| Name: | QUEENS BOULEVARD EXTENDED CARE FACILITY MANAGEMENT LLC |
| Jurisdiction: | New York |
| Legal type: | DOMESTIC LIMITED LIABILITY COMPANY |
| Status: | Active |
| Date of registration: | 02 Feb 2012 (13 years ago) |
| Entity Number: | 4197367 |
| ZIP code: | 11377 |
| County: | Queens |
| Place of Formation: | New York |
| Address: | 61-11 QUEENS BOULEVARD, WOODSIDE, NY, United States, 11377 |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| QUEENS BOULEVARD EXTENDED CARE FACILITY MANAGEMENT, LLC 401(K) PLAN | 2023 | 464655926 | 2024-10-10 | QUEENS BOULEVARD EXTENDED CARE FACILITY MANAGEMENT, LLC | 251 | |||||||||||||
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| Name | Role | Address |
|---|---|---|
| QUEENS BOULEVARD EXTENDED CARE FACILITY MANAGEMENT LLC | DOS Process Agent | 61-11 QUEENS BOULEVARD, WOODSIDE, NY, United States, 11377 |
| Start date | End date | Type | Value |
|---|---|---|---|
| 2023-03-16 | 2024-12-04 | Address | 61-11 QUEENS BOULEVARD, WOODSIDE, NY, 11377, USA (Type of address: Service of Process) |
| 2014-06-04 | 2023-03-16 | Address | 61-11 QUEENS BLVD, WOODSIDE, NY, 11377, USA (Type of address: Service of Process) |
| 2012-02-02 | 2014-06-04 | Address | 61-11 QUEENS BOULEVARD, WOODSIDE, NY, 11377, USA (Type of address: Service of Process) |
| Filing Number | Date Filed | Type | Effective Date |
|---|---|---|---|
| 241204001436 | 2024-12-04 | BIENNIAL STATEMENT | 2024-12-04 |
| 230316001472 | 2023-03-16 | BIENNIAL STATEMENT | 2022-02-01 |
| 211116001757 | 2021-11-16 | BIENNIAL STATEMENT | 2021-11-16 |
| 191106060413 | 2019-11-06 | BIENNIAL STATEMENT | 2018-02-01 |
| 160104000267 | 2016-01-04 | CERTIFICATE OF PUBLICATION | 2016-01-04 |
| 140604002287 | 2014-06-04 | BIENNIAL STATEMENT | 2014-02-01 |
| 140304000226 | 2014-03-04 | CERTIFICATE OF AMENDMENT | 2014-03-04 |
| 120202000555 | 2012-02-02 | ARTICLES OF ORGANIZATION | 2012-02-02 |
| Inspection Nr | Report ID | Date Opened | Site Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 345876981 | 0215600 | 2022-04-05 | 61-11 QUEENS BOULEVARD, FLUSHING, NY, 11377 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| Type | Inspection |
| Activity Nr | 1479868 |
| Health | Yes |
Violation Items
| Citation ID | 01001 |
| Citaton Type | Other |
| Standard Cited | 19040041 A02 |
| Issuance Date | 2022-08-16 |
| Current Penalty | 1450.0 |
| Initial Penalty | 1450.0 |
| Final Order | 2022-09-14 |
| Nr Instances | 1 |
| Nr Exposed | 1 |
| FTA Current Penalty | 0.0 |
| Citation text line | 29 CFR 1904.41(a)(2): The establishment had 20 or more but fewer than 250 employees at any time during the previous calendar year, and the establishment was classified as an industry listed in appendix A to subpart E of this part, but did not electronically submit information from OSHA 300A Summary of Work-Related Injuries and Illnesses to OSHA or OSHA's designee. The employer did not submit the information once a year, no later than the date listed in paragraph (c) of this section of the year after the calendar year covered by the form: a) Queens Boulevard Extended Care Facility Management LLC : On or about 4/05/2022, and times prior thereto, the employer failed during calendar year 2021, to electronically submit information from the OSHA Form 300A or equivalent by 03/02/2022. The establishment employed approximately 200 employees and was classified in 623110 during calendar year 2021. |
| Inspection Type | Fat/Cat |
| Scope | Partial |
| Safety/Health | Health |
| Close Conference | 2020-10-16 |
| Case Closed | 2022-08-09 |
Related Activity
| Type | Accident |
| Activity Nr | 1608061 |
Violation Items
| Citation ID | 01001A |
| Citaton Type | Serious |
| Standard Cited | 19100134 E01 |
| Issuance Date | 2020-10-16 |
