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  5. AVALON GARDENS REHABILITATION & HEALTH CARE CENTER, LLC

AVALON GARDENS REHABILITATION & HEALTH CARE CENTER, LLC

Company Details

Name: AVALON GARDENS REHABILITATION & HEALTH CARE CENTER, LLC
Jurisdiction: New York
Legal type: DOMESTIC LIMITED LIABILITY COMPANY
Status: Active
Date of registration: 29 Apr 2003 (22 years ago)
Entity Number: 2900158
ZIP code: 11598
County: Suffolk
Place of Formation: New York
Address: 945 BROADWAY, WOODMERE, NY, United States, 11598

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
AVALON GARDENS REHABILITATION & HEALTH CARE CENTER, LLC 401(K) PLAN 2018 020677283 2019-08-20 AVALON GARDENS REHABILITATION & HEALTH CARE CENTER, LLC 61
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 623000
Sponsor’s telephone number 6317242200
Plan sponsor’s address 7 RT 25A, SMITHTOWN, NY, 11787
AVALON GARDENS REHABILITATION & HEALTH CARE CENTER, LLC 401(K) PLAN 2017 020677283 2018-05-14 AVALON GARDENS REHABILITATION & HEALTH CARE CENTER, LLC 65
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 623000
Sponsor’s telephone number 6317242200
Plan sponsor’s address 7 RT 25A, SMITHTOWN, NY, 11787
AVALON GARDENS REHABILITATION & HEALTH CARE CENTER, LLC 401(K) PLAN 2016 020677283 2017-07-06 AVALON GARDENS REHABILITATION & HEALTH CARE CENTER, LLC 67
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 623000
Sponsor’s telephone number 6317242200
Plan sponsor’s address 7 RT 25A, SMITHTOWN, NY, 11787

Signature of
Role Plan administrator
Date 2017-07-06
Name of individual signing JERYLE LOHAN
AVALON GARDENS REHABILITATION & HEALTH CARE CENTER , LLC 401(K) PLAN 2015 020677283 2016-07-05 AVALON GARDENS REHABILITATION & HEALTH CARE CENTER, LLC 85
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 623000
Sponsor’s telephone number 6317242200
Plan sponsor’s address 7 RT 25A, SMITHTOWN, NY, 11787

Signature of
Role Plan administrator
Date 2016-07-05
Name of individual signing JERYLE LOHAN

DOS Process Agent

Name Role Address
C/O SENTOSACARE, LLC DOS Process Agent 945 BROADWAY, WOODMERE, NY, United States, 11598

History

Start date End date Type Value
2009-01-30 2018-01-08 Address 97 POWERHOUSE ROAD, ROSLYN HEIGHTS, NY, 11577, USA (Type of address: Service of Process)
2005-06-16 2009-01-30 Address 7 ROUTE 25A, SMITHTOWN, NY, 11787, USA (Type of address: Service of Process)
2003-04-29 2005-06-16 Address ROUTE 25A, SMITHTOWN, NY, 11787, USA (Type of address: Service of Process)

Filings

Filing Number Date Filed Type Effective Date
180108006524 2018-01-08 BIENNIAL STATEMENT 2017-04-01
130418002683 2013-04-18 BIENNIAL STATEMENT 2013-04-01
130128002403 2013-01-28 BIENNIAL STATEMENT 2011-04-01
090429002751 2009-04-29 BIENNIAL STATEMENT 2009-04-01
090130000492 2009-01-30 CERTIFICATE OF CHANGE 2009-01-30
070417002396 2007-04-17 BIENNIAL STATEMENT 2007-04-01
050616002286 2005-06-16 BIENNIAL STATEMENT 2005-04-01
030429000707 2003-04-29 ARTICLES OF ORGANIZATION 2003-04-29

OSHA's Inspections within Industry

Inspection Nr Report ID Date Opened Site Address
339015059 0214700 2013-04-18 7 RT. 25A, SMITHTOWN, NY, 11787
Inspection Type Complaint
Scope Complete
Safety/Health Health
Close Conference 2013-09-04
Emphasis N: NURSING
Case Closed 2014-07-31

