(4) Declaration of Resident's Rights Unabated B $19,000.00 8/26/2021 Paid in Full
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
The Bradford Village of Kernersville - West HAL-034-069 10/16/2019 10A NCAC 13F .1004(a) Medication Administration; G.S. 131D-21(4) Declaration of Resident's Rights Unabated B $16,500.00 8/24/2020 Settlement Agreement
The Bradford Village of Kernersville - West HAL-034-069 10/23/2020 10A NCAC 13F .1004(a) Medication Administration; G.S. 131D-21(4) Declaration of Resident's Rights A2 $2,000.00 7/7/2021 Paid in Full
The Bradford Village of Kernersville - West HAL-034-069 10/23/2020 10A NCAC 13F .0902(b) Health Care; G.S. 131D-21(4) Declaration of Resident's Rights A1 $6,000.00 7/7/2021 Paid in Full
The Bradford Village of Kernersville - West HAL-034-069 3/19/2021 10A NCAC 13F .1004(a) Medication Administration; G.S. 131D-21(4) 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(4) Declaration of Resident's Rights Unabated B $16,800.00 8/31/2022 Appealed
The Bradford Village of Kernersville - West HAL-034-069 4/7/2022 10A NCAC 13F .0902(b) Health Care; G.S. 131D-21(4) Declaration of Resident's Rights A2 $12,000.00 12/21/2022
The Ivy at Clemmons HAL-034-105 2/11/2020 10A NCAC 13F .0902(b) Health Care; G.S. 131D-21(2) Declaration of Resident's Rights A1 $4,000.00 2/15/2021 Paid in Full
The Ivy at Clemmons HAL-034-105 2/11/2020 10A NCAC 13F .0909 Resident Rights; G.S. 131D-21(2) Declaration of Resident's Rights A2 $2,000.00 2/15/2021 Paid in Full
The Ivy at Clemmons HAL-034-105 2/11/2020 10A NCAC 13F .1004(a) Medication Administration; G.S. 131D-21(2) Declaration of Resident's Rights A2 $2,000.00 7/21/2021 Paid in Full
The Ivy at Clemmons HAL-034-105 2/11/2020 G.S. § 131D-25 Implementation; G.S. 131D-21(2) Declaration of Resident's Rights A1 $4,000.00 7/21/2021 Paid in Full
The Ivy at Clemmons HAL-034-105 5/7/2020 10A NCAC 13F .1004(a) Medication Administration; G.S. 131D-21(2) Declaration of Resident's Rights A1 $12,000.00 7/7/2021 Settlement Agreement
The Ivy at Clemmons HAL-034-105 5/7/2020 10A NCAC 13F .0902(b) Health Care; G.S. 131D-21(4) Declaration of Resident's Rights Unabated A1 $66,000.00 7/7/2021 Settlement Agreement
The Ivy at Clemmons HAL-034-105 5/7/2020 G.S. § 131D-25 Implementation; G.S. 131D-21(2) Declaration of Resident's Rights Unabated A1 $66,000.00 7/7/2021 Settlement Agreement
The Ivy at Clemmons HAL-034-105 10/1/2020 10A NCAC 13F .1004(a) Medication Administration; G.S. 131D-21(2) Declaration of Resident's Rights Unabated A2 $55,000.00 7/7/2021 Settlement Agreement
The Ivy at Clemmons HAL-034-105 1/13/2021 10A NCAC 13F .0909 Resident Rights; G.S. 131D-21(2) Declaration of Resident's Rights A1 $20,000.00 3/16/2022 Appealed
The Ivy at Clemmons HAL-034-105 4/20/2021 10A NCAC 13F .0901(b) Personal Care and Supervision; G.S. 131D-21(4) Declaration of Resident's Rights A2 $18,000.00 4/20/2022 Appealed
The Ivy at Clemmons HAL-034-105 4/20/2021 10A NCAC 13F .1004(a) Medication Administration; G.S. 131D-21(4) Declaration of Resident's Rights A2 $13,500.00 4/20/2022 Appealed
The Ivy at Clemmons HAL-034-105 4/20/2021 G.S. § 131D-25 Implementation; G.S. 131D-21(4) Declaration of Resident's Rights A2 $18,000.00 4/20/2022 Appealed
The Ivy at Clemmons 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
The Ivy at Clemmons 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
The Ivy at Clemmons 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
The Ivy at Clemmons 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
The Ivy at Clemmons HAL-034-105 5/17/2022 10A NCAC 13F .1004(a) Medication Administration; G.S. 131D-21(4) Declaration of Resident's Rights A2 $15,000.00 12/21/2022

Franklin County

Facility Facility License Inspection Date & Nature of Validation Rules Areas Cited Level Cited Penalty Amount Date Penalty Imposed Current Status
Franklin Manor Assisted Living Center HAL-035-024 12/8/2021 10A NCAC 13F .0909 Resident Rights; G.S. 131D-21(2) Declaration of Resident's Rights A2 $2,000.00 8/5/2022 Appealed
Franklin Manor Assisted Living Center HAL-035-024 12/8/2021 10A NCAC 13F .0901(b) Personal Care and Supervision; G.S. 131D-21(4) Declaration of Resident's Rights Unabated A2 $50,250.00 8/5/2022 Appealed
Heart to Heart Family Care Home FCL-035-033 7/31/2020 10A NCAC 13G .0909 Residents' Rights; G.S. 131D-21(4) Declaration of Resident's Rights A2 $500.00 8/26/2021 Paid in Full
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 HAL-035-031 11/26/2019 10A NCAC 13F .0909 Resident Rights; G.S. 131D-21(4) Declaration of Resident's Rights A2 $9,000.00 8/7/2020 Settlement Agreement
Southern Living for Seniors of Louisburg, NC HAL-035-031 11/26/2019 10A NCAC 13F .1004(a) Medication Administration; G.S. 131D-21(4) Declaration of Resident's Rights A2 $9,000.00 8/7/2020 Settlement Agreement
Southern Living for Seniors of Louisburg, NC HAL-035-031 11/26/2019 G.S. § 131D-25 Implementation; G.S. 131D-21(2) Declaration of Resident's Rights A2 $9,000.00 8/7/2020 Settlement Agreement
Southern Living for Seniors of Louisburg, NC HAL-035-031 11/26/2019 G.S. 131D-21(5) Declaration of Resident's Rights; G.S. 131D-21(2) Declaration of Resident's Rights A2 $5,250.00 8/7/2020 Settlement Agreement
Southern Living for Seniors of Louisburg, NC HAL-035-031 8/14/2020 10A NCAC 13F .0909 Resident Rights; G.S. 131D-21(2) Declaration of Resident's Rights A2 $2,000.00 12/10/2021 Paid in Full
Southern Living for Seniors of Louisburg, NC HAL-035-031 8/4/2021 10A NCAC 13F .0909 Resident Rights; G.S. 131D-21(4) Declaration of Resident's Rights A2 $12,000.00 5/16/2022 Paid in Full
Southern Living for Seniors of Louisburg, NC 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

Gaston County

Facility Facility License Inspection Date & Nature of Validation Rules Areas Cited Level Cited Penalty Amount Date Penalty Imposed Current Status
Country Time Inn HAL-036-018 4/8/2020 10A NCAC 13F .1004(a) Medication Administration; G.S. 131D-21(4) Declaration of Resident's Rights A2 $2,000.00 8/26/2021 Paid in Full
Woodlawn Haven HAL-036-006 5/19/2020 10A NCAC 13F .0901(a) Personal Care and Supervision; G.S. 131D-21(2) Declaration of Resident's Rights A1 $10,500.00 8/26/2021 Paid in Full
Wellington House HAL-036-031 10/12/2020 10A NCAC 13F .0909 Resident Rights; G.S. 131D-21(4) Declaration of Resident's Rights A2 $3,500.00 8/26/2021 Settlement Agreement

Granville County

Facility Facility License Inspection Date & Nature of Validation Rules Areas Cited Level Cited Penalty Amount Date Penalty Imposed Current Status
Harris Home (Closed) FCL-039-002 7/2/2019 10A NCAC 13G .0901(b) Personal Care and Supervision; G.S. 131D-21(4) Declaration of Resident's Rights Unabated B $8,700.00 8/7/2020 Paid in Full
Toney Rest Home HAL-039-017 12/30/2020 10A NCAC 13F .1801 (a) (b) Infection Prevention & Control Program (Emer); G.S. 131D-21(4) Declaration of Resident's Rights A1 $12,000.00 9/9/2021 Settlement Agreement
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 (Closed) FCL-041-078 8/25/2020 10A NCAC 13G .0909 Residents' Rights; G.S. 131D-21(4) Declaration of Resident's Rights A2 $1,000.00 7/21/2021 Paid in Full
Alpha Concord of Greensboro HAL-041-082 3/29/2021 10A NCAC 13F .0901(c) Personal Care and Supervision; G.S. 131D-21(2) Declaration of Resident's Rights A1 $15,000.00 9/29/2021 Settlement Agreement
Brookdale High Point North AL (NC) HAL-041-039 1/14/2020 10A NCAC 13F .1004(a) Medication Administration; G.S. 131D-21(4) Declaration of Resident's Rights A2 $3,000.00 7/21/2021 Paid in Full
Brookdale Lawndale Park HAL-041-062 8/10/2018 10A NCAC 13F .0902(b) Health Care; G.S. 131D-21(2) Declaration of Resident's Rights Unabated B $700.00 9/23/2021 Paid in Full
Carriage House Senior Living Community HAL-041-065 7/20/2021 10A NCAC 13F .0901(b) Personal Care and Supervision; G.S. 131D-21(4) 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(4) Declaration of Resident's Rights A1 $7,000.00 6/10/2022 Paid in Full
Guilford House HAL-041-077 12/6/2019 10A NCAC 13F .1004(a) Medication Administration; G.S. 131D-21(4) Declaration of Resident's Rights Unabated B $6,400.00 6/14/2021 Settlement Agreement
Guilford House HAL-041-077 8/11/2021 10A NCAC 13F .0901(b) Personal Care and Supervision; G.S. 131D-21(2) Declaration of Resident's Rights A1 $16,000.00 6/10/2022 Settlement Agreement
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(2) 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(4) Declaration of Resident's Rights Unabated B $30,800.00 2/4/2022 Settlement Agreement
Liggins Family Care Woodmere Center (CLOSED) FCL-041-071 7/21/2020 10A NCAC 13G .0909 Residents' Rights; G.S. 131D-21(2) Declaration of Resident's Rights A2 $3,500.00 7/7/2021 Not Paid - Referred to Controller's Office
Liggins Family Care Woodmere Center (CLOSED) FCL-041-071 7/21/2020 10A NCAC 13G .0601(a) Management and Other Staff; G.S. 131D-21(2) Declaration of Resident's Rights A2 $3,500.00 7/7/2021 Paid in Full
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 7/10/2020 10A NCAC 13F .0909 Resident Rights; G.S. 131D-21(2) Declaration of Resident's Rights A1 $9,000.00 8/26/2021 Paid in Full
Piedmont Christian Home HAL-041-010 7/10/2020 G.S. § 131D-25 Implementation; G.S. 131D-21(2) Declaration of Resident's Rights A1 $9,000.00 8/26/2021 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 HAL-041-023 3/16/2022 10A NCAC 13F .1004(a) Medication Administration; G.S. 131D-21(4) Declaration of Resident's Rights A2 $4,000.00 8/5/2022 Appealed
St. Gales Estates 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 Appealed

