Inspection Detail

Case Status: CLOSED

Inspection: 1480015.015 - 101571 - Sholom Community Alliance Llc

Inspection Information - Office: Minnesota Department Of Labor And Industry

Inspection Nr: 1480015.015

Report ID: 0552700

Date Opened: 06/03/2020

Site Address:
101571 - Sholom Community Alliance Llc
3610 Phillips Parkway
Minneapolis, MN 55426

Mailing Address:
3610 Phillips Parkway, Minneapolis, MN 55426

Union Status: NonUnion

SIC:

NAICS: 623311/Continuing Care Retirement Communities

Inspection Type: Fat/Cat

Scope: Partial

Advanced Notice: N

Ownership: Private

Safety/Health: Safety

Close Conference: 10/16/2020

Emphasis:

Case Closed: 02/26/2021

Related Activity
Type	Activity Nr	Safety	Health
Accident	1600211

Case Status: CLOSED

Violation Summary
Violations/Penalties	Serious	Willful	Repeat	Other	Unclass	Total
Initial Violations	1			2		3
Current Violations	1			1		2
Initial Penalty	$25,000	$0	$0	$7,000	$0	$32,000
Current Penalty	$25,000	$0	$0	$2,100	$0	$27,100
FTA Penalty	$0	$0	$0	$0	$0	$0

Violation Items
#	Citation ID	Citation Type	Standard Cited	Issuance Date	Abatement Due Date	Current Penalty	Initial Penalty	FTA Penalty	Contest	Latest Event	Note
1.	01001	Serious	19100134 A02	10/22/2020	11/15/2020	$25,000	$25,000	$0	10/28/2020	F - Formal Settlement
2.	02001	Other	19040039 A01	10/22/2020	10/26/2020	$2,100	$3,500	$0	10/28/2020	F - Formal Settlement
3.	02002	Other	19040039 A02	10/22/2020	10/26/2020	$0	$3,500	$0	10/28/2020	F - Formal Settlement	Citation has been deleted.

Investigation Summary

Investigation Nr: 127180.015

Event: 05/18/2020

Employee with COVID-19 infection dies

At approximately 12:00 a.m. on May 18, 2020, an employee reporting illness, did not report to work that day. That same week, a patient in the Memory Care Unit, where the employee worked full-time, had been hospitalized and diagnosed with COVID-19, and later died from COVID-19 complications. The employee was hospitalized on April 26, 2020, with COVID-19 symptoms. On May 18, 2020, the employee died from COVID-19 complications.

Keywords: Infectious Disease

Investigated Inspection
#	Inspection	Age	Sex	Degree of Injury	Nature of Injury	Occupation
1	1480015.015	62	M	Fatality		Occupation not reported

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