01 / INSPECTION LEDGER
Survey cycles in this release
| Cycle | Health date | Health deficiencies | Fire date | Fire deficiencies |
|---|---|---|---|---|
| Cycle 1 | 2021-03-11 | 5 | 2021-03-11 | 3 |
| Cycle 2 | 2020-01-15 | 2 | 2020-01-15 | 3 |
| Cycle 3 | 2018-11-29 | 2 | 2018-11-29 | 2 |
CMS CCN 0150442026-08-01 PROCESSING DATE
NURSING HOME PUBLIC RECORD
Caregivers Of Pleasant Grove, Inc
700 First Avenue · Pleasant Grove, AL 35127 · Jefferson County
Certified beds64CMS provider file
Recent citation rows17current CMS citation release
Penalty rows0current CMS penalties file
Read this record carefully.
The citation files cover the three most recent standard inspections plus qualifying complaint and infection-control inspections in the prior three years. A correction date is a CMS field; this site does not independently verify conditions. Absence from a file is not proof that no issue exists.
02 / CITATION DETAIL
17 rows in the current release
0 rows carry G–L scope/severity codes; 0 carry J–L. 2 tag codes appear on more than one survey date. These counts describe citation rows, not residents or incidents.
2021-03-11 · HEALTHF0583Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Keep residents' personal and medical records private and confidential.
Correction field: Deficient, Provider has date of correction · 2021-04-152021-03-11 · HEALTHF0641Severity D · isolated; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Ensure each resident receives an accurate assessment.
Correction field: Deficient, Provider has date of correction · 2021-04-152021-03-11 · HEALTHF0656Severity E · pattern; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Correction field: Deficient, Provider has date of correction · 2021-04-152021-03-11 · HEALTHF0692Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide enough food/fluids to maintain a resident's health.
Correction field: Deficient, Provider has date of correction · 2021-04-152021-03-11 · HEALTHF0812Severity F · widespread; potential for more than minimal harm
Nutrition and Dietary Deficiencies
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Correction field: Deficient, Provider has date of correction · 2021-04-152021-03-11 · FIREK0211Severity E · pattern; potential for more than minimal harm
Egress Deficiencies
Keep aisles, corridors, and exits free of obstruction in case of emergency.
Correction field: Deficient, Provider has date of correction · 2021-04-212021-03-11 · FIREK0232Severity E · pattern; potential for more than minimal harm
Egress Deficiencies
Have corridors or aisles that are unobstructed and are at least 8 feet in width.
Correction field: Deficient, Provider has date of correction · 2021-04-212021-03-11 · FIREK0923Severity D · isolated; potential for more than minimal harm
Gas, Vacuum, and Electrical Systems Deficiencies
Have proper medical gas storage and administration areas.
Correction field: Deficient, Provider has date of correction · 2021-04-212020-01-15 · HEALTHF0812Severity F · widespread; potential for more than minimal harm
Nutrition and Dietary Deficiencies
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Correction field: Deficient, Provider has date of correction · 2020-02-192020-01-15 · HEALTHF0880Severity D · isolated; potential for more than minimal harm
Infection Control Deficiencies
Provide and implement an infection prevention and control program.
Correction field: Deficient, Provider has date of correction · 2020-02-192020-01-15 · FIREK0324Severity D · isolated; potential for more than minimal harm
Smoke Deficiencies
Provide properly protected cooking facilities.
Correction field: Deficient, Provider has date of correction · 2020-02-262020-01-15 · FIREK0351Severity D · isolated; potential for more than minimal harm
Smoke Deficiencies
Install an approved automatic sprinkler system.
Correction field: Deficient, Provider has date of correction · 2020-02-262020-01-15 · FIREK0355Severity D · isolated; potential for more than minimal harm
Smoke Deficiencies
Properly select, install, inspect, or maintain portable fire extinguishes.
Correction field: Deficient, Provider has date of correction · 2020-02-262018-11-29 · HEALTHF0577Severity C · widespread; potential for minimal harm
Resident Rights Deficiencies
Allow residents to easily view the nursing home's survey results and communicate with advocate agencies.
Correction field: Deficient, Provider has date of correction · 2019-01-032018-11-29 · HEALTHF0880Severity D · isolated; potential for more than minimal harm
Infection Control Deficiencies
Provide and implement an infection prevention and control program.
Correction field: Deficient, Provider has date of correction · 2019-01-032018-11-29 · FIREK0353Severity D · isolated; potential for more than minimal harm
Smoke Deficiencies
Inspect, test, and maintain automatic sprinkler systems.
Correction field: Deficient, Provider has date of correction · 2019-01-082018-11-29 · FIREK0363Severity D · isolated; potential for more than minimal harm
Smoke Deficiencies
Install corridor and hallway doors that block smoke.
Correction field: Deficient, Provider has date of correction · 2019-01-0803 / ENFORCEMENT FILE
Penalties reported by CMS
Fine amounts and payment-denial days are shown exactly as aggregated from the current penalties file. They do not imply an unpaid balance.
| Date | Type | Fine amount | Payment-denial days |
|---|---|---|---|
| No penalty row appeared in the August 2026 penalties file. | |||
04 / OWNERSHIP DISCLOSURES
Who appears in the CMS file
- CHURCH, CLYDEIndividual · 5% OR GREATER DIRECT OWNERSHIP INTEREST50% · since 07/01/2010
- CHURCH, ALICIAIndividual · DIRECT OWNERSHIP INTERESTNOT APPLICABLE · since 07/01/2023
- ROSEMORE, MICHAELIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 07/01/2025
- CHURCH, CLYDEIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 07/01/2010
- POTTS, SUSANIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 07/01/2023
- SHOEMAKE, MARTINAIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 11/20/2023
- ROSEMORE, MICHAELIndividual · ADP OF THE SNFNOT APPLICABLE · since 07/09/2025
- SHOEMAKE, MARTINAIndividual · ADP OF THE SNFNOT APPLICABLE · since 01/27/2025
Names and roles are self-reported CMS disclosure fields. Exact-name pages do not prove that similarly named people or organizations are the same entity.
05 / CMS STAFFING FIELDS
Reported hours and turnover
Staffing fields are provider-reported and case-mix context matters. CMS applies footnotes and exclusions not reproduced as a new score here.
Total nurse hours3.94per resident day
RN hours0.30per resident day
Weekend nurse hours3.29per resident day
Staff turnover52.6%CMS reported field
06 / LOCAL RECORDS
Open the Pleasant Grove ledger →