Evergreen Living Home #1

Facility Information

License Number: FCL-011-193
Site Address: 101 Country Time Lane
Leicester, NC 28748
County:Buncombe
Capacity: 6 Beds

Statement of Deficiencies

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 TypeDocument TypeInspection DatePagesIDR Pending
ACLS Annual and Follow-up No Deficiencies Cited 3/30/2021 No
ACLS Annual and Follow-up No Deficiencies Cited 3/13/2019 No
ACLS Annual Statement of Deficiency with Plan of Correction 10/11/2017 4 No
ACLS Annual and Follow-up No Deficiencies Cited 10/22/2015 No
Constr Biennial Statement of Deficiency with Plan of Correction 11/15/2023 6 No
Constr Biennial No Deficiencies Cited 5/24/2018 0 No
Constr Complaint Follow-up No Deficiencies Cited 6/10/2015 0 No
Constr Complaint Follow-up Statement of Deficiency with Plan of Correction 3/25/2015 3 No
Constr Complaint Follow-up Statement of Deficiency 3/25/2015 3 No
Constr Biennial Follow-up No Deficiencies Cited 3/25/2015 0 No
Constr Complaint Follow-up Statement of Deficiency with Plan of Correction 2/11/2015 2 No
Constr Biennial Follow-up Statement of Deficiency with Plan of Correction 2/11/2015 3 No
Constr Complaint Follow-up Statement of Deficiency 2/11/2015 2 No
Constr Biennial Follow-up Statement of Deficiency 2/11/2015 2 No
Constr Biennial Statement of Deficiency with Plan of Correction 12/30/2014 2 No
Constr Complaint Statement of Deficiency with Plan of Correction 12/30/2014 2 No
Constr Biennial Statement of Deficiency 12/30/2014 2 No
Constr Complaint Statement of Deficiency 12/30/2014 2 No

Star Rating

Star Ratings are based on the results of DHSR inspections and some inspections by the County Department of Social Services (DSS).

StarsScoreIssue DateMeritsDemeritsInspection Type 
Four Stars (4) 102.5 5/10/2023 2.5 0 Annual View Worksheet
Four Stars (4) 100 5/29/2021 0 0 Annual View Worksheet
Four Stars (4) 103.5 5/9/2019 3.5 0 Annual View Worksheet
Four Stars (4) 100.5 12/1/2017 2.5 2 Annual View Worksheet
Four Stars (4) 102.5 11/5/2015 2.5 0 Annual View Worksheet
Three Stars (3) 97.5 7/16/2015 5 0 Reissue View Worksheet
Three Stars (3) 92.5 4/7/2015 0 10 Reissue View Worksheet
Four Stars (4) 102.5 10/17/2013 2.5 0 Annual View Worksheet
Three Stars (3) 100 10/17/2012 0 0 Annual View Worksheet
Three Stars (3) 100.25 12/20/2011 1.25 0 Follow-up View Worksheet
Three Stars (3) 99 10/27/2011 2.5 3.5 Annual View Worksheet
Four Stars (4) 100 8/20/2010 0 0 Annual View Worksheet
Three Stars (3) 100 1/26/2009 0 0 Annual View Worksheet

Penalties

Penalties imposed during the last 36 months are listed.

This facility has not received any penalties in the last three years.