Harnett County

Facility Facility License Inspection Date & Nature of Validation Rules Areas Cited Level Cited Penalty Amount Date Penalty Imposed Current Status
Alzheimer's Related Care of Dunn (Closed) HAL-043-026 2/27/2018 10A NCAC 13F .0901(b) Personal Care and Supervision; G.S. 131D-21(2) Declaration of Resident's Rights A2 $9,000.00 8/24/2020 Not Paid - Referred to Controller's Office
Alzheimer's Related Care of Dunn (Closed) HAL-043-026 3/15/2018 10A NCAC 13F .1004(a) Medication Administration; G.S. 131D-21(2) Declaration of Resident's Rights Unabated Type B $23,400.00 8/24/2020 Not Paid - Referred to Controller's Office
Alzheimer's Related Care of Dunn (Closed) HAL-043-026 6/27/2019 10A NCAC 13F .0909 Resident Rights; G.S. 131D-21(2) Declaration of Resident's Rights A2 $12,000.00 8/24/2020 Not Paid - Referred to Controller's Office
Alzheimer's Related Care of Dunn (Closed) HAL-043-026 10/9/2019 10A NCAC 13F .0305(h)(4) Physical Environment; G.S. 131D-21(4) Declaration of Resident's Rights A2 $18,000.00 8/24/2020 Not Paid - Referred to Controller's Office
Alzheimer's Related Care of Dunn (Closed) HAL-043-026 10/9/2019 10A NCAC 13F .0901(b) Personal Care and Supervision; G.S. 131D-21(2) Declaration of Resident's Rights A2 $20,000.00 8/24/2020 Not Paid - Referred to Controller's Office
Alzheimer's Related Care of Dunn (Closed) HAL-043-026 10/9/2019 10A NCAC 13F .0902(b) Health Care; G.S. 131D-21(4) Declaration of Resident's Rights A2 $16,000.00 8/24/2020 Not Paid - Referred to Controller's Office
Arc of Dunn (Closed) HAL-043-033 10/6/2020 10A NCAC 13F .0901(b) Personal Care and Supervision; G.S. 131D-21(2) Declaration of Resident's Rights A2 $6,000.00 8/26/2021 Not Paid - Referred to Controller's Office
Arc of Dunn (Closed) HAL-043-033 8/23/2021 10A NCAC 13F .0901(b) Personal Care and Supervision; G.S. 131D-21(2) 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(2) 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(4) 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 8/2/2019 10A NCAC 13F .0901(b) Personal Care and Supervision; G.S. 131D-21(4) Declaration of Resident's Rights A2 $250.00 8/7/2020 Paid in Full
Green Leaf Care Center HAL-043-027 1/15/2021 10A NCAC 13F .0902(b) Health Care; G.S. 131D-21(2) Declaration of Resident's Rights A1 $3,000.00 12/17/2021 Paid in Full
Johnson Better Care 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 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(2) Declaration of Resident's Rights A1 $7,000.00 3/16/2022 Settlement Agreement
Senter's Rest Home HAL-043-024 9/18/2019 10A NCAC 13F .0902(b) Health Care; G.S. 131D-21(4) Declaration of Resident's Rights A2 $1,500.00 8/7/2020 Paid in Full
Senter's Rest Home HAL-043-024 6/26/2020 10A NCAC 13F .0305(h)(4) Physical Environment; G.S. 131D-21(2) Declaration of Resident's Rights A2 $9,000.00 8/26/2021 Settlement Agreement

Haywood County

Facility Facility License Inspection Date & Nature of Validation Rules Areas Cited Level Cited Penalty Amount Date Penalty Imposed Current Status
Chestnut Park Retirement Center HAL-044-022 9/15/2020 10A NCAC 13F .0909 Resident Rights; G.S. 131D-21(4) Declaration of Resident's Rights A2 $1,000.00 8/31/2021 Paid in Full
McCracken Rest Home HAL-044-046 2/2/2021 10A NCAC 13F .0311(b) Other Requirements; G.S. 131D-21(4) Declaration of Resident's Rights A2 $2,000.00 5/16/2022 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(4) Declaration of Resident's Rights A1 $2,000.00 5/16/2022 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
The Gardens of Hendersonville HAL-045-129 5/14/2021 10A NCAC 13F .0306(a)(5) Housekeeping and Furnishings; G.S. 131D-21(4) Declaration of Resident's Rights A1 $1,000.00 3/16/2022 Paid in Full
The Landings of Mills River HAL-045-127 8/8/2019 10A NCAC 13F .0902(c)(3-4) Health Care; G.S. 131D-21(4) Declaration of Resident's Rights A2 $1,000.00 8/7/2020 Appealed

Hertford County

Facility Facility License Inspection Date & Nature of Validation Rules Areas Cited Level Cited Penalty Amount Date Penalty Imposed Current Status
Carver Manor (Closed) FCL-046-002 12/23/2020 10A NCAC 13G .1701 (a) (b) Infection Prevention & Control Program (emer); G.S. 131D-21(4) Declaration of Resident's Rights A2 $4,000.00 8/31/2021 Paid in Full
Carver Manor (Closed) FCL-046-002 4/28/2021 10A NCAC 13G .0302 (b) Design And Construction; G.S. 131D-21(4) 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(2) 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(2) Declaration of Resident's Rights A1 $7,000.00 3/16/2022 Paid in Full

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 6/7/2019 10A NCAC 13F .0901(b) Personal Care and Supervision; G.S. 131D-21(2) Declaration of Resident's Rights A2 $1,000.00 8/24/2020 Paid in Full
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
The Crossings at Wayside (Closed) HAL-047-011 8/15/2019 10A NCAC 13F .0901(a) Personal Care and Supervision; G.S. 131D-21(4) Declaration of Resident's Rights A2 $3,500.00 7/21/2021 Paid in Full
The Crossings at Wayside (Closed) HAL-047-011 8/15/2019 G.S. § 131D-25 Implementation; G.S. 131D-21(4) Declaration of Resident's Rights A2 $7,000.00 7/21/2021 Paid in Full
The Crossings at Wayside (Closed) HAL-047-011 8/15/2019 10A NCAC 13F .0909 Resident Rights; G.S. 131D-21(4) Declaration of Resident's Rights A2 $3,500.00 8/30/2021 Paid in Full
The Crossings at Wayside (Closed) HAL-047-011 8/20/2019 10A NCAC 13F .0901(b) Personal Care and Supervision; G.S. 131D-21(2) Declaration of Resident's Rights A2 $250.00 8/24/2020 Paid in Full
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
Brookdale Peachtree Memory Care HAL-049-021 11/15/2019 10A NCAC 13F .0909 Resident Rights; G.S. 131D-21(2) Declaration of Resident's Rights A1 $12,000.00 7/21/2021 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(4) Declaration of Resident's Rights A2 $2,000.00 9/21/2022 Appealed
The Hermitage HAL-050-017 12/15/2020 10A NCAC 13F .1801 (a) (b) Infection Prevention & Control Program (Emer); G.S. 131D-21(2) Declaration of Resident's Rights A2 $1,000.00 8/31/2021 Paid in Full
The Hermitage HAL-050-017 3/29/2022 10A NCAC 13F .0902(b) Health Care; G.S. 131D-21(4) Declaration of Resident's Rights A1 $4,000.00 12/21/2022

