NC DHSR ACLS: Inspections, Ratings and Penalties

Facility Information

License Number:	HAL-034-093
Site Address:	3150 Burke Mill Road Winston-Salem, NC 27103
County:	Forsyth
Capacity:	100 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 Type	Document Type	Inspection Date	Pages	IDR Pending
ACLS Annual	No Deficiencies Cited	8/10/2023		No
ACLS Annual	No Deficiencies Cited	9/17/2021	0	No
Other	No Deficiencies Cited	9/29/2020		No
ACLS Follow-up	Statement of Deficiency	4/16/2020	19	No
ACLS Follow-up	Statement of Deficiency with Plan of Correction	4/16/2020	20	No
ACLS Complaint	Statement of Deficiency with Plan of Correction	1/17/2020	60	No
ACLS Complaint	Statement of Deficiency	1/17/2020	60	No
ACLS Complaint	Statement of Deficiency	1/17/2020	60	No
ACLS Complaint and Follow-up	Statement of Deficiency	11/15/2019	339	No
ACLS Complaint and Follow-up	Statement of Deficiency	11/15/2019	339	No
ACLS Annual and Complaint	Statement of Deficiency	7/26/2019	82	No
ACLS Annual and Complaint	Statement of Deficiency with Plan of Correction	7/26/2019	82	No
ACLS Annual and Complaint	Statement of Deficiency	7/26/2019	82	No
ACLS Annual	No Deficiencies Cited	8/23/2017		No
ACLS Annual and Complaint	No Deficiencies Cited	3/3/2016		No
ACLS Annual	Statement of Deficiency	10/29/2015	10	No
ACLS Annual	Statement of Deficiency with Plan of Correction	10/29/2015	10	No
Constr Biennial Follow-up	Statement of Deficiency with Plan of Correction	6/21/2023	3	No
Constr Biennial Follow-up	No Deficiencies Cited	10/3/2019	0	No
Constr Biennial Follow-up	Statement of Deficiency	9/12/2019	2	No
Constr Biennial	Statement of Deficiency with Plan of Correction	7/18/2019	11	No
Constr Biennial	Statement of Deficiency	7/18/2019	11	No
Constr Biennial Follow-up	No Deficiencies Cited	8/21/2017	0	No
Constr Biennial Follow-up	Statement of Deficiency with Plan of Correction	7/13/2017	3	No
Constr Biennial Follow-up	Statement of Deficiency	7/13/2017	1	No
Constr Biennial	Statement of Deficiency with Plan of Correction	6/2/2017	10	No
Constr Biennial	Statement of Deficiency	6/2/2017	10	No
Constr Biennial Follow-up	No Deficiencies Cited	9/25/2015	0	No
Constr Biennial Follow-up	Statement of Deficiency with Plan of Correction	7/29/2015	2	No
Constr Biennial Follow-up	Statement of Deficiency	7/29/2015	2	No
Constr Biennial Follow-up	Statement of Deficiency with Plan of Correction	6/25/2015	2	No
Constr Biennial	Statement of Deficiency	6/18/2015	2	No
Constr Biennial	Statement of Deficiency	4/9/2015	7	No
Constr Biennial	Statement of Deficiency with Plan of Correction	4/9/2015	7	No

Star Rating

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
	(4)	102.5	9/5/2023	2.5	0	Annual	View Worksheet
	(3)	104.5	10/18/2021	4.5	0	Annual	View Worksheet
(ZERO STARS)	(0)	27	5/29/2020	10	0	Follow-up	View Worksheet
(ZERO STARS)	(0)	17	3/5/2020	0	15.5	Complaint	View Worksheet
(ZERO STARS)	(0)	32.5	3/5/2020	5	47	Follow-up	View Worksheet
	(1)	74.5	10/15/2019	0	25.5	Annual	View Worksheet
	(4)	102.5	10/20/2017	2.5	0	Annual	View Worksheet
	(3)	100.25	3/8/2016	1.25	0	Follow-up	View Worksheet
	(3)	99	11/24/2015	2.5	3.5	Annual	View Worksheet
	(4)	104.5	6/26/2013	4.5	0	Annual	View Worksheet
	(3)	102.25	9/12/2012	1.25	0	Follow-up	View Worksheet
	(3)	101	6/7/2012	4.5	3.5	Annual	View Worksheet
	(3)	93.5	4/25/2011	10	0	Follow-up	View Worksheet
	(2)	83.5	2/28/2011	2.5	19	Annual	View Worksheet
	(3)	102.5	10/26/2009	4.5	2	Annual	View Worksheet