Victorian Village Hlth & Well

Inspection findings

1. Mar 26, 2026 Health · 1 finding
   • Serious Scope/severity G Complaint

     F0689 Quality of Life and Care Deficiencies

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

     Corrected Mar 27, 2026 · CMS health inspection

2. Jul 3, 2025 Health · 6 findings
   • Not serious Scope/severity D

     F0689 Quality of Life and Care Deficiencies

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

     Corrected Jul 4, 2025 · CMS health inspection

   • Not serious Scope/severity E

     F0808 Nutrition and Dietary Deficiencies

     Ensure therapeutic diets are prescribed by the attending physician and may be delegated to a registered or licensed dietitian, to the extent allowed by State law.

     Corrected Jul 4, 2025 · CMS health inspection

   • Not serious Scope/severity E

     F0880 Infection Control Deficiencies

     Provide and implement an infection prevention and control program.

     Corrected Jul 4, 2025 · CMS health inspection

   • Not serious Scope/severity E

     K0321 Smoke Deficiencies

     Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.

     Corrected Jul 16, 2025 · CMS fire safety

   • Not serious Scope/severity E

     K0341 Smoke Deficiencies

     Install a fire alarm system that can be heard throughout the facility.

     Corrected Jul 16, 2025 · CMS fire safety

   • Not serious Scope/severity E

     K0920 Gas, Vacuum, and Electrical Systems Deficiencies

     Ensure proper usage of power strips and extension cords.

     Corrected Jul 16, 2025 · CMS fire safety

3. Jun 5, 2025 Health · 2 findings
   • Not serious Scope/severity D Complaint

     F0583 Resident Rights Deficiencies

     Keep residents' personal and medical records private and confidential.

     Corrected Jun 6, 2025 · CMS health inspection

   • Not serious Scope/severity D Complaint

     F0628 Resident Rights Deficiencies

     Provide the required documentation or notification related to the resident's needs, appeal rights, or bed-hold policies.

     Corrected Jun 6, 2025 · CMS health inspection

4. Sep 13, 2024 Fire Safety · 11 findings
   • Not serious Scope/severity F

     E0026 Emergency Preparedness Deficiencies

     Establish roles under a Waiver declared by secretary.

     Corrected Sep 19, 2024 · CMS fire safety

   • Not serious Scope/severity D

     F0658 Resident Assessment and Care Planning Deficiencies

     Ensure services provided by the nursing facility meet professional standards of quality.

     Corrected Sep 14, 2024 · CMS health inspection

   • Not serious Scope/severity D

     F0677 Quality of Life and Care Deficiencies

     Provide care and assistance to perform activities of daily living for any resident who is unable.

     Corrected Sep 14, 2024 · CMS health inspection

   • Not serious Scope/severity D

     F0690 Quality of Life and Care Deficiencies

     Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.

     Corrected Sep 14, 2024 · CMS health inspection

   • Not serious Scope/severity D

     F0760 Pharmacy Service Deficiencies

     Ensure that residents are free from significant medication errors.

     Corrected Sep 14, 2024 · CMS health inspection

   • Not serious Scope/severity F

     F0812 Nutrition and Dietary Deficiencies

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

     Corrected Sep 14, 2024 · CMS health inspection

   • Not serious Scope/severity D

     F0880 Infection Control Deficiencies

     Provide and implement an infection prevention and control program.

     Corrected Sep 14, 2024 · CMS health inspection

   • Not serious Scope/severity F

     F0887 Infection Control Deficiencies

     Educate residents and staff on COVID-19 vaccination, offer the COVID-19 vaccine to eligible residents and staff after education, and properly document each resident and staff member's vaccination status.

     Corrected Sep 14, 2024 · CMS health inspection

   • Not serious Scope/severity D

     K0911 Gas, Vacuum, and Electrical Systems Deficiencies

     Meet requirements for the installation and maintenance of electrical systems.

     Corrected Sep 19, 2024 · CMS fire safety

   • Not serious Scope/severity F

     K0923 Gas, Vacuum, and Electrical Systems Deficiencies

     Have proper medical gas storage and administration areas.

     Corrected Sep 19, 2024 · CMS fire safety

   • Not serious Scope/severity F

     K0926 Gas, Vacuum, and Electrical Systems Deficiencies

     Ensure that personnel concerned with handling of medical gases and cylinders are trained on the risk.

     Corrected Sep 19, 2024 · CMS fire safety

5. Aug 31, 2023 Health · 12 findings
   • Not serious Scope/severity D

     F0558 Resident Rights Deficiencies

     Reasonably accommodate the needs and preferences of each resident.