Johnston County

Facility Facility License Inspection Date & Nature of Validation Rules Areas Cited Level Cited Penalty Amount Date Penalty Imposed Current Status
Classic Care Homes #1 HAL-051-062 10/30/2019 10A NCAC 13F .1004(a) Medication Administration; G.S. 131D-21(2) Declaration of Resident's Rights Unabated B $18,000.00 3/1/2021 Settlement Agreement
Classic Care Homes #3 HAL-051-063 7/17/2019 10A NCAC 13F .0904(a)(2) Nutrition and Food Service; G.S. 131D-21(2) Declaration of Resident's Rights Unabated B $11,000.00 8/24/2020 Settlement Agreement
Classic Care Homes #3 HAL-051-063 9/10/2019 10A NCAC 13F .0507 Training On Cardio-Pulmonary Resuscitation; G.S. 131D-21(2) Declaration of Resident's Rights Continuing Unabated B $18,000.00 9/8/2021 Settlement Agreement
Clayton House HAL-051-041 4/1/2021 10A NCAC 13F .0901(b) Personal Care and Supervision; G.S. 131D-21(4) Declaration of Resident's Rights A2 $1,000.00 3/16/2022 Paid in Full
Four Oaks Senior Living HAL-051-060 8/11/2020 10A NCAC 13F .0311(d) Other Requirements; G.S. 131D-21(2) Declaration of Resident's Rights A1 $12,000.00 8/26/2021 Settlement Agreement
Freedom Care Services #1 (closed) FCL-051-070 7/2/2020 10A NCAC 13G .0601(a) Management and Other Staff; G.S. 131D-21(2) 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(2) Declaration of Resident's Rights A2 $2,000.00 12/17/2021 Paid in Full
Sam's Family Care Homes (Closed) FCL-051-067 7/10/2019 10A NCAC 13G .0601(a) Management and Other Staff; G.S. 131D-21(2) Declaration of Resident's Rights A1 $6,000.00 8/24/2020 Not Paid - Referred to Controller's Office
Sam's Family Care Homes (Closed) FCL-051-067 7/10/2019 10A NCAC 13G .0902(b) Health Care; G.S. 131D-21(2) Declaration of Resident's Rights A1 $3,500.00 8/24/2020 Not Paid - Referred to Controller's Office
The Villas @ Benson 1 FCL-051-056 12/2/2020 10A NCAC 13G .0601(d) Management and Other Staff; G.S. 131D-21(4) Declaration of Resident's Rights A2 $1,000.00 8/26/2021 Paid in Full
The Villas @ Benson 1 FCL-051-056 2/9/2021 10A NCAC 13G .0302 (b) Design And Construction; G.S. 131D-21(4) Declaration of Resident's Rights Unabated B $1,250.00 9/23/2021 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
Leak's Adult Family Care #3 (Closed) FCL-053-019 6/20/2019 10A NCAC 13G .0315(a)(5) Housekeeping and Furnishings; G.S. 131D-21(4) Declaration of Resident's Rights A1 $2,000.00 8/7/2020 Not Paid - Referred to Controller's Office
Magnolia House Retirement Center (Closed) HAL-053-029 5/6/2020 10A NCAC 13F .0901(b) Personal Care and Supervision; G.S. 131D-21(4) Declaration of Resident's Rights A1 $7,000.00 8/31/2021 Not Paid - Referred to Controller's Office
Sanford Manor HAL-053-030 10/26/2021 10A NCAC 13F .0901(c) Personal Care and Supervision; G.S. 131D-21(2) Declaration of Resident's Rights A1 $8,000.00 8/17/2022 Paid in Full

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(4) Declaration of Resident's Rights A2 $3,000.00 8/17/2022 Paid in Full
The Addison of Lincolnton HAL-055-009 8/31/2020 10A NCAC 13F .0909 Resident Rights; G.S. 131D-21(4) Declaration of Resident's Rights A1 $13,500.00 7/21/2021 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
Franklin House HAL-056-006 11/13/2018 10A NCAC 13F .0902(b) Health Care; G.S. 131D-21(4) Declaration of Resident's Rights A1 $7,000.00 11/13/2020 Settlement Agreement
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

Martin County

Facility Facility License Inspection Date & Nature of Validation Rules Areas Cited Level Cited Penalty Amount Date Penalty Imposed Current Status
Vintage Inn Retirement Community HAL-058-010 9/26/2019 10A NCAC 13F .0902(b) Health Care; G.S. 131D-21(4) Declaration of Resident's Rights A2 $10,500.00 3/1/2021 Appealed
Vintage Inn Retirement Community HAL-058-010 9/26/2019 G.S. § 131D-25 Implementation; G.S. 131D-21(2) Declaration of Resident's Rights A1 $14,000.00 3/1/2021 Appealed
Vintage Inn Retirement Community HAL-058-010 9/26/2019 10A NCAC 13F .0901(b) Personal Care and Supervision; G.S. 131D-21(2) Declaration of Resident's Rights A2 $5,250.00 3/1/2021 Settlement Agreement
Vintage Inn Retirement Community HAL-058-010 10/16/2020 10A NCAC 13F .0909 Resident Rights; G.S. 131D-21(4) Declaration of Resident's Rights A2 $16,000.00 8/26/2021 Settlement Agreement
Vintage Inn Retirement Community HAL-058-010 3/5/2021 10A NCAC 13F .0902(b) Health Care; G.S. 131D-21(4) Declaration of Resident's Rights A1 $15,000.00 2/4/2022 Appealed
Vintage Inn Retirement Community HAL-058-010 4/8/2022 10A NCAC 13F .0901(a) Personal Care and Supervision; G.S. 131D-21(4) Declaration of Resident's Rights A2 $8,000.00 12/21/2022 Appealed
Vintage Inn Retirement Community HAL-058-010 4/8/2022 10A NCAC 13F .0901(b) Personal Care and Supervision; G.S. 131D-21(4) Declaration of Resident's Rights A2 $5,250.00 12/21/2022 Appealed
Vintage Inn Retirement Community HAL-058-010 4/8/2022 10A NCAC 13F .1004(a) Medication Administration; G.S. 131D-21(2) Declaration of Resident's Rights A1 $7,000.00 12/21/2022 Appealed

McDowell County

Facility Facility License Inspection Date & Nature of Validation Rules Areas Cited Level Cited Penalty Amount Date Penalty Imposed Current Status
Lake James Lodge Assisted Living HAL-059-032 1/6/2020 10A NCAC 13F .1004(a) Medication Administration; G.S. 131D-21(2) Declaration of Resident's Rights A2 $500.00 3/1/2021 Paid in Full

