Inspection Detail

Case Status: CLOSED

Inspection: 1532351.015 - Petersen Health Junction, Llc

Inspection Information - Office: Peoria Area Office

Inspection Nr: 1532351.015

Report ID: 0524500

Date Opened: 05/24/2021

Site Address:
Petersen Health Junction, Llc
129 S 1st Avenue
Canton, IL 61520

Mailing Address:
830 West Trailcreek Drive Attn: Greg Wilson, Peoria, IL 61614

Union Status: NonUnion

SIC:

NAICS: 623110/Nursing Care Facilities

Inspection Type: Fat/Cat

Scope: Partial

Advanced Notice: N

Ownership: Private

Safety/Health: Health

Close Conference: 05/24/2021

Emphasis: N:Covid-19

Case Closed: 10/07/2021

Related Activity
Type	Activity Nr	Safety	Health
Accident	1769406

Case Status: CLOSED

Violation Summary
Violations/Penalties	Serious	Willful	Repeat	Other	Unclass	Total
Initial Violations	1					1
Current Violations	1					1
Initial Penalty	$13,653	$0	$0	$0	$0	$13,653
Current Penalty	$13,653	$0	$0	$0	$0	$13,653
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	Latest Event
1.	01001A	Serious	19100134 C01	08/10/2021	08/25/2021	$13,653	$13,653	$0	Z - Issued
2.	01001B	Serious	19100134 E01	08/10/2021	09/01/2021	$0	$0	$0	Z - Issued
3.	01001C	Serious	19100134 F02	08/10/2021	09/01/2021	$0	$0	$0	Z - Issued
4.	01001D	Serious	19100134 K03	08/10/2021	09/01/2021	$0	$0	$0	Z - Issued

Investigation Summary

Investigation Nr: 135781.015

Event: 05/19/2021

Employee with COVID-19 infection dies

An employee was working in housekeeping at a nursing care or skilled nursing facility. On April 22, 2021, during routine testing at work, she tested positive for COVID-19. She was admitted to the hospital. She was on a ventilator until she died at 1:30 p.m. on May 19, 2021.

Keywords: Infectious Disease

Investigated Inspection
#	Inspection	Age	Sex	Degree of Injury	Nature of Injury	Occupation
1	1532351.015	50	F	Fatality

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