Related Activity
Type Complaint
Activity Nr 813793
Safety Yes

Violation Items
Citation ID 01001
Citaton Type Serious
Standard Cited 19100022 A02
Issuance Date 2013-09-13
Abatement Due Date 2013-10-02
Current Penalty 1800.0
Initial Penalty 3000.0
Contest Date 2013-12-30
Final Order 2014-04-28
Nr Instances 1
Nr Exposed 3
Gravity 1
FTA Current Penalty 0.0
Citation text line 1910.22(a)(2): The floor of every workroom was not maintained in a clean and, so far as possible, a dry condition: a) At the work site, dish washing area; the employer did not maintain the floor in a dry condition; on or about 4/18/13. Note: The employer is required to submit abatement certification for this item item in accordance with 29 CFR 1903.19.
Citation ID 01002
Citaton Type Serious
Standard Cited 19100037 A03
Issuance Date 2013-09-13
Abatement Due Date 2013-10-02
Current Penalty 1800.0
Initial Penalty 3000.0
Contest Date 2013-12-30
Final Order 2014-04-28
Nr Instances 1
Nr Exposed 3
Gravity 1
FTA Current Penalty 0.0
Citation text line 29 CFR 1910.37(a)(3): Exit routes were not free and unobstructed. Materials or equipment were placed, either permanently or temporarily within the exit route: a) At the work site, dish washing area the exit route was obstructed by table placed temporarily within the exit route; on or about 4/18/13. Note: The employer is required to submit abatement certification for this item item in accordance with 29 CFR 1903.19.
Citation ID 01003
Citaton Type Serious
Standard Cited 19100037 B02
Issuance Date 2013-09-13
Abatement Due Date 2013-09-25
Current Penalty 1800.0
Initial Penalty 3000.0
Contest Date 2013-12-30
Final Order 2014-04-28
Nr Instances 2
Nr Exposed 6
Gravity 1
FTA Current Penalty 0.0
Citation text line 29 CFR 1910.37(b)(2): Each exit was not clearly visible and marked by a sign reading Exit. (a) At the work site, basement, dish room; exit was not marked by a sign reading "Exit"; on or about 4/18/13. (b) At the work site, first floor, exit door #14 Nurses station (azalea); exit was not marked by a sign reading "Exit"; on or about 6/11/13. Note: The employer is required to submit abatement certification for this item accordance with 29 CFR 1903.19.
Citation ID 01004
Citaton Type Serious
Standard Cited 19100101 B
Issuance Date 2013-09-13
Abatement Due Date 2013-09-19
Current Penalty 3000.0
Initial Penalty 5000.0
Contest Date 2013-12-30
Final Order 2014-04-28
Nr Instances 1
Nr Exposed 3
Gravity 5
FTA Current Penalty 0.0
Citation text line 29 CFR 1910.101(b): Section 3.4.4, Compressed Gas Association Pamphlet P11965, as adopted by 29 CFR 1910.101(b): Compressed gas cylinder(s) in use were not properly supported to prevent them from being knocked over: (a) At the work site; carpenter shop; compressed gas cylinder containing acetylene was stored on it's side on a cart and was not secured from falling or from being knocked over; on or about 6/5/13. Note: The employer is required to submit abatement certification for this item in accordance with 29 CFR 1903.19.
Citation ID 01005
Citaton Type Serious
Standard Cited 19100151 C
Issuance Date 2013-09-13
Abatement Due Date 2013-10-31
Current Penalty 2400.0
Initial Penalty 4000.0
Contest Date 2013-12-30
Final Order 2014-04-28
Nr Instances 1
Nr Exposed 3
Gravity 5
FTA Current Penalty 0.0
Citation text line 29 CFR 1910.151(c): Where employees were exposed to injurious corrosive material suitable facilities for quick drenching or flushing of the eyes and body were not provide within the work area for immediate emergency use: a) At the worksite, kitchen area; the employees were not provided with an eye wash for quick drenching or flushing of the eyes and body during the use of, such as, but not limited to, sanitizer resolve three containing sodium hypochlorite, on or about 4/18/13. Note: The employer is required to submit abatement certification for this item in accordance with 29 CFR 1903.19.
Citation ID 01006
Citaton Type Serious
Standard Cited 19100253 B04 III
Issuance Date 2013-09-13
Abatement Due Date 2013-09-19
Current Penalty 1800.0
Initial Penalty 3000.0
Contest Date 2013-12-30
Final Order 2014-04-28
Nr Instances 1
Nr Exposed 3
Gravity 1
FTA Current Penalty 0.0
Citation text line 1910.253(b)(4)(iii): Oxygen cylinders in storage were not separated from fuelgas cylinders or combustible materials (especially oil or grease), a minumum distance of 20 feet (6.1 m) or by a noncombustible barrier at least 5 feet (1.5 m) high having a fire resistant rating of at least one half hour: a) At the work site, carpentar shop; one acetylene cylinder and one oxygen cylinder were stored together, on or about 6/5/13. Note: The employer is required to submit abatement certification for this item accordance with 29 CFR 1903.19.
Citation ID 01007
Citaton Type Serious
Standard Cited 19100305 B01 II
Issuance Date 2013-09-13
