| License Number: | HAL-066-001 |
| Site Address: |
3277 HWY 35 Woodland, NC 27897 |
| County: | Northampton |
| Capacity: | 24 Beds |
Statements of Deficiencies (form used by the state to document inspections) are posted for adult care facilities with survey dates beginning November 1, 2014 and deficiencies or violations were identified.
Note: A Yes under the column, IDR Pending, indicates the facility has requested Informal Dispute Resolution (IDR), a process that gives a facility the opportunity to dispute all or some of the findings of a state inspection. If the Statement of Deficiency is changed as a result of IDR, the web page will be updated.
| Inspection Type | Document Type | Inspection Date | Pages | IDR Pending |
|---|---|---|---|---|
| ACLS Follow-up | No Deficiencies Cited | 3/4/2021 | No | |
| Other | Statement of Deficiency with Plan of Correction | 10/22/2020 | 13 | No |
| Other | Statement of Deficiency | 10/22/2020 | 13 | No |
| ACLS Follow-up | Statement of Deficiency with Plan of Correction | 1/23/2020 | 8 | No |
| ACLS Annual and Follow-up | Statement of Deficiency | 9/19/2019 | 37 | No |
| ACLS Annual | Statement of Deficiency with Plan of Correction | 1/13/2016 | 8 | No |
| ACLS Annual | Statement of Deficiency | 1/13/2016 | 7 | No |
| Constr Biennial Follow-up | No Deficiencies Cited | 9/4/2018 | 0 | No |
| Constr Biennial | Statement of Deficiency with Plan of Correction | 8/2/2018 | 1 | No |
| Constr Biennial | Statement of Deficiency | 8/2/2018 | 1 | No |
| Constr Biennial Follow-up | No Deficiencies Cited | 10/28/2016 | 0 | No |
| Constr Biennial | Statement of Deficiency with Plan of Correction | 8/24/2016 | 6 | No |
| Constr Biennial | Statement of Deficiency | 8/24/2016 | 6 | No |
Star Ratings are based on the results of DHSR inspections and some inspections by the County Department of Social Services (DSS).
| Stars | Score | Issue Date | Merits | Demerits | Inspection Type | ||
|---|---|---|---|---|---|---|---|
|
(3) | 102.5 | 5/11/2022 | 2.5 | 0 | Annual | View Worksheet |
|
|
(3) | 91 | 4/27/2020 | 7.5 | 0 | Follow-up | View Worksheet |
|
(2) | 83.5 | 3/4/2020 | 1 | 17.5 | Annual | View Worksheet |
|
(4) | 103.5 | 2/10/2016 | 3.5 | 0 | Annual | View Worksheet |
|
|
(4) | 103.5 | 9/6/2013 | 3.5 | 0 | Annual | View Worksheet |
|
|
(4) | 103.5 | 6/27/2012 | 3.5 | 0 | Annual | View Worksheet |
|
|
(3) | 103.5 | 6/21/2011 | 3.5 | 0 | Annual | View Worksheet |
|
|
(3) | 99 | 3/24/2010 | 1 | 2 | Annual | View Worksheet |
|
|
(3) | 101 | 5/19/2009 | 1 | 0 | Annual | View Worksheet |
Penalties imposed during the last 36 months are listed.
| Facility | Facility License | Inspection Date & Nature of Validation | Rules Areas Cited | Level Cited | Penalty Amount | Date Penalty Imposed | Current Status |
|---|---|---|---|---|---|---|---|
| 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 | 4000 | 8/31/2021 | Paid in Full |