Inspection Detail

Case Status: CLOSED

Inspection: 1444427.015 - 144029 - Autumn Care Of Statesville, Llc

Inspection Information - Office: Nc Department Of Labor - Charlotte

Inspection Nr: 1444427.015

Report ID: 0453730

Date Opened: 11/12/2019

Site Address:
144029 - Autumn Care Of Statesville, Llc
2001 Van Haven Drive
Statesville, NC 28625

Mailing Address:
2001 Van Haven Drive, Statesville, NC 28677

Union Status: NonUnion

SIC:8051

NAICS: 623110/Nursing Care Facilities

Inspection Type: Planned

Scope: Complete

Advanced Notice: N

Ownership: Private

Safety/Health: Health

Close Conference: 11/12/2019

Emphasis:

Case Closed: 12/01/2020

Case Status: CLOSED

Violation Summary
Violations/Penalties	Serious	Willful	Repeat	Other	Unclass	Total
Initial Violations	1		2	4		7
Current Violations	1		2	4		7
Initial Penalty	$4,500	$0	$3,100	$4,050	$0	$11,650
Current Penalty	$3,375	$0	$2,325	$3,036	$0	$8,736
FTA Penalty	$0	$0	$0	$0	$0	$0

Violation Items
#	Citation ID	Citaton Type	Standard Cited	Issuance Date	Abatement Due Date	Current Penalty	Initial Penalty	FTA Penalty	Latest Event
1.	01001	Repeat	19100133 A01	12/12/2019	12/16/2019	$2,250	$3,000	$0	C - Contested
2.	01002	Repeat	19101200 G01	12/12/2019	12/16/2019	$75	$100	$0	C - Contested
3.	02001A	Serious	19101030 C01 V	12/12/2019	12/27/2019	$3,375	$4,500	$0	C - Contested
4.	02001B	Serious	19101030 C02 I	12/12/2019	12/16/2019	$0	$0	$0	Z - Issued
5.	02001C	Serious	19101030 H01 II B	12/12/2019	12/16/2019	$0	$0	$0	Z - Issued
6.	03001	Other	19100132 D01 I	12/12/2019	12/27/2019	$1,012	$1,350	$0	C - Contested
7.	03002	Other	19100303 B02	12/12/2019	12/27/2019	$0	$0	$0	Z - Issued
8.	03003	Other	19100305 J02 IV	12/12/2019	12/16/2019	$1,012	$1,350	$0	C - Contested
9.	03004	Other	19101200 F06 II	12/12/2019	12/16/2019	$1,012	$1,350	$0	C - Contested

Thank You for Visiting Our Website

You are exiting the Department of Labor's Web server.

The Department of Labor does not endorse, takes no responsibility for, and exercises no control over the linked organization or its views, or contents, nor does it vouch for the accuracy or accessibility of the information contained on the destination server. The Department of Labor also cannot authorize the use of copyrighted materials contained in linked Web sites. Users must request such authorization from the sponsor of the linked Web site. Thank you for visiting our site. Please click the button below to continue.