Mecklenburg County

Facility Facility License Inspection Date & Nature of Validation Rules Areas Cited Level Cited Penalty Amount Date Penalty Imposed Current Status
Brighton Gardens of Charlotte HAL-060-029 11/25/2020 10A NCAC 13F .1004(a) Medication Administration; G.S. 131D-21(2) Declaration of Resident's Rights A1 $12,000.00 8/31/2021 Paid in Full
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(2) Declaration of Resident's Rights A2 $7,000.00 12/21/2022 Paid in Full
Brookdale Carriage Club Providence II HAL-060-049 6/16/2020 10A NCAC 13F .0901(b) Personal Care and Supervision; G.S. 131D-21(4) Declaration of Resident's Rights A2 $1,000.00 8/31/2021 Paid in Full
Brookdale Carriage Club Providence II HAL-060-049 11/6/2020 10A NCAC 13F .0901(b) Personal Care and Supervision; G.S. 131D-21(4) Declaration of Resident's Rights A2 $2,000.00 8/31/2021 Paid in Full
Brookdale South Charlotte HAL-060-101 8/19/2020 10A NCAC 13F .0909 Resident Rights; G.S. 131D-21(4) Declaration of Resident's Rights A2 $1,500.00 8/31/2021 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(4) 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(4) Declaration of Resident's Rights A1 $2,000.00 3/16/2022 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(4) Declaration of Resident's Rights A2 $1,000.00 8/5/2022 Paid in Full
Charlotte Square HAL-060-087 8/23/2019 10A NCAC 13F .0902(b) Health Care; G.S. 131D-21(4) Declaration of Resident's Rights A2 $2,000.00 8/24/2020 Paid in Full
Charlotte Square HAL-060-087 8/17/2020 10A NCAC 13F .1004(a) Medication Administration; G.S. 131D-21(4) Declaration of Resident's Rights A1 $2,000.00 8/31/2021 Paid in Full
Charlotte Square HAL-060-087 8/17/2020 10A NCAC 13F .0909 Resident Rights; G.S. 131D-21(2) Declaration of Resident's Rights A1 $15,000.00 8/31/2021 Paid in Full
Charlotte Square HAL-060-087 4/1/2021 10A NCAC 13F .0901(a) Personal Care and Supervision; G.S. 131D-21(2) Declaration of Resident's Rights A2 $7,000.00 9/30/2021 Paid in Full
Charlotte Square HAL-060-087 4/1/2021 10A NCAC 13F .0901(b) Personal Care and Supervision; G.S. 131D-21(4) Declaration of Resident's Rights A2 $7,000.00 9/30/2021 Paid in Full
Charlotte Square HAL-060-087 4/1/2021 10A NCAC 13F .0902(b) Health Care; G.S. 131D-21(2) Declaration of Resident's Rights A1 $14,000.00 9/30/2021 Paid in Full
East Towne HAL-060-149 7/29/2019 10A NCAC 13F .0902(c)(3-4) Health Care; G.S. 131D-21(4) Declaration of Resident's Rights A2 $15,000.00 10/1/2020 Settlement Agreement
East Towne HAL-060-149 7/29/2019 G.S. § 131D-25 Implementation; G.S. 131D-21(4) Declaration of Resident's Rights A1 $15,000.00 10/1/2020 Settlement Agreement
East Towne HAL-060-149 7/29/2019 10A NCAC 13F .0606 Staffing Chart; G.S. 131D-21(2) Declaration of Resident's Rights A2 $15,000.00 10/1/2020 Settlement Agreement
East Towne HAL-060-149 7/29/2019 10A NCAC 13F .0901(a) Personal Care and Supervision; G.S. 131D-21(2) Declaration of Resident's Rights A2 $15,000.00 10/1/2020 Settlement Agreement
East Towne HAL-060-149 7/29/2019 10A NCAC 13F .0901(b) Personal Care and Supervision; G.S. 131D-21(4) Declaration of Resident's Rights A2 $15,000.00 10/1/2020 Settlement Agreement
East Towne HAL-060-149 7/29/2019 10A NCAC 13F .0901(c) Personal Care and Supervision; G.S. 131D-21(2) Declaration of Resident's Rights A2 $15,000.00 10/1/2020 Settlement Agreement
East Towne HAL-060-149 7/29/2019 10A NCAC 13F .1004(a) Medication Administration; G.S. 131D-21(2) Declaration of Resident's Rights A1 $20,000.00 10/1/2020 Settlement Agreement
East Towne HAL-060-149 7/29/2019 10A NCAC 13F .0902(b) Health Care; G.S. 131D-21(2) Declaration of Resident's Rights Unabated A $146,000.00 10/1/2020 Settlement Agreement
East Towne HAL-060-149 10/18/2019 10A NCAC 13F .0902(b) Health Care; G.S. 131D-21(4) Declaration of Resident's Rights A2 $15,000.00 8/24/2020 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 A2 $15,000.00 2/4/2022 Appealed
East Towne HAL-060-149 7/15/2020 10A NCAC 13F .0901(c) Personal Care and Supervision; G.S. 131D-21(4) Declaration of Resident's Rights A1 $15,000.00 2/4/2022 Appealed
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 Appealed
East Towne HAL-060-149 7/15/2020 10A NCAC 13F .1004(a) Medication Administration; G.S. 131D-21(4) Declaration of Resident's Rights A2 $15,000.00 2/4/2022 Appealed
House of Peace FCL-060-153 4/6/2022 10A NCAC 13G .0902(b) Health Care; G.S. 131D-21(4) Declaration of Resident's Rights A1 $2,000.00 12/21/2022
Legacy Heights Senior Living Community HAL-060-152 11/22/2021 10A NCAC 13F .0901(b) Personal Care and Supervision; G.S. 131D-21(4) Declaration of Resident's Rights A2 $500.00 8/5/2022 Paid in Full
McClain's Family Care 1 FCL-060-123 9/4/2020 10A NCAC 13G .0909 Residents' Rights; G.S. 131D-21(4) Declaration of Resident's Rights A2 $1,000.00 7/21/2021 Paid in Full
McClain's Family Care 1 FCL-060-123 9/4/2020 10A NCAC 13G .0601(a) Management and Other Staff; G.S. 131D-21(4) Declaration of Resident's Rights A2 $1,000.00 7/21/2021 Paid in Full
Mint Hill Senior Living HAL-060-136 7/2/2020 10A NCAC 13F .0902(b) Health Care; G.S. 131D-21(4) Declaration of Resident's Rights A1 $9,000.00 8/26/2021 Settlement Agreement
Mint Hill Senior Living HAL-060-136 1/30/2020 10A NCAC 13F .0902(c)(3-4) Health Care; G.S. 131D-21(4) Declaration of Resident's Rights A1 $3,500.00 6/14/2021 Settlement Agreement
Mint Hill Senior Living HAL-060-136 12/11/2020 10A NCAC 13F .0311(a) Other Requirements; G.S. 131D-21(2) Declaration of Resident's Rights A2 $3,000.00 9/8/2021 Settlement Agreement
Northlake House HAL-060-150 6/16/2020 10A NCAC 13F .0901(b) Personal Care and Supervision; G.S. 131D-21(2) Declaration of Resident's Rights A2 $500.00 7/21/2021 Paid in Full
Parker Terrace HAL-060-054 10/3/2019 10A NCAC 13F .0902(b) Health Care; G.S. 131D-21(2) Declaration of Resident's Rights A1 $3,500.00 8/7/2020 Paid in Full
Queen City Assisted Living HAL-060-126 2/20/2020 10A NCAC 13F .1004(a) Medication Administration; G.S. 131D-21(4) Declaration of Resident's Rights A2 $5,250.00 8/26/2021 Settlement Agreement
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
Sunrise on Providence HAL-060-165 7/28/2020 10A NCAC 13F .0909 Resident Rights; G.S. 131D-21(2) Declaration of Resident's Rights A2 $4,000.00 8/26/2021 Paid in Full
Sunrise on Providence HAL-060-165 9/23/2020 10A NCAC 13F .0901(c) Personal Care and Supervision; G.S. 131D-21(2) Declaration of Resident's Rights A1 $16,000.00 8/31/2021 Paid in Full
TerraBella Little Avenue HAL-060-156 1/30/2020 10A NCAC 13F .0901(b) Personal Care and Supervision; G.S. 131D-21(2) Declaration of Resident's Rights A2 $500.00 8/24/2020 Paid in Full
The Charlotte Assisted Living HAL-060-158 8/6/2020 10A NCAC 13F .0902(b) Health Care; G.S. 131D-21(4) Declaration of Resident's Rights A2 $750.00 7/21/2021 Paid in Full
The Charlotte Assisted Living HAL-060-158 11/12/2020 10A NCAC 13F .0901(b) Personal Care and Supervision; G.S. 131D-21(4) Declaration of Resident's Rights A1 $4,000.00 8/31/2021 Paid in Full
The Charlotte Assisted Living HAL-060-158 11/12/2020 10A NCAC 13F .0909 Resident Rights; G.S. 131D-21(4) Declaration of Resident's Rights A2 $7,000.00 8/31/2021 Paid in Full
The Crossings at Steele Creek (Closed) HAL-060-130 11/14/2019 10A NCAC 13F .0704(a)(1) Resident Contract, Information On Home And; G.S. 131D-21(2) Declaration of Resident's Rights A1 $3,500.00 8/24/2020 Paid in Full
The Crossings at Steele Creek (Closed) HAL-060-130 3/5/2020 10A NCAC 13F .0901(c) Personal Care and Supervision; G.S. 131D-21(4) Declaration of Resident's Rights A2 $8,000.00 5/3/2021 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(2) 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(4) Declaration of Resident's Rights A2 $750.00 3/16/2022 Paid in Full
The Parc at Sharon Amity HAL-060-125 9/13/2019 10A NCAC 13F .1004(a) Medication Administration; G.S. 131D-21(2) Declaration of Resident's Rights A1 $9,000.00 10/1/2020 Settlement Agreement
The Parc at Sharon Amity HAL-060-125 9/13/2019 10A NCAC 13F .0902(b) Health Care; G.S. 131D-21(4) Declaration of Resident's Rights A2 $1,500.00 10/1/2020 Settlement Agreement
The Parc at Sharon Amity HAL-060-125 9/27/2019 10A NCAC 13F .0902(b) Health Care; G.S. 131D-21(2) Declaration of Resident's Rights A1 $5,250.00 10/1/2020 Settlement Agreement
The Parc at Sharon Amity HAL-060-125 9/27/2019 10A NCAC 13F .1004(a) Medication Administration; G.S. 131D-21(4) Declaration of Resident's Rights A2 $5,250.00 10/1/2020 Settlement Agreement
The Parc at Sharon Amity HAL-060-125 12/22/2020 10A NCAC 13F .1801 (a) (b) Infection Prevention & Control Program (Emer); G.S. 131D-21(4) Declaration of Resident's Rights A1 $6,000.00 8/31/2021 Appealed
The Parc at Sharon Amity HAL-060-125 1/20/2021 10A NCAC 13F .0902(b) Health Care; G.S. 131D-21(2) Declaration of Resident's Rights A2 $3,500.00 9/8/2021 Settlement Agreement
The Parc at Sharon Amity HAL-060-125 1/20/2021 10A NCAC 13F .0901(b) Personal Care and Supervision; G.S. 131D-21(2) Declaration of Resident's Rights A2 $3,500.00 9/8/2021 Settlement Agreement
The Parc at Sharon Amity HAL-060-125 1/20/2021 10A NCAC 13F .0909 Resident Rights; G.S. 131D-21(2) Declaration of Resident's Rights A1 $7,000.00 9/8/2021 Settlement Agreement
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 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(2) 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
Willow Ridge Assisted Living HAL-060-111 1/11/2021 10A NCAC 13F .0901(b) Personal Care and Supervision; G.S. 131D-21(4) 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(4) 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(4) 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 Appealed
Willow Ridge Assisted Living HAL-060-111 2/24/2022 10A NCAC 13F .0902(b) Health Care; G.S. 131D-21(2) Declaration of Resident's Rights A2 $5,250.00 8/31/2022 Appealed
Sunrise on Providence HAL-060-165 1/15/2021 10A NCAC 13F .0901(b) Personal Care and Supervision; G.S. 131D-21(4) 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(4) 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(4) Declaration of Resident's Rights Unabated B $8,000.00 6/10/2022 Appealed

Moore County

Facility Facility License Inspection Date & Nature of Validation Rules Areas Cited Level Cited Penalty Amount Date Penalty Imposed Current Status
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

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(4) Declaration of Resident's Rights A1 $500.00 8/17/2022 Paid in Full
Somerset Court of Rocky Mount HAL-064-029 2/28/2020 10A NCAC 13F .0901(b) Personal Care and Supervision; G.S. 131D-21(4) Declaration of Resident's Rights A2 $1,000.00 3/1/2021 Settlement Agreement
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(4) 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 Appealed
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 Appealed
Castle Creek Memory Care HAL-065-034 3/18/2021 10A NCAC 13F .1004(a) Medication Administration; G.S. 131D-21(2) Declaration of Resident's Rights A1 $12,000.00 8/17/2022 Appealed
Coastal Cove of Wilmington FCL-065-046 9/16/2020 10A NCAC 13G .0909 Residents' Rights; G.S. 131D-21(2) Declaration of Resident's Rights A2 $2,000.00 12/17/2021 Paid in Full
Morningside of Wilmington HAL-065-045 7/27/2020 10A NCAC 13F .0909 Resident Rights; G.S. 131D-21(2) Declaration of Resident's Rights A2 $1,000.00 8/31/2021 Paid in Full
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(2) 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(2) Declaration of Resident's Rights A2 $1,000.00 8/17/2022 Paid in Full
New Hanover House HAL-065-036 3/23/2018 10A NCAC 13F .0902(b) Health Care; G.S. 131D-21(2) Declaration of Resident's Rights A2 $250.00 8/31/2021 Paid in Full
New Hanover House HAL-065-036 3/23/2018 10A NCAC 13F .0901(b) Personal Care and Supervision; G.S. 131D-21(4) Declaration of Resident's Rights A2 $250.00 8/31/2021 Paid in Full
Spring Arbor of Wilmington HAL-065-014 11/1/2019 10A NCAC 13F .0902(b) Health Care; G.S. 131D-21(4) Declaration of Resident's Rights A1 $2,000.00 8/7/2020 Paid in Full
Spring Arbor of Wilmington HAL-065-014 11/1/2019 G.S. § 131D-25 Implementation; G.S. 131D-21(2) Declaration of Resident's Rights A1 $3,500.00 8/7/2020 Paid in Full
Spring Arbor of Wilmington HAL-065-014 11/10/2020 10A NCAC 13F .0909 Resident Rights; G.S. 131D-21(2) Declaration of Resident's Rights A1 $5,250.00 8/26/2021 Paid in Full
Spring Arbor of Wilmington HAL-065-014 11/10/2020 10A NCAC 13F .0901(b) Personal Care and Supervision; G.S. 131D-21(2) Declaration of Resident's Rights A1 $9,000.00 8/26/2021 Paid in Full

