All citations for Avondale Villa Post-Acute

State inspectors check nursing homes that take Medicare or Medicaid against federal rules, usually about once a year, and also look into complaints. Each rule a home did not meet is a citation.

Back to Avondale Villa Post-Acute

Last standard health inspection on record

May 16, 2025

Showing 1 to 20 of 20 citations

  1. No harm, with potential for more than minimal harm

    Have simulated fire drills held at unexpected times.

    Widespread (many residents). CMS level F.

    Fire safety citation K-0712, Miscellaneous Deficiencies. Inspection of March 25, 2022. Found during a standard inspection.

    The home gave a date the problem would be corrected (April 15, 2022).

  2. No harm, with potential for more than minimal harm

    Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures.

    Pattern (more than a few residents). CMS level E.

    Health citation F-0756, Pharmacy Service Deficiencies. Inspection of March 25, 2022. Found during a standard inspection.

    The home gave a date the problem would be corrected (April 11, 2022).

  3. No harm, with potential for more than minimal harm

    Provide and implement an infection prevention and control program.

    Pattern (more than a few residents). CMS level E.

    Health citation F-0880, Infection Control Deficiencies. Inspection of March 25, 2022. Found during a standard inspection.

    The home gave a date the problem would be corrected (April 11, 2022).

  4. No harm, with potential for more than minimal harm

    Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.

    Isolated (one or a few residents). CMS level D.

    Health citation F-0689, Quality of Life and Care Deficiencies. Inspection of December 21, 2023. Found during a complaint inspection.

    The home gave a date the problem would be corrected (January 17, 2024).

  5. No harm, with potential for more than minimal harm

    Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.

    Isolated (one or a few residents). CMS level D.

    Health citation F-0842, Resident Assessment and Care Planning Deficiencies. Inspection of December 21, 2023. Found during a complaint inspection.

    The home gave a date the problem would be corrected (January 17, 2024).

  6. No harm, with potential for more than minimal harm

    Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.

    Isolated (one or a few residents). CMS level D.

    Health citation F-0755, Pharmacy Service Deficiencies. Inspection of March 25, 2022. Found during a standard inspection.

    The home gave a date the problem would be corrected (April 11, 2022).

  7. No harm, with potential for more than minimal harm

    Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.

    Isolated (one or a few residents). CMS level D.

    Health citation F-0812, Nutrition and Dietary Deficiencies. Inspection of March 25, 2022. Found during a standard inspection.

    The home gave a date the problem would be corrected (April 11, 2022).

  8. No harm, with potential for more than minimal harm

    Develop and maintain an Emergency Preparedness Program (EP).

    Isolated (one or a few residents). CMS level D.

    Emergency preparedness citation E-0004, Emergency Preparedness Deficiencies. Inspection of March 25, 2022. Found during a standard inspection.

    The home gave a date the problem would be corrected (April 15, 2022).

  9. No harm, with potential for more than minimal harm

    Address subsistence needs for staff and patients.

    Isolated (one or a few residents). CMS level D.

    Emergency preparedness citation E-0015, Emergency Preparedness Deficiencies. Inspection of March 25, 2022. Found during a standard inspection.

    The home gave a date the problem would be corrected (April 15, 2022).

  10. No harm, with potential for more than minimal harm

    Establish procedures for tracking staff and patients during an emergency.

    Isolated (one or a few residents). CMS level D.

    Emergency preparedness citation E-0018, Emergency Preparedness Deficiencies. Inspection of March 25, 2022. Found during a standard inspection.

    The home gave a date the problem would be corrected (April 15, 2022).

  11. No harm, with potential for more than minimal harm

    Establish policies and procedures for volunteers.

    Isolated (one or a few residents). CMS level D.

    Emergency preparedness citation E-0024, Emergency Preparedness Deficiencies. Inspection of March 25, 2022. Found during a standard inspection.

    The home gave a date the problem would be corrected (April 15, 2022).

  12. No harm, with potential for more than minimal harm

    Establish roles under a Waiver declared by secretary.

    Isolated (one or a few residents). CMS level D.

    Emergency preparedness citation E-0026, Emergency Preparedness Deficiencies. Inspection of March 25, 2022. Found during a standard inspection.

    The home gave a date the problem would be corrected (April 15, 2022).

  13. No harm, with potential for more than minimal harm

    Provide primary/alternate means for communication.

    Isolated (one or a few residents). CMS level D.

    Emergency preparedness citation E-0032, Emergency Preparedness Deficiencies. Inspection of March 25, 2022. Found during a standard inspection.

    The home gave a date the problem would be corrected (April 15, 2022).

  14. No harm, with potential for more than minimal harm

    Establish emergency prep training and testing.

    Isolated (one or a few residents). CMS level D.

    Emergency preparedness citation E-0036, Emergency Preparedness Deficiencies. Inspection of March 25, 2022. Found during a standard inspection.

    The home gave a date the problem would be corrected (April 15, 2022).

  15. No harm, with potential for more than minimal harm

    Use approved construction type or materials.

    Isolated (one or a few residents). CMS level D.

    Fire safety citation K-0161, Construction Deficiencies. Inspection of March 25, 2022. Found during a standard inspection.

    The home gave a date the problem would be corrected (April 15, 2022).

  16. No harm, with potential for more than minimal harm

    Inspect, test, and maintain automatic sprinkler systems.

    Isolated (one or a few residents). CMS level D.

    Fire safety citation K-0353, Smoke Deficiencies. Inspection of March 25, 2022. Found during a standard inspection.

    The home gave a date the problem would be corrected (April 15, 2022).

  17. No harm, with potential for more than minimal harm

    Install corridor and hallway doors that block smoke.

    Isolated (one or a few residents). CMS level D.

    Fire safety citation K-0363, Smoke Deficiencies. Inspection of March 25, 2022. Found during a standard inspection.

    The home gave a date the problem would be corrected (April 15, 2022).

  18. No harm, with potential for more than minimal harm

    Ensure proper usage of power strips and extension cords.

    Isolated (one or a few residents). CMS level D.

    Fire safety citation K-0920, Gas, Vacuum, and Electrical Systems Deficiencies. Inspection of March 25, 2022. Found during a standard inspection.

    The home gave a date the problem would be corrected (April 15, 2022).

  19. No harm, with potential for more than minimal harm

    Have proper medical gas storage and administration areas.

    Isolated (one or a few residents). CMS level D.

    Fire safety citation K-0923, Gas, Vacuum, and Electrical Systems Deficiencies. Inspection of March 25, 2022. Found during a standard inspection.

    The home gave a date the problem would be corrected (April 15, 2022).

  20. No harm, with potential for minimal harm

    Provide rooms that are at least 80 square feet per resident in multiple rooms and 100 square feet for single resident rooms.

    Pattern (more than a few residents). CMS level B.

    Health citation F-0912, Environmental Deficiencies. Inspection of March 25, 2022. Found during a standard inspection.

    The home gave a date the problem would be corrected (April 11, 2022).

Source: CMS Provider Information, Fire Safety Deficiencies, Health Deficiencies, Citation Code Look-up, data as of September 30, 2026. Inspection results describe the home at the time of each inspection.