| Abatement Due Date | 2020-11-04 |
| Current Penalty | 0.0 |
| Initial Penalty | 13494.0 |
| Contest Date | 2020-10-23 |
| Final Order | 2021-09-29 |
| Nr Instances | 1 |
| Nr Exposed | 2 |
| Gravity | 10 |
| FTA Current Penalty | 0.0 |
| Citation text line | 29 CFR 1910.134(e)(1): The employer did not provide a medical evaluation to determine the employee's ability to use a respirator, before the employee was fit tested or required to use the respirator in the workplace: a) On or about 5/4/2020 and thereafter - establishment, 61-11 Queens Boulevard, Woodside, NY 11377 Employer did not ensure that employees, an LPN and a Recreation Therapist, who were required to wear N95 respirators, were provided a medical evaluation prior to use of the respirators. ABATEMENT CERTIFICATION IS REQUIRED FOR THIS ITEM PURSUANT TO 29 CFR 1903.19 |
| Citation ID | 01001B |
| Citaton Type | Other |
| Standard Cited | 19100134 F02 |
| Issuance Date | 2020-10-16 |
| Abatement Due Date | 2020-11-04 |
| Current Penalty | 10795.4 |
| Initial Penalty | 0.0 |
| Contest Date | 2020-10-23 |
| Final Order | 2021-09-29 |
| Nr Instances | 1 |
| Nr Exposed | 1 |
| Gravity | 10 |
| FTA Current Penalty | 0.0 |
| Citation text line | 29 CFR 1910.134(f)(2): Employee(s) using tight-fitting facepiece respirators were not fit tested prior to initial use of the respirator: a) On or about 5/26/2020 and thereafter - establishment, 61-11 Queens Boulevard, Woodside, NY 11377 Employer did not ensure that a Recreational Therapist, who was required to wear a N95 respirator while providing care to known and suspected COVID-19 residents, was fit tested prior to initial use of the respirator. ABATEMENT CERTIFICATION IS REQUIRED FOR THIS ITEM PURSUANT TO 29 CFR 1903.19 |
| Citation ID | 02001 |
| Citaton Type | Other |
| Standard Cited | 19040004 A |
| Issuance Date | 2020-10-16 |
| Abatement Due Date | 2020-11-12 |
| Current Penalty | 0.0 |
| Initial Penalty | 1928.0 |
| Contest Date | 2020-10-23 |
| Final Order | 2021-09-29 |
| Nr Instances | 1 |
| Nr Exposed | 1 |
| FTA Current Penalty | 0.0 |
| Citation text line | 29 CFR 1904.4(a): The employer did not record each work-related fatality, injury or illness case that resulted in the general recording criteria on the OSHA Form 300 or equivalent: At the establishment, 61-11 Queens Boulevard, Woodside, NY 11377 The following case involving COVID-19 illness was not recorded on the calendar year 2020 OSHA-300 Log of Work-Related Injuries and Illnesses: a) On or about 4/17/2020, the employer failed to record an employee's work-related confirmed case of COVID-19 that resulted in 59 days away from work. ABATEMENT CERTIFICATION IS REQUIRED FOR THIS ITEM PURSUANT TO 29 CFR 1903.19 |
| Citation ID | 02002 |
| Citaton Type | Other |
| Standard Cited | 19100134 C02 I |
| Issuance Date | 2020-10-16 |
| Abatement Due Date | 2020-11-10 |
| Current Penalty | 0.0 |
| Initial Penalty | 0.0 |
| Contest Date | 2020-10-23 |
| Final Order | 2021-09-29 |
| Nr Instances | 1 |
| Nr Exposed | 40 |
| FTA Current Penalty | 0.0 |
| Citation text line | 29 CFR 1910.134(c)(2)(i): When the employer determined that any voluntary respirator use was permissible, the employer did not provide the respirator users with the information in Appendix D of this section ("Information for Employees Using Respirator When Not Required Under the Standard"): a) On or about 4/16/2020 and thereafter - establishment, 61-11 Queens Boulevard, Woodside, NY 11377 Food Services Management employees were provided with N95 filtering facepiece respirators for voluntary use and were not provided with the information outlined in Appendix D. ABATEMENT CERTIFICATION IS REQUIRED FOR THIS ITEM PURSUANT TO 29 CFR 1903.19 |
Date of last update: 26 Mar 2025
Sources: New York Secretary of State