Northampton County

Facility Facility License Inspection Date & Nature of Validation Rules Areas Cited Level Cited Penalty Amount Date Penalty Imposed Current Status
Hampton Manor HAL-066-012 4/14/2020 10A NCAC 13F .0901(b) Personal Care and Supervision; G.S. 131D-21(2) Declaration of Resident's Rights A2 $9,000.00 3/1/2021 Settlement Agreement
Pine Forest Rest Home HAL-066-001 10/22/2020 10A NCAC 13F .0909 Resident Rights; G.S. 131D-21(4) Declaration of Resident's Rights A2 $4,000.00 8/31/2021 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 G.S. 131D-21(4) Declaration of Resident's Rights A1 $1,500.00 12/17/2021 Paid in Full
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
The ARC Community HAL-067-004 10/26/2020 10A NCAC 13F .0901(b) Personal Care and Supervision; G.S. 131D-21(4) Declaration of Resident's Rights A1 $12,000.00 8/26/2021 Settlement Agreement
The ARC Community HAL-067-004 10/26/2020 10A NCAC 13F .1501(b) Use Of Physical Restraints And Alternatives; G.S. 131D-21(4) Declaration of Resident's Rights A1 $12,000.00 8/26/2021 Settlement Agreement
The ARC Community HAL-067-004 10/26/2020 10A NCAC 13F .0601 (a) Management Of Facilities; G.S. 131D-21(4) Declaration of Resident's Rights A1 $14,000.00 8/26/2021 Settlement Agreement
The ARC Community HAL-067-004 10/26/2020 10A NCAC 13F .0902(b) Health Care; G.S. 131D-21(4) Declaration of Resident's Rights A1 $12,000.00 8/26/2021 Settlement Agreement

Orange County

Facility Facility License Inspection Date & Nature of Validation Rules Areas Cited Level Cited Penalty Amount Date Penalty Imposed Current Status
Cedar Grove Family Care Home # 1 FCL-068-031 9/15/2020 10A NCAC 13G .0909 Residents' Rights; G.S. 131D-21(4) Declaration of Resident's Rights A2 $1,000.00 7/7/2021 Paid in Full
Cedar Grove Family Care Home #2 FCL-068-033 9/15/2020 10A NCAC 13G .0909 Residents' Rights; G.S. 131D-21(4) Declaration of Resident's Rights A1 $1,000.00 8/31/2021 Paid in Full

Pender County

Facility Facility License Inspection Date & Nature of Validation Rules Areas Cited Level Cited Penalty Amount Date Penalty Imposed Current Status
Poplar Grove (Formerly named Ashe Gardens) HAL-071-015 9/24/2019 G.S. § 131D-25 Implementation; G.S. 131D-21(4) Declaration of Resident's Rights A1 $10,000.00 10/1/2020 Settlement Agreement
Poplar Grove (Formerly named Ashe Gardens) HAL-071-015 9/24/2019 10A NCAC 13F .0901(b) Personal Care and Supervision; G.S. 131D-21(2) Declaration of Resident's Rights A1 $20,000.00 10/1/2020 Settlement Agreement
Poplar Grove (Formerly named Ashe Gardens) HAL-071-015 9/24/2019 10A NCAC 13F .1004(a) Medication Administration; G.S. 131D-21(4) Declaration of Resident's Rights A1 $20,000.00 10/1/2020 Settlement Agreement
Poplar Grove (Formerly named Ashe Gardens) HAL-071-015 9/24/2019 10A NCAC 13F .0902(b) Health Care; G.S. 131D-21(4) Declaration of Resident's Rights A1 $10,000.00 10/1/2020 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 HAL-072-013 3/11/2020 10A NCAC 13F .0902(b) Health Care; G.S. 131D-21(2) Declaration of Resident's Rights A2 $4,000.00 5/3/2021 Settlement Agreement
Hertford Manor HAL-072-013 3/11/2020 10A NCAC 13F .0901(c) Personal Care and Supervision; G.S. 131D-21(4) Declaration of Resident's Rights A1 $16,000.00 5/3/2021 Settlement Agreement
Hertford Manor 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(4) 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

Pitt County

Facility Facility License Inspection Date & Nature of Validation Rules Areas Cited Level Cited Penalty Amount Date Penalty Imposed Current Status
Brookdale Dickinson Avenue HAL-074-011 10/7/2021 10A NCAC 13F .0902(b) Health Care; G.S. 131D-21(4) Declaration of Resident's Rights A2 $2,000.00 6/10/2022 Paid in Full
Brookdale W. Arlington Boulevard HAL-074-012 7/31/2019 10A NCAC 13F .0909 Resident Rights; G.S. 131D-21(4) Declaration of Resident's Rights A2 $1,000.00 8/31/2021 Paid in Full
Brookdale W. Arlington Boulevard HAL-074-012 7/31/2019 10A NCAC 13F .0902(b) Health Care; G.S. 131D-21(4) Declaration of Resident's Rights A1 $4,000.00 8/31/2021 Paid in Full
Care One Assisted Living of Greenville 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 HAL-074-044 6/11/2021 10A NCAC 13F .0906(f)(4) Other Resident Care and Services; G.S. 131D-21(2) Declaration of Resident's Rights A1 $7,000.00 3/16/2022 Paid in Full
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
Winterville Manor HAL-074-026 2/18/2020 10A NCAC 13F .0902(b) Health Care; G.S. 131D-21(4) Declaration of Resident's Rights A2 $1,000.00 8/26/2021 Settlement Agreement

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 Appealed
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 Appealed
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 Appealed
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 Appealed
North Pointe Assisted Living Of Archdale HAL-076-032 6/11/2021 10A NCAC 13F .0909 Resident Rights; G.S. 131D-21(4) 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(2) Declaration of Resident's Rights A2 $2,000.00 8/31/2022 Paid in Full
Hermitage Retirement Center HAL-077-012 12/3/2021 10A NCAC 13F .0901(b) Personal Care and Supervision; G.S. 131D-21(4) 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(4) Declaration of Resident's Rights A2 $500.00 8/31/2022 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
Covenant Care HAL-078-038 1/17/2021 10A NCAC 13F .0901(b) Personal Care and Supervision; G.S. 131D-21(4) Declaration of Resident's Rights A2 $2,000.00 8/31/2021 Paid in Full
Dial's Family Care Home # 10 FCL-078-079 5/31/2019 10A NCAC 13G .0909 Residents' Rights; G.S. 131D-21(4) Declaration of Resident's Rights A1 $2,000.00 8/24/2020 Paid in Full
Dial's Family Care Home #4 FCL-078-077 5/1/2019 10A NCAC 13G .0909 Residents' Rights; G.S. 131D-21(2) Declaration of Resident's Rights A2 $3,500.00 12/20/2021 Not Paid - Referred to Controller's Office
Lumberton Assisted Living HAL-078-084 12/12/2019 10A NCAC 13F .1205 Health Care Personnel Registry; G.S. 131D-21(4) Declaration of Resident's Rights A2 $7,000.00 3/1/2021 Settlement Agreement
Lumberton Assisted Living HAL-078-084 12/12/2019 10A NCAC 13F .0909 Resident Rights; G.S. 131D-21(4) Declaration of Resident's Rights A2 $4,000.00 3/1/2021 Settlement Agreement
Morning Star Assisted Living #3 HAL-078-065 2/5/2021 10A NCAC 13F .0305(h)(4) Physical Environment; G.S. 131D-21(4) Declaration of Resident's Rights A2 $1,000.00 8/31/2021 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(2) Declaration of Resident's Rights A1 $8,000.00 4/20/2022 Paid in Full
Brookdale Reidsville HAL-079-007 9/12/2019 10A NCAC 13F .1004(a) Medication Administration; G.S. 131D-21(4) Declaration of Resident's Rights A1 $7,000.00 8/7/2020 Settlement Agreement
Ezana's Scarlet Oaks (Closed) FCL-079-106 8/23/2019 10A NCAC 13G .0909 Residents' Rights; G.S. 131D-21(2) Declaration of Resident's Rights A2 $2,000.00 7/21/2021 Not Paid - Referred to Controller's Office
Faithworks Family Care Home FCL-079-067 9/26/2019 10A NCAC 13G .0901(a) Personal Care and Supervision; G.S. 131D-21(2) Declaration of Resident's Rights A1 $3,500.00 3/4/2020 Paid in Full
Faithworks Family Care Home FCL-079-067 9/26/2019 10A NCAC 13G .0909 Residents' Rights; G.S. 131D-21(4) Declaration of Resident's Rights A1 $3,500.00 3/4/2020 Paid in Full
Faithworks Family Care Home FCL-079-067 9/26/2019 10A NCAC 13G .0902(b) Health Care; G.S. 131D-21(4) Declaration of Resident's Rights A1 $3,500.00 3/4/2020 Paid in Full
R & D Wilson Home Care FCL-079-075 7/8/2021 10A NCAC 13G .0302 (b) Design And Construction; G.S. 131D-21(4) Declaration of Resident's Rights Unabated B $5,700.00 5/16/2022 Paid in Full

