Inspection Details

Inspection #
INSP-0062107
Inspection Date(s)
7/5/2024
Status
Complete
Inspection Type
Compliance (Annual)
Worksheet Type
Assisted Living Home
Certificate Number
AL12286H
Location Type
โ€”

Initial Comments

The following deficiencies were found during the on-site compliance inspection conducted on July 5, 2024:

Statement of Deficiency

2 deficiencies found
Deficiency #1
✓ Plan Provided
Rule
A. A manager shall ensure that: 10. Oxygen containers are secured in an upright position;
Evidence
Based on observation and interview, the manager failed to ensure oxygen containers were secured in an upright position. The deficient practice posed a risk of a potential explosion or leak of a compressed gas. Findings include: 1. During a tour of the facility, the Compliance Officers observed three oxygen containers in an unlocked outdoor storage shed. Two of the containers were stored upright in a box, but not secured. One oxygen container was stored in the box, but not upright or secured. 2. In an interview, E1 acknowledged the oxygen containers were not secured in an upright position.
Plan of Correction
Permanent Correction Date
2024-07-05
Deficiency #2
✓ Plan Provided
Rule
A. A manager shall ensure that: 11. Poisonous or toxic materials stored by the assisted living facility are maintained in labeled containers in a locked area separate from food preparation and storage, dining areas, and medications and are inaccessible to residents;
Evidence
Based on observation and interview, the manager failed to ensure poisonous or toxic materials stored by the assisted living facility were maintained in a locked area inaccessible to residents. The deficient practice posed a risk to the physical health and safety of a resident. Findings include: 1. During a tour of the facility, the Compliance Officers observed the following poisonous or toxic materials stored unlocked by the assisted living facility: - One gallon of Liquinox Grow All Purpose Liquid Fertilizer stored in an outdoor gazebo, - Bissell Clean and Refresh stored in an unlocked outside storage shed, - One gallon of Behr Masonry, Stucco & Brick paint stored in an unlocked outside storage shed, - One gallon of Behr Interior Ceiling Flat paint stored in an unlocked outside storage shed, - One gallon of Behr Cabinet, Door, and Trim Enamel paint stored in an unlocked outside storage shed, and - One quart of Mapei Ultrabond ECO 373 flooring adhesive stored in an unlocked outside storage shed. 2. In an interview, E1 acknowledged there were poisonous or toxic materials stored by the assisted living facility maintained in unlocked areas.
Plan of Correction
Permanent Correction Date
2024-07-05