Abatement Due Date 2013-09-19
Current Penalty 2400.0
Initial Penalty 4000.0
Contest Date 2013-12-30
Final Order 2014-04-28
Nr Instances 1
Nr Exposed 3
Gravity 5
FTA Current Penalty 0.0
Citation text line 29 CFR 1910.305(b)(1)(ii): Unused openings in cabinets, boxes, and fittings were not effectively closed: a) At the work site, food service area; the electrical panel box had two rectangular openings approximately 2 1/2 " wide by 1 " high and 2" wide by 2 3/4" high; on or about 4/18/13. Note: The employer is required to submit abatement certification for this item accordance with 29 CFR 1903.19.
Citation ID 01008A
Citaton Type Serious
Standard Cited 19101030 C01 IV B
Issuance Date 2013-09-13
Abatement Due Date 2013-10-31
Current Penalty 2400.0
Initial Penalty 4000.0
Contest Date 2013-12-30
Final Order 2014-04-28
Nr Instances 1
Nr Exposed 5
Gravity 5
FTA Current Penalty 0.0
Citation text line 29 CFR 1910.1030(c)(1)(iv)(B): The Exposure Control Plan was not documented annually for effective safer medical devices designed to eliminate or minimize occupational exposure: a) At the work site; the employer did not include in the Exposure Control Plan annual documentation for effective safer medical devices designed to eliminate or minimize occupational exposure, such as, but not limited to, needle stick injuries, on or about 6/11/2013. Note: The employer is required to submit abatement certification for this item in accordance with 29 CFR 1903.19.
Citation ID 01008B
Citaton Type Serious
Standard Cited 19101030 D02 II
Issuance Date 2013-09-13
Abatement Due Date 2013-10-31
Current Penalty 0.0
Initial Penalty 0.0
Contest Date 2013-12-30
Final Order 2014-04-28
Nr Instances 1
Nr Exposed 5
Gravity 5
FTA Current Penalty 0.0
Citation text line 1910.1030(d)(2)(ii): The employer did not examine and maintain or replace on a regular schedule engineering controls to ensure their effectiveness: a) At the work site; the employer did not examine and maintain or replace effective safer medical devices designed to eliminate or minimize occupational exposure, such as, but not limited to, needle stick injuries, on or about 6/11/2013. Note: The employer is required to submit abatement certification for this item in accordance with 29 CFR 1903.19.
Citation ID 01009A
Citaton Type Serious
Standard Cited 19101030 D03 I
Issuance Date 2013-09-13
Abatement Due Date 2013-10-31
Current Penalty 2400.0
Initial Penalty 4000.0
Contest Date 2013-12-30
Final Order 2014-04-28
Nr Instances 1
Nr Exposed 5
Gravity 5
FTA Current Penalty 0.0
Citation text line 1910.1030(d)(3)(i) The employer did not provide appropriate personal protective equipment, such as, but not limited to, eye protection: a) At the work site, pediatric unit ; employees with the job title of nurse providing care to residents, such as, but not limited to, wound care or tube dressing change did not receive eye protection, on or about 6/5/2013. b) At the work site, resident care (azalea) spill kit for blood or body fluid and isolation cart; employees with the job title of nurse were not provided with eye protection, on or about 6/11/2013 Note: The employer is required to submit abatement certification for this item item in accordance with 29 CFR 1903.19.
Citation ID 01009B
Citaton Type Serious
Standard Cited 19101030 D03 X
Issuance Date 2013-09-13
Abatement Due Date 2013-10-31
Current Penalty 0.0
Initial Penalty 0.0
Contest Date 2013-12-30
Final Order 2014-04-28
Nr Instances 2
Nr Exposed 5
Gravity 5
FTA Current Penalty 0.0
Citation text line 1910.1030(d)(3)(x) Masks, Eye Protection, and Face Shields. Masks in combination with eye protection devices, such as goggles or glasses with solid side shields, or chin-length face shields, were not worn whenever splashes, spray, spatter, or droplets of blood or other potentially infectious materials may be generated and eye, nose, or mouth contamination can be reasonably anticipated: a) At the work site, pediatric unit ; employees with the job title of nurse providing care to residents, such as, but not limited to, wound care or tube dressing change did not receive eye protection, on or about 6/5/2013. b) At the work site, resident care (azalea) spill kit for blood or body fluid and isolation cart; employees with the job title of nurse were not provided with eye protection, on or about 6/11/2013 Note: The employer is required to submit abatement certification for this item item in accordance with 29 CFR 1903.19.
Citation ID 01010
Citaton Type Serious
Standard Cited 19101030 D04 I
Issuance Date 2013-09-13
Abatement Due Date 2013-10-31
Current Penalty 2400.0
Initial Penalty 4000.0
Contest Date 2013-12-30
Final Order 2014-04-28
Nr Instances 1
Nr Exposed 5
Gravity 5
FTA Current Penalty 0.0