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 8/25/2020 10A NCAC 13F .0909 Resident Rights; G.S. 131D-21(4) Declaration of Resident's Rights A2 $7,000.00 7/7/2021 Paid in Full
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 Appealed
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 Appealed
Best of Care Assisted Living HAL-080-019 1/28/2020 10A NCAC 13F .1004(a) Medication Administration; G.S. 131D-21(4) Declaration of Resident's Rights A1 $12,000.00 2/15/2021 Settlement Agreement
Best of Care Assisted Living HAL-080-019 1/28/2020 10A NCAC 13F .0902(b) Health Care; G.S. 131D-21(2) Declaration of Resident's Rights A1 $12,000.00 2/15/2021 Settlement Agreement

Rutherford County

Facility Facility License Inspection Date & Nature of Validation Rules Areas Cited Level Cited Penalty Amount Date Penalty Imposed Current Status
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
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

Stanly County

Facility Facility License Inspection Date & Nature of Validation Rules Areas Cited Level Cited Penalty Amount Date Penalty Imposed Current Status
Woodhaven Court HAL-084-009 7/31/2020 10A NCAC 13F .0909 Resident Rights; G.S. 131D-21(6) Declaration of Resident's Rights A2 $3,000.00 8/26/2021 Settlement Agreement

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(4) 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

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-088-075 10/30/2020 10A NCAC 13F .0902(b) Health Care; G.S. 131D-21(4) Declaration of Resident's Rights A2 $2,000.00 8/26/2021 Appealed
Kingsbridge House HAL-088-075 10/30/2020 10A NCAC 13F .1004(a) Medication Administration; G.S. 131D-21(4) Declaration of Resident's Rights A2 $2,000.00 8/26/2021 Appealed
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 Appealed
Kingsbridge House HAL-088-015 1/22/2021 10A NCAC 13F .0902(b) Health Care; G.S. 131D-21(2) Declaration of Resident's Rights Unabated A2 $30,375.00 6/10/2022 Appealed
Kingsbridge House HAL-088-015 1/22/2021 10A NCAC 13F .1004(a) Medication Administration; G.S. 131D-21(2) Declaration of Resident's Rights Unabated A2 $37,500.00 12/17/2021 Appealed

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 5/17/2019 10A NCAC 13F .1308(a) Special Care Unit Staff; G.S. 131D-21(2) Declaration of Resident's Rights A2 $2,000.00 10/1/2020 Settlement Agreement
Tyrrell House HAL-089-002 5/17/2019 10A NCAC 13F .0902(b) Health Care; G.S. 131D-21(2) Declaration of Resident's Rights A1 $6,000.00 10/1/2020 Settlement Agreement
Tyrrell House HAL-089-002 5/17/2019 10A NCAC 13F .0901(a) Personal Care and Supervision; G.S. 131D-21(4) Declaration of Resident's Rights A2 $2,000.00 10/1/2020 Settlement Agreement
Tyrrell House HAL-089-002 5/17/2019 10A NCAC 13F .0901(b) Personal Care and Supervision; G.S. 131D-21(4) Declaration of Resident's Rights A1 $7,000.00 10/1/2020 Settlement Agreement
Tyrrell House HAL-089-002 5/17/2019 10A NCAC 13F .1205 Health Care Personnel Registry; G.S. 131D-21(2) Declaration of Resident's Rights A2 $1,000.00 10/1/2020 Settlement Agreement
Tyrrell House HAL-089-002 5/17/2019 G.S. § 131D-25 Implementation; G.S. 131D-21(2) Declaration of Resident's Rights A1 $7,000.00 10/1/2020 Settlement Agreement
Tyrrell House HAL-089-002 8/20/2019 10A NCAC 13F .0909 Resident Rights; G.S. 131D-21(2) Declaration of Resident's Rights A2 $1,500.00 10/1/2020 Settlement Agreement
Tyrrell House HAL-089-002 8/20/2019 10A NCAC 13F .1212(d) Reporting of Accidents and Incidents; G.S. 131D-21(2) Declaration of Resident's Rights A2 $1,500.00 10/1/2020 Settlement Agreement
Tyrrell House HAL-089-002 8/20/2019 10A NCAC 13F .1310 Other Applicable Rules For Special Care Units; G.S. 131D-21(4) Declaration of Resident's Rights A2 $1,500.00 10/1/2020 Settlement Agreement
Tyrrell House HAL-089-002 10/30/2019 10A NCAC 13F .1004(a) Medication Administration; G.S. 131D-21(4) Declaration of Resident's Rights Unabated B $11,850.00 10/1/2020 Settlement Agreement
Tyrrell House HAL-089-002 10/30/2019 10A NCAC 13F .0901(a) Personal Care and Supervision; G.S. 131D-21(4) Declaration of Resident's Rights Unabated A1 $69,750.00 10/1/2020 Settlement Agreement
Tyrrell House HAL-089-002 10/30/2019 G.S. § 131D-25 Implementation; G.S. 131D-21(2) Declaration of Resident's Rights Unabated A1 $69,750.00 10/1/2020 Settlement Agreement
Tyrrell House HAL-089-002 11/30/2020 10A NCAC 13F .0901(b) Personal Care and Supervision; G.S. 131D-21(2) Declaration of Resident's Rights A1 $13,500.00 8/26/2021 Settlement Agreement
Tyrrell House HAL-089-002 11/30/2020 10A NCAC 13F .1801 (a) (b) Infection Prevention & Control Program (Emer); G.S. 131D-21(2) Declaration of Resident's Rights A2 $9,000.00 8/26/2021 Settlement Agreement
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 Appealed

Union County

Facility Facility License Inspection Date & Nature of Validation Rules Areas Cited Level Cited Penalty Amount Date Penalty Imposed Current Status
Poplin Terrace (Closed) FCL-090-018 7/13/2020 10A NCAC 13G .0901(b) Personal Care and Supervision; G.S. 131D-21(2) Declaration of Resident's Rights A1 $3,500.00 6/11/2021 Settlement Agreement
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