     Corrected Sep 1, 2023 · CMS health inspection

   • Not serious Scope/severity D

     F0583 Resident Rights Deficiencies

     Keep residents' personal and medical records private and confidential.

     Corrected Sep 1, 2023 · CMS health inspection

   • Not serious Scope/severity D

     F0688 Quality of Life and Care Deficiencies

     Provide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM and/or mobility, unless a decline is for a medical reason.

     Corrected Sep 1, 2023 · CMS health inspection

   • Not serious Scope/severity D

     F0690 Quality of Life and Care Deficiencies

     Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.

     Corrected Sep 1, 2023 · CMS health inspection

   • Not serious Scope/severity D

     F0695 Quality of Life and Care Deficiencies

     Provide safe and appropriate respiratory care for a resident when needed.

     Corrected Sep 1, 2023 · CMS health inspection

   • Not serious Scope/severity E

     F0808 Nutrition and Dietary Deficiencies

     Ensure therapeutic diets are prescribed by the attending physician and may be delegated to a registered or licensed dietitian, to the extent allowed by State law.

     Corrected Sep 1, 2023 · CMS health inspection

   • Not serious Scope/severity F

     F0812 Nutrition and Dietary Deficiencies

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

     Corrected Sep 1, 2023 · CMS health inspection

   • Not serious Scope/severity D

     F0880 Infection Control Deficiencies

     Provide and implement an infection prevention and control program.

     Corrected Sep 1, 2023 · CMS health inspection

   • Not serious Scope/severity E

     F0925 Environmental Deficiencies

     Make sure there is a pest control program to prevent/deal with mice, insects, or other pests.

     Corrected Sep 1, 2023 · CMS health inspection

   • Not serious Scope/severity D

     K0341 Smoke Deficiencies

     Install a fire alarm system that can be heard throughout the facility.

     Corrected Sep 6, 2023 · CMS fire safety

   • Not serious Scope/severity F

     K0345 Smoke Deficiencies

     Have approved installation, maintenance and testing program for fire alarm systems.

     Corrected Sep 6, 2023 · CMS fire safety

   • Not serious Scope/severity E

     K0372 Smoke Deficiencies

     Ensure smoke barriers are constructed to a 1 hour fire resistance rating.

     Corrected Sep 6, 2023 · CMS fire safety

Owners and managers (as published by CMS)

• BREEMS, TIM — corporate director, NOT APPLICABLE, since 04/01/2024
• DEGRAFF, DAVE — corporate director, NOT APPLICABLE, since 04/01/2024
• FEENSTRA, THEODORE — corporate director, NOT APPLICABLE, since 04/02/2022
• KATS, STEVEN — corporate director, NOT APPLICABLE, since 04/01/2026
• KOLDENHOVEN, ARNOLD — corporate director, NOT APPLICABLE, since 04/01/2024
• KRIEPS, JAMIE — operational/managerial control, NOT APPLICABLE, since 04/01/2024
• KRIEPS, JAMIE — adp of the snf, NOT APPLICABLE, since 02/07/2025
• LEO, GARY — corporate director, NOT APPLICABLE, since 04/01/2024
• MULKI, M GHAITH — operational/managerial control, NOT APPLICABLE, since 04/01/2024
• MULKI, M GHAITH — adp of the snf, NOT APPLICABLE, since 04/01/2024
• OTTE, LARRY — corporate officer, NOT APPLICABLE, since 10/01/2025
• PETROELJE, ROB — corporate director, NOT APPLICABLE, since 04/01/2024
• VAN ESSEN, DARREN — corporate director, NOT APPLICABLE, since 04/02/2022
• VAN SOLKEMA, KEVIN — corporate director, NOT APPLICABLE, since 04/01/2026
• VOSS, DAVID — corporate director, NOT APPLICABLE, since 04/02/2022
• WOO, ERIC — corporate director, NOT APPLICABLE, since 04/01/2024
• YONKER, KYLE — corporate director, NOT APPLICABLE, since 04/02/2022
• ZANDSTRA, JOHANNA — operational/managerial control, NOT APPLICABLE, since 04/01/2024
• REST HAVEN ILLIANA CHRISTIAN CONVALESCENT HOME — adp of the snf, NOT APPLICABLE, since 01/26/2015
• REST HAVEN ILLIANA CHRISTIAN CONVALESCENT HOME — 5% or greater direct ownership interest, 100%, since 01/26/2015