Citation text line 1910.1030(d)(4)(i) Employer did not ensure that the worksite is maintained in a clean and sanitary condition. The employer did not determine and implement an appropriate written schedule for cleaning and method of decontamination based upon the type of soil present: a) At the work site; oxygen storage room; the employer did not maintain the workplace in a clean and sanitary condition, such as, but not limited to; the proper disposal of contaminated gloves; on or about 6/11/2013. Note: The employer is required to submit abatement certification for this item in accordance with 29 CFR 1903.19.
Citation ID 01011A
Citaton Type Serious
Standard Cited 19101030 D04 III B1III
Issuance Date 2013-09-13
Abatement Due Date 2013-10-31
Current Penalty 2400.0
Initial Penalty 4000.0
Contest Date 2013-12-30
Final Order 2014-04-28
Nr Instances 2
Nr Exposed 5
Gravity 5
FTA Current Penalty 0.0
Citation text line 1910.1030(d)(4)(iii)(B)(1)(iii): Regulated waste was not labeled or color-coded with paragraph (g)(1)(i); a) At the worksite; Soiled holding room (Spring), contaminated laundry was placed in clear plastic bags; on or abour 6/5/2013. b) At the worksite; Utility Room (Carnation) contaminated laundry was placed in clear plastic bags; on or about 6/11/2013. Note: The employer is required to submit abatement certification for this item in accordance with 29 CFR 1903.19.
Citation ID 01011B
Citaton Type Serious
Standard Cited 19101030 D04 IV A 2
Issuance Date 2013-09-13
Abatement Due Date 2013-10-31
Current Penalty 0.0
Initial Penalty 0.0
Contest Date 2013-12-30
Final Order 2014-04-28
Nr Instances 2
Nr Exposed 5
Gravity 5
FTA Current Penalty 0.0
Citation text line 1910.1030(d)(4)(iv)(A)(2): Contaminated laundry was not placed and transported in bags or containers labeled or color-coded in accordance with paragraph (g)(1)(i) of this standard: a) At the worksite; Soiled holding room (Spring), contaminated laundry was placed in clear plastic bags; on or about 6/5/2013. b)At the worksite; Utility Room (Carnation) contaminated laundry was placed in clear plastic bags; on or about 6/11/2013. Note: The employer is required to submit abatement certification for this item in accordance with 29 CFR 1903.19.
Citation ID 01011C
Citaton Type Serious
Standard Cited 19101030 G02 VII
Issuance Date 2013-09-13
Abatement Due Date 2013-10-31
Current Penalty 0.0
Initial Penalty 0.0
Contest Date 2013-12-30
Final Order 2014-04-28
Nr Instances 1
Nr Exposed 5
Gravity 5
FTA Current Penalty 0.0
Citation text line 1910.1030(g)(2)(vii): Training: training program did not contain the following element: When contaminated laundry is placed and transported in bags or containers it must be labeled or color-coded in accordance with paragraph (g)(1)(i) of this standard: a) At the worksite; Soiled holding room (Spring), contaminated laundry was placed in clear plastic bags; on or about 6/5/2013. b)At the worksite; Utility Room (Carnation) contaminated laundry was placed in clear plastic bags; on or about 6/11/2013. Note: The employer is required to submit abatement certification for this item in accordance with 29 CFR 1903.19.
Citation ID 02001
Citaton Type Other
Standard Cited 19100157 C01
Issuance Date 2013-09-13
Abatement Due Date 2013-10-09
Current Penalty 0.0
Initial Penalty 0.0
Contest Date 2013-12-30
Final Order 2014-04-28
Nr Instances 1
Nr Exposed 3
FTA Current Penalty 0.0
Citation text line 1910.157(c)(1) The employer did not provide portable fire extinguisher so that they are readily accessible to employees without subjecting the employees to possible injury: (a) At the work site, cooking area; portable fire extinguisher was blocked by debris; on or about 4/18/13. Note: The employer is required to submit abatement certification for this item in accordance with 29 CFR 1903.19.
Citation ID 02002
Citaton Type Other
Standard Cited 19101200 E01 I
Issuance Date 2013-09-13
Abatement Due Date 2013-10-31
Current Penalty 0.0
Initial Penalty 0.0
Contest Date 2013-12-30
Final Order 2014-04-28
Nr Instances 1
Nr Exposed 3
FTA Current Penalty 0.0
Citation text line 1910.1200(e)(1)(i) A list of the hazardous chemicals known to be present was not provided to identify and reference the appropriate safety data sheet (the list may be compiled for the workplace as a whole or for individual work areas); (a) At the work site; the employer did not provde a list of identify and reference ; on or about 6/5/13. Note: The employer is required to submit abatement certification for this item in accordance with 29 CFR 1903.19.

Related by officers

C/O SENTOSACARE, LLC

GOLDEN GATE NURSING HOME MANAGEMENT, LLC WHITE PLAINS CENTER FOR NURSING CARE LLC

Related by address

945 BROADWAY, WOODMERE, NY, United States, 11598

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Date of last update: 30 Mar 2025

Sources: New York Secretary of State

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