Wake County

Facility Facility License Inspection Date & Nature of Validation Rules Areas Cited Level Cited Penalty Amount Date Penalty Imposed Current Status
Allcare Assisted Living (Closed) FCL-092-018 10/31/2019 10A NCAC 13G .0901(b) Personal Care and Supervision; G.S. 131D-21(4) Declaration of Resident's Rights A2 $500.00 7/7/2021 Paid in Full
Allcare Assisted Living (Closed) FCL-092-018 10/31/2019 10A NCAC 13G .0902(b) Health Care; G.S. 131D-21(4) Declaration of Resident's Rights A2 $500.00 7/7/2021 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(4) Declaration of Resident's Rights A1 $4,000.00 12/21/2022
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
Avendelle Assisted Living at Waterford Landing FCL-092-127 7/18/2019 10A NCAC 13G .0902(b) Health Care; G.S. 131D-21(4) Declaration of Resident's Rights A2 $500.00 9/8/2021 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(2) 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(2) Declaration of Resident's Rights A2 $1,000.00 9/16/2022 Paid in Full
Cadence Garner HAL-092-215 1/20/2021 10A NCAC 13F .0901(b) Personal Care and Supervision; G.S. 131D-21(2) Declaration of Resident's Rights A2 $4,000.00 8/31/2021 Paid in Full
Cadence Garner HAL-092-215 1/20/2021 10A NCAC 13F .1801 (c) Infection Prevention & Control Program (temp); G.S. 131D-21(4) Declaration of Resident's Rights A2 $1,000.00 8/31/2021 Paid in Full
Carillon Assisted Living of Knightdale (Closed) HAL-092-166 1/16/2020 10A NCAC 13F .0902(b) Health Care; G.S. 131D-21(2) Declaration of Resident's Rights A1 $4,000.00 6/14/2021 Not Paid - Referred to Controller's Office
Chatham Commons HAL-092-203 9/16/2019 10A NCAC 13F .0901(b) Personal Care and Supervision; G.S. 131D-21(2) Declaration of Resident's Rights A1 $6,000.00 9/14/2020 Settlement Agreement
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 Appealed
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 Appealed
Chatham Commons HAL-092-203 6/2/2021 10A NCAC 13F .0902(b) Health Care; G.S. 131D-21(4) Declaration of Resident's Rights Unabated A2 $67,500.00 4/20/2022 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(4) Declaration of Resident's Rights A2 $1,000.00 12/21/2022
Heart to Live 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
Heartfields at Cary HAL-092-156 5/13/2019 10A NCAC 13F .0902(b) Health Care; G.S. 131D-21(2) Declaration of Resident's Rights Unabated A1 $55,500.00 9/14/2020 Paid in Full
Kelley's Family at Drayton Reserve FCL-092-251 7/3/2019 10A NCAC 13G .0317(d) Building Service Equipment; G.S. 131D-21(4) Declaration of Resident's Rights A2 $1,000.00 8/24/2020 Paid in Full
Morningside of Raleigh HAL-092-217 12/22/2020 10A NCAC 13F .0901(b) Personal Care and Supervision; G.S. 131D-21(1) Declaration of Resident's Rights A2 $500.00 8/26/2021 Paid in Full
Morningside of Raleigh HAL-092-217 3/30/2022 10A NCAC 13F .0901(a) Personal Care and Supervision; G.S. 131D-21(2) Declaration of Resident's Rights A1 $14,000.00 12/21/2022 Paid in Full
Novelty Healthcare III FCL-092-249 2/28/2020 10A NCAC 13G .0902(b) Health Care; G.S. 131D-21(2) Declaration of Resident's Rights A2 $500.00 3/1/2021 Paid in Full
Novelty Healthcare III FCL-092-249 2/28/2020 10A NCAC 13G .0906 (f)(1)-(4) Other Resident Services; G.S. 131D-21(2) Declaration of Resident's Rights A2 $500.00 3/1/2021 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 6/21/2019 10A NCAC 13F .0902(b) Health Care; G.S. 131D-21(2) Declaration of Resident's Rights A2 $5,250.00 8/7/2020 Settlement Agreement
Oliver House HAL-092-182 12/22/2020 10A NCAC 13F .1801 (a) (b) Infection Prevention & Control Program (Emer); G.S. 131D-21(2) Declaration of Resident's Rights A1 $9,000.00 8/26/2021 Settlement Agreement
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(2) 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(2) 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(2) 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(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 .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(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 .1004(a) Medication Administration; G.S. 131D-21(4) Declaration of Resident's Rights A2 $3,500.00 5/16/2022 Settlement Agreement
Spring Arbor of Cary HAL-092-204 9/13/2021 10A NCAC 13F .0901(b) Personal Care and Supervision; G.S. 131D-21(4) Declaration of Resident's Rights A2 $1,000.00 6/10/2022 Paid in Full
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
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 Appealed
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 Appealed
The Addison of Fuquay-Varina HAL-092-219 8/6/2021 10A NCAC 13F .0901(b) Personal Care and Supervision; 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 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
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 Appealed
The Addison of Fuquay-Varina HAL-092-219 9/3/2021 10A NCAC 13F .0909 Resident Rights; A1 $7,000.00 8/17/2022 Appealed
The Addison of Fuquay-Varina HAL-092-219 11/12/2021 10A NCAC 13F .0902(b) Health Care; G.S. 131D-21(4) Declaration of Resident's Rights Unabated A2 $64,500.00 8/17/2022 Appealed
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 .0309 (d) Plan For Evacuation; G.S. 131D-21(4) Declaration of Resident's Rights A2 $4,000.00 8/31/2022 Appealed
The Addison of Knightdale HAL-092-220 2/8/2022 10A NCAC 13F .0311(a) Other Requirements; G.S. 131D-21(2) Declaration of Resident's Rights A2 $4,000.00 8/31/2022 Appealed
The Addison of Knightdale HAL-092-220 2/8/2022 10A NCAC 13F .0605 Staffing Of Personal Care Aide Supervisors; G.S. 131D-21(2) Declaration of Resident's Rights A2 $4,000.00 8/31/2022 Appealed
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 Appealed
The Addison of Knightdale HAL-092-220 2/8/2022 10A NCAC 13F .1004(a) Medication Administration; G.S. 131D-21(2) Declaration of Resident's Rights A2 $2,000.00 8/31/2022 Appealed
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 Appealed
The Covington HAL-092-181 3/12/2020 10A NCAC 13F .0901(b) Personal Care and Supervision; G.S. 131D-21(4) Declaration of Resident's Rights A2 $2,000.00 5/3/2021 Settlement Agreement
Wake Assisted Living HAL-092-144 3/19/2021 10A NCAC 13F .1004(a) Medication Administration; G.S. 131D-21(4) Declaration of Resident's Rights A2 $2,000.00 4/20/2022 Paid in Full
Waltonwood Lake Boone HAL-092-210 9/26/2019 10A NCAC 13F .0901(b) Personal Care and Supervision; G.S. 131D-21(4) Declaration of Resident's Rights A2 $1,000.00 6/14/2021 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
Pivotal Care (Closed) FCL-093-012 11/4/2020 10A NCAC 13G .0601(a) Management and Other Staff; G.S. 131D-21(4) Declaration of Resident's Rights A1 $6,000.00 7/7/2021 Not Paid - Referred to Controller's Office
Pivotal Care (Closed) FCL-093-012 11/4/2020 10A NCAC 13G .0902(b) Health Care; G.S. 131D-21(2) Declaration of Resident's Rights A1 $3,500.00 7/7/2021 Not Paid - Referred to Controller's Office
Pivotal Care (Closed) FCL-093-012 11/4/2020 10A NCAC 13G .1701 (a) (b) Infection Prevention & Control Program (emer); G.S. 131D-21(2) Declaration of Resident's Rights A1 $1,750.00 7/7/2021 Not Paid - Referred to Controller's Office
Pivotal Care (Closed) FCL-093-012 2/5/2021 10A NCAC 13G .1004(a) Medication Administration; G.S. 131D-21(4) 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(2) 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(2) 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(2) 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(2) 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 4.4A (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
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(4) Declaration of Resident's Rights Unabated B $17,900.00 4/20/2022 Not Paid - Referred to Controller's Office

Washington County

Facility Facility License Inspection Date & Nature of Validation Rules Areas Cited Level Cited Penalty Amount Date Penalty Imposed Current Status
Marie Webb's Family Home Care (Closed) FCL-094-003 6/2/2020 10A NCAC 13G .0901(b) Personal Care and Supervision; G.S. 131D-21(2) Declaration of Resident's Rights A2 $2,000.00 8/26/2021 Settlement Agreement

Wayne County

Facility Facility License Inspection Date & Nature of Validation Rules Areas Cited Level Cited Penalty Amount Date Penalty Imposed Current Status
Woodard's Retirement Village HAL-096-009 10/2/2020 10A NCAC 13F .0902(b) Health Care; G.S. 131D-21(4) Declaration of Resident's Rights A1 $7,000.00 11/8/2021 Settlement Agreement
Woodard's Retirement Village HAL-096-009 10/2/2020 G.S. § 131D-25 Implementation; G.S. 131D-21(4) Declaration of Resident's Rights A1 $14,000.00 11/8/2021 Settlement Agreement
You're At Home With Sozo (Closed) FCL-096-052 7/7/2020 10A NCAC 13G .0909 Residents' Rights; G.S. 131D-21(4) Declaration of Resident's Rights A2 $2,000.00 8/26/2021 Paid in Full
You're At Home With Sozo (Closed) FCL-096-052 7/7/2020 10A NCAC 13G .0601(a) Management and Other Staff; G.S. 131D-21(4) Declaration of Resident's Rights A2 $2,000.00 8/26/2021 Paid in Full
Countryside Village HAL-096-049 2/14/2020 10A NCAC 13F .0902(b) Health Care; G.S. 131D-21(2) Declaration of Resident's Rights A2 $3,500.00 3/1/2021 Paid in Full
Countryside Village HAL-096-049 2/14/2020 10A NCAC 13F .1004(a) Medication Administration; G.S. 131D-21(4) Declaration of Resident's Rights A1 $1,500.00 3/1/2021 Paid in Full
Countryside Village HAL-096-049 8/24/2020 10A NCAC 13F .0902(b) Health Care; G.S. 131D-21(2) Declaration of Resident's Rights A2 $4,000.00 8/26/2021 Settlement Agreement
Countryside Village HAL-096-049 8/24/2020 10A NCAC 13F .0909 Resident Rights; G.S. 131D-21(2) Declaration of Resident's Rights A1 $9,000.00 8/26/2021 Settlement Agreement
Countryside Village HAL-096-049 8/24/2020 10A NCAC 13F .1212(d) Reporting of Accidents and Incidents; G.S. 131D-21(4) Declaration of Resident's Rights A2 $4,000.00 8/26/2021 Settlement Agreement
Countryside Village HAL-096-049 8/24/2020 G.S. § 131D-25 Implementation; G.S. 131D-21(4) Declaration of Resident's Rights A1 $9,000.00 8/26/2021 Settlement Agreement
Countryside Village HAL-096-049 8/24/2020 10A NCAC 13F .1205 Health Care Personnel Registry; G.S. 131D-21(4) Declaration of Resident's Rights A1 $9,000.00 8/26/2021 Settlement Agreement
Eagle's Pointe HAL-096-051 8/26/2019 10A NCAC 13F .1004(a) Medication Administration; G.S. 131D-21(4) Declaration of Resident's Rights A1 $4,000.00 6/14/2021 Settlement Agreement
Eagle's Pointe HAL-096-051 12/16/2019 10A NCAC 13F .0901(b) Personal Care and Supervision; G.S. 131D-21(4) Declaration of Resident's Rights A1 $7,000.00 7/21/2021 Appealed
Eagle's Pointe HAL-096-051 7/16/2020 10A NCAC 13F .0901(b) Personal Care and Supervision; G.S. 131D-21(4) Declaration of Resident's Rights A1 $10,500.00 8/26/2021 Appealed
Eagle's Pointe HAL-096-051 7/16/2020 10A NCAC 13F .0902(b) Health Care; G.S. 131D-21(2) Declaration of Resident's Rights A2 $5,250.00 8/26/2021 Appealed
Eagle's Pointe HAL-096-051 7/16/2020 10A NCAC 13F .0909 Resident Rights; G.S. 131D-21(2) Declaration of Resident's Rights A2 $5,250.00 8/26/2021 Appealed
Eagle's Pointe HAL-096-051 7/16/2020 G.S. § 131D-25 Implementation; G.S. 131D-21(2) Declaration of Resident's Rights A1 $4,000.00 8/26/2021 Settlement Agreement
Eagle's Pointe HAL-096-051 7/16/2020 10A NCAC 13F .1004(a) Medication Administration; G.S. 131D-21(2) Declaration of Resident's Rights A1 $9,000.00 8/26/2021 Appealed
Fremont Rest Center HAL-096-024 4/16/2021 10A NCAC 13F .0901(b) Personal Care and Supervision; G.S. 131D-21(4) Declaration of Resident's Rights A1 $4,000.00 8/31/2021 Settlement Agreement
Fremont Rest Center HAL-096-024 4/16/2021 10A NCAC 13F .0901(b) Personal Care and Supervision; G.S. 131D-21(4) Declaration of Resident's Rights A2 $5,250.00 4/20/2022 Appealed
Fremont Rest Center HAL-096-024 4/16/2021 10A NCAC 13F .0901(c) Personal Care and Supervision; G.S. 131D-21(2) Declaration of Resident's Rights A1 $2,000.00 4/20/2022 Appealed
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 Appealed
Fremont Rest Center HAL-096-024 4/16/2021 10A NCAC 13F .0909 Resident Rights; G.S. 131D-21(4) Declaration of Resident's Rights A2 $3,500.00 4/20/2022 Appealed
Fremont Rest Center HAL-096-024 4/16/2021 10A NCAC 13F .1205 Health Care Personnel Registry; G.S. 131D-21(2) Declaration of Resident's Rights A2 $3,500.00 4/20/2022 Appealed
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
Somerset Court of Goldsboro HAL-096-047 12/4/2020 10A NCAC 13F .0901(b) Personal Care and Supervision; G.S. 131D-21(4) 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 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 3/1/2021 10A NCAC 13F .0902(b) Health Care; G.S. 131D-21(2) Declaration of Resident's Rights A2 $2,000.00 8/17/2022 Appealed
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 Appealed
Somerset Court of Goldsboro HAL-096-047 9/23/2021 10A NCAC 13F .1004(a) Medication Administration; G.S. 131D-21(4) Declaration of Resident's Rights Unabated B $14,500.00 8/17/2022 Appealed
Woodard's Retirement Village HAL-096-009 10/2/2020 10A NCAC 13F .1308(a) Special Care Unit Staff; G.S. 131D-21(4) Declaration of Resident's Rights A1 $14,000.00 11/8/2021 Settlement Agreement
Woodard's Retirement Village HAL-096-009 10/2/2020 10A NCAC 13F .0901(b) Personal Care and Supervision; G.S. 131D-21(4) Declaration of Resident's Rights A2 $4,000.00 11/8/2021 Settlement Agreement

