Inspection Summary

Apr 2022 – Mar 2026
65%
of inspections passed with no issues found
15 of 23 inspections · Apr 2022 – Mar 2026
Inspections with issues
8 of 23 inspections
Total violations cited
25 violations total
What the violations were about
Resident services 10Resident protections 4Environmental standards 3Records & reports 3Admission standards 2Admission & retention standards 1Personnel 1Resident funds & valuables 1
In plain language
  • The most recent inspection was on February 4, 2026 (relicensure survey) and found 12 violations.
  • Across 23 inspections in the current reporting window, 15 found no violations at all; inspectors cited 25 violations in total.
  • Of the 23 visits in this window, 21 were prompted by complaints and 2 were routine or other surveys.
  • The state has 1 formal enforcement action on record for this facility.

A violation is a rule breach noted by a state inspector. Most are administrative and get corrected through an approved plan of correction; the sections below show exactly what was cited and the status of each correction plan.

Provider Information

Type
Adult Home
Operating Certificate
330-E-005
County
Jefferson
Phone
(315) 782-6800
Operated By
Samaritan Senior Village, Inc.
DOH Regional Office
Central New York Regional Office

Inspection Details

Apr 2022 – Mar 2026
ℹ Violations under dispute through the Inspection Review Process (IRP) are not displayed.
February 4, 2026 Relicensure Survey 12 Violations
▼
Resident protections
Regulation cited: CFR 487.5 (d) (1)
Plan/Notice of Correction Under Review
Resident protections
Regulation cited: CFR 487.5 (d) (6)
Plan/Notice of Correction Under Review
Resident funds and valuables
Regulation cited: CFR 487.6 (c) (12)
Plan/Notice of Correction Under Review
Resident services
Regulation cited: CFR 487.7 (d) (11)
Plan/Notice of Correction Under Review
Resident services
Regulation cited: CFR 487.7 (f) (5)
Plan/Notice of Correction Under Review
Resident services
Regulation cited: CFR 487.7 (f) (8)
Plan/Notice of Correction Under Review
Resident services
Regulation cited: CFR 487.7 (g) (1) (ii-xiv)
Plan/Notice of Correction Under Review
Records and reports
Regulation cited: CFR 487.10 (c) (1-3)
Plan/Notice of Correction Under Review
Records and reports
Regulation cited: CFR 487.10 (d) (1-2)
Plan/Notice of Correction Under Review
Environmental standards
Regulation cited: CFR 487.11 (i) (1)
Plan/Notice of Correction Under Review
Environmental standards
Regulation cited: CFR 487.11 (k) (1-3)
Plan/Notice of Correction Under Review
Environmental standards
Regulation cited: CFR 487.11 (l) (1)
Plan/Notice of Correction Under Review
July 16, 2025 Complaint Survey 1 Violation
▼
Resident services
Regulation cited: CFR 487.7 (f) (5)
Plan/Notice of Correction Approved
June 17, 2025 Complaint Survey 0 Violations
▼

✓ No violations found

May 19, 2025 Complaint Survey 0 Violations
▼

✓ No violations found

April 11, 2025 Complaint Survey 0 Violations
▼

✓ No violations found

March 25, 2025 Complaint Survey 0 Violations
▼

✓ No violations found

February 20, 2025 Relicensure, Complaint, Follow-up Survey 0 Violations
▼

✓ No violations found

February 20, 2025 Complaint Survey 0 Violations
▼

✓ No violations found

January 10, 2025 Complaint Survey 1 Violation
▼
Resident services
Regulation cited: CFR 487.7 (f) (5)
Plan/Notice of Correction Approved
August 19, 2024 Relicensure, Complaint Survey 6 Violations
▼
Admission standards
Regulation cited: CFR 487.4 (c) (9)
Plan/Notice of Correction Approved
Resident protections
Regulation cited: CFR 487.5 (d) (6)
Plan/Notice of Correction Approved
Resident services
Regulation cited: CFR 487.7 (d) (12-13)
Plan/Notice of Correction Approved
Resident services
Regulation cited: CFR 487.7 (e) (6)
Plan/Notice of Correction Approved
Resident services
Regulation cited: CFR 487.7 (g) (1) (ii-xiv)
Plan/Notice of Correction Approved
Records and reports
Regulation cited: CFR 487.10 (c) (1-3)
Plan/Notice of Correction Approved
April 11, 2024 Complaint Survey 0 Violations
▼

✓ No violations found

March 29, 2024 Complaint Survey 0 Violations
▼

✓ No violations found

March 21, 2024 Complaint Survey 1 Violation
▼
Admission standards
Regulation cited: CFR 487.4 (c) (5)
Plan/Notice of Correction Approved
December 5, 2023 Complaint Survey 0 Violations
▼

✓ No violations found

November 10, 2023 Complaint Survey 1 Violation
▼
Resident services
Regulation cited: CFR 487.7 (g) (1) (ii-xiv)
Plan/Notice of Correction Approved
October 3, 2023 Relicensure Survey 2 Violations
▼
Personnel
Regulation cited: CFR 487.9 (a) (15)
Plan/Notice of Correction Approved
Admission and retention standards.
Regulation cited: CFR 1001.7 (k) (5)
Plan/Notice of Correction Approved
September 20, 2023 Complaint Survey 1 Violation
▼
Resident protections
Regulation cited: CFR 487.5 (f) (4-5)
Plan/Notice of Correction Approved
July 28, 2023 Complaint Survey 0 Violations
▼

✓ No violations found

June 16, 2023 Complaint Survey 0 Violations
▼

✓ No violations found

June 8, 2023 Complaint Survey 0 Violations
▼

✓ No violations found

May 24, 2023 Complaint Survey 0 Violations
▼

✓ No violations found

May 10, 2023 Complaint Survey 0 Violations
▼

✓ No violations found

February 24, 2023 Complaint Survey 0 Violations
▼

✓ No violations found

Enforcement & Orders

Apr 2022 – Mar 2026
1 enforcement action — Stipulation & Order agreement signed with the NY Department of Health.
August 8, 2025
Stipulation & Order
#ACF-25-047