Inspection Details: Q0P3


Date
1/17/2023
Event ID
Q0P3
Inspection type(s)
Validation
Deficiencies cited
3

Citation Details

C0000
Severity Level: 0
Visits: 2
Scope
Visit Number
1
Visit Date
1/19/2023
Corrected Date
N/A
Details

The findings of the re-licensure survey, conducted 01/17/23  through 01/19/23, are documented in this report. The survey was conducted to determine compliance with the OARs 411 Division 54 for Residential Care and Assisted Living Facilities and Home and Community Based Services Regulations OARs 411 Division 004.


Abbreviations possibly used in this document:


ADL:activities of daily living

bid:twice a day

CBG:capillary blood glucose or

blood sugar

CG:caregiver

cm:centimeter

ED:Executive Director

F:Fahrenheit

HH:Home Health

LPN:Licensed Practical Nurse

MA:          Medication Aide

MAR:Medication Administration

Record

MCC:Memory Care Community

mg:milligram

ml:milliliter

MT:Medication Technician

OT:Occupational Therapist

PT: Physical Therapist

PRN:as needed

qd:every day or daily

qid:four times a day

QI:     quality improvement

RCC:       Resident Care Coordinator

RN:     Registered Nurse

TAR:     Treatment Administration

Record

tid:           three times a day

Visit Number
2
Visit Date
4/7/2023
Corrected Date
N/A
Details



The findings of the re-visit to the re-licensure survey of 01/19/23, conducted 04/07/23, are documented in this report. It was determined the facility was in substantial compliance with the OARs 411 Division 54 for Residential Care and Assisted Living Facilities and OARs 411 Division 004 for Home and Community Based Services Regulations.




C0613
Severity Level: 2
Visits: 2
Scope
Widespread/Minimal harm or potential for moderate harm
Visit Number
1
Visit Date
1/19/2023
Corrected Date
N/A
Details

Based on observation and interview, it was determined the facility failed to ensure all interior materials and surfaces were kept clean and in good repair. Findings include, but are not limited to:


The interior of the facility was toured on 01/17/23 at 11:05 am.


a. The following areas needed repair:


* The linoleum floor behind the washer and dryer equipment in Laundry Room A and Laundry Room B was torn making it an uncleanable surface; and

* The wall under the wastewater outlets of both washing machines in Laundry Room A had flaking and peeling paint caused by water damage.


b. The following areas needed cleaning:


* The ceiling vent in the dining area directly above the window for passing food trays from the kitchen was covered with layers of dust; and

* Kitchen cabinet surfaces in the Activity Room had dried debris and were sticky.


The building was toured and areas needing cleaning or repair were discussed with Staff 1 (Executive Director) and Staff 3 (Maintenance Director) at 09:40 am on 01/18/23. They acknowledged the areas needing cleaning and repair.

Plan of Correction

The Laundry Room walls were scheduled to be painted and floors replaced in February.  Flooring has been ordered.

The ceiling vent and Activity Room kitchen cabinets have been cleaned.





These items have been added to the custodian's cleaning checklist.


Monthly




Executive Director

Visit Number
2
Visit Date
4/7/2023
Corrected Date
3/20/2023
Details

There are no detail notes for this visit.

C0655
Severity Level: 2
Visits: 2
Scope
Widespread/Minimal harm or potential for moderate harm
Visit Number
1
Visit Date
1/19/2023
Corrected Date
N/A
Details

Based on observation and interview, it was determined the facility failed to provide exit door alarms or other acceptable systems for security purposes and to alert staff when residents exit the ALF. Findings include, but are not limited to:


The interior of the facility was toured on 01/17/23 at 11:05 am.


* The doors leading to the central courtyard lacked a system that alerted staff when a resident exited the building.


The building was toured and areas needing alarms were discussed with Staff 1 (Executive Director) and Staff 3 (Maintenance Director) at 09:40 am on 01/18/23. They acknowledged the need to install exit door alarms.



Plan of Correction

This is a new interpretation for door alarms to the courtyard.  Alarms are being ordered and will be installed.




Alarms will be installed on doors leading out to the courtyard.




Once alarms are installed they will be monitored by maintenance during monthly routine checks.




Executive Director

Visit Number
2
Visit Date
4/7/2023
Corrected Date
3/20/2023
Details

There are no detail notes for this visit.