Wilkes County

Facility Facility License Inspection Date & Nature of Validation Rules Areas Cited Level Cited Penalty Amount Date Penalty Imposed Current Status
Rose Glen Manor HAL-097-015 11/6/2019 10A NCAC 13F .1004(a) Medication Administration; G.S. 131D-21(4) Declaration of Resident's Rights Unabated B $3,750.00 8/24/2020 Settlement Agreement

Wilson County

Facility Facility License Inspection Date & Nature of Validation Rules Areas Cited Level Cited Penalty Amount Date Penalty Imposed Current Status
Called 2 Care Family Home #3 (Closed) FCL-098-034 1/31/2020 10A NCAC 13G .0601 (b)(2) Management And Other Staff; G.S. 131D-21(2) Declaration of Resident's Rights A2 $2,000.00 6/14/2021 Settlement Agreement
Called 2 Care Family Home #3 (Closed) FCL-098-034 5/15/2020 10A NCAC 13G .0909 Residents' Rights; G.S. 131D-21(4) Declaration of Resident's Rights A2 $2,000.00 6/14/2021 Settlement Agreement
Called 2 Care Family Home #3 (Closed) FCL-098-034 5/15/2020 10A NCAC 13G .0302 (b) Design And Construction; G.S. 131D-21(4) Declaration of Resident's Rights Unabated B $9,975.00 9/8/2021 Settlement Agreement
Parkwood Village HAL-098-030 10/15/2019 10A NCAC 13F .0901(b) Personal Care and Supervision; G.S. 131D-21(4) Declaration of Resident's Rights A1 $7,000.00 8/26/2021 Paid in Full
Wilson Assisted Living HAL-098-027 7/16/2019 10A NCAC 13F .0901(b) Personal Care and Supervision; G.S. 131D-21(2) Declaration of Resident's Rights A2 $8,000.00 9/14/2020 Paid in Full
Wilson Assisted Living HAL-098-027 7/16/2019 G.S. § 131D-25 Implementation; G.S. 131D-21(4) Declaration of Resident's Rights A2 $9,000.00 9/14/2020 Paid in Full
Wilson Assisted Living HAL-098-027 9/28/2020 10A NCAC 13F .0902(b) Health Care; G.S. 131D-21(4) Declaration of Resident's Rights A1 $15,000.00 8/26/2021 Paid in Full
Wilson Assisted Living HAL-098-027 9/28/2020 10A NCAC 13F .0901(b) Personal Care and Supervision; G.S. 131D-21(4) Declaration of Resident's Rights A1 $15,000.00 8/26/2021 Paid in Full
Wilson Assisted Living HAL-098-027 2/15/2021 10A NCAC 13F .0902(b) Health Care; G.S. 131D-21(4) Declaration of Resident's Rights A2 $12,000.00 8/31/2021 Paid in Full
Wilson House HAL-098-023 3/10/2020 10A NCAC 13F .0909 Resident Rights; G.S. 131D-21(2) Declaration of Resident's Rights A1 $4,000.00 5/3/2021 Settlement Agreement
Wilson House HAL-098-023 6/8/2020 10A NCAC 13F .1308(a) Special Care Unit Staff; G.S. 131D-21(2) Declaration of Resident's Rights A2 $3,500.00 7/21/2021 Settlement Agreement
Wilson House HAL-098-023 6/8/2020 10A NCAC 13F .0902(b) Health Care; G.S. 131D-21(4) Declaration of Resident's Rights A2 $10,000.00 7/21/2021 Settlement Agreement
Wilson House HAL-098-023 6/8/2020 G.S. § 131D-25 Implementation; G.S. 131D-21(2) Declaration of Resident's Rights A1 $8,000.00 7/21/2021 Settlement Agreement
Wilson House HAL-098-023 6/8/2020 10A NCAC 13F .0901(b) Personal Care and Supervision; G.S. 131D-21(2) Declaration of Resident's Rights A2 $3,500.00 7/21/2021 Settlement Agreement
Wilson House HAL-098-023 6/8/2020 10A NCAC 13F .0909 Resident Rights; G.S. 131D-21(4) Declaration of Resident's Rights A1 $8,000.00 7/21/2021 Settlement Agreement
Wilson House HAL-098-023 12/22/2021 10A NCAC 13F .1004(a) Medication Administration; G.S. 131D-21(4) Declaration of Resident's Rights A1 $14,000.00 8/31/2022 Appealed

Yadkin County

Facility Facility License Inspection Date & Nature of Validation Rules Areas Cited Level Cited Penalty Amount Date Penalty Imposed Current Status
Patriot Living of Yadkinville HAL-099-015 3/11/2020 10A NCAC 13F .0902(b) Health Care; G.S. 131D-21(2) Declaration of Resident's Rights A1 $3,000.00 8/26/2021 Paid in Full

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 HAL-100-006 10/16/2019 10A NCAC 13F .0901(b) Personal Care and Supervision; G.S. 131D-21(4) Declaration of Resident's Rights A2 $16,000.00 8/7/2020 Settlement Agreement
Southern Living for Seniors of Burnsville, NC HAL-100-006 10/16/2019 10A NCAC 13F .0902(b) Health Care; G.S. 131D-21(4) Declaration of Resident's Rights Unabated A2 $126,000.00 8/7/2020 Settlement Agreement
Southern Living for Seniors of Burnsville, NC 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 Appealed
Southern Living for Seniors of Burnsville, NC HAL-100-006 2/18/2022 10A NCAC 13F .0604(e) Personal Care And Other Staffing; G.S. 131D-21(4) Declaration of Resident's Rights A2 $16,000.00 8/17/2022 Appealed
Southern Living for Seniors of Burnsville, NC HAL-100-006 2/18/2022 10A NCAC 13F .0601 (b) Management Of Facilities With A Capacity Or; G.S. 131D-21(2) Declaration of Resident's Rights A1 $20,000.00 8/17/2022 Appealed
Southern Living for Seniors of Burnsville, NC HAL-100-006 3/17/2022 10A NCAC 13F .0601 (b) Management Of Facilities With A Capacity Or; G.S. 131D-21(2) Declaration of Resident's Rights Unabated A2 $3,750.00 8/17/2022 Appealed
Southern Living for Seniors of Burnsville, NC 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 Appealed
Southern Living for Seniors of Burnsville, NC 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 Appealed
Southern Living for Seniors of Burnsville, NC HAL-100-006 3/17/2022 10A NCAC 13F .1205 Health Care Personnel Registry; G.S. 131D-21(2) Declaration of Resident's Rights A1 $20,000.00 8/17/2022 Appealed
Southern Living for Seniors of Burnsville, NC HAL-100-006 5/10/2022 10A NCAC 13F .0909 Resident Rights; G.S. 131D-21(2) Declaration of Resident's Rights A1 $2,000.00 8/17/2022 Appealed
Southern Living for Seniors of Burnsville, NC 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 Appealed
Southern Living for Seniors of Burnsville, NC HAL-100-006 5/10/2022 10A NCAC 13F .0305(h)(4) Physical Environment; G.S. 131D-21(2) Declaration of Resident's Rights A1 $20,000.00 8/17/2022 Appealed
Southern Living for Seniors of Burnsville, NC HAL-100-006 5/10/2022 10A NCAC 13F .0407(a)(7) Other Staff Qualifications; G.S. 131D-21(2) Declaration of Resident's Rights A2 $20,000.00 8/17/2022 Appealed
Southern Living for Seniors of Burnsville, NC 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 Appealed
Southern Living for Seniors of Burnsville, NC 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 Appealed
Southern Living for Seniors of Burnsville, NC 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 Appealed
Southern Living for Seniors of Burnsville, NC HAL-100-006 5/10/2022 10A NCAC 13F .0901(c) Personal Care and Supervision; G.S. 131D-21(2) Declaration of Resident's Rights A1 $20,000.00 8/17/2022 Appealed
Southern Living for Seniors of Burnsville, NC 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 Appealed
Southern Living for Seniors of Burnsville, NC 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 Appealed