Cheerful Adult Homes LLC

OAR 411-050-0750(2)(a-d) Resident Records: Assessment/SDS 913/Adv Dire (2) The record must contain the following information:(a) A complete initial screening assessment and general information form (SDS 902) as described in OAR 411-051-0110.(b) Documentation on form (SDS 913) that the licensee or administrator has informed private-pay residents of the availability of a long-term care assessment.(c) Documentation on form (SDS 0342A) that the licensee or administrator has oriented the resident to emergency evacuation procedures as described in OAR 411-050-0725(1). (d) Documentation that the licensee or administrator has informed all residents of the right to formulate an Advance Directive.

A review of Resident 1's record revealed no documentation on form SDS 0342A that the administrator had oriented Resident 1 to emergency evacuation procedures as described in OAR 411-050-0725(1).

Technical Assistance Provided. Written plan of correction not required.

OAR 411-049-0120(1)(a) Background Check Documentation (1) All subject individuals (SI) must have an approved background check, which for non-licensees or non-licensee applicants, may include an approved preliminary fitness determination, prior to operating, working in, training in, or living in an AFH. (a) Licensees must maintain documentation of preliminary and final fitness determinations with the home's facility records in accordance with these rules and the background check rules.

During scheduled renewal inspection it was found that substitute caregiver #1 did not have the correct position on the approved background check.

Statement of Correction Written as Received: Correction done. SI matches the job deseription. More attention will be taken when doing the Background of SI.

OAR 411-049-0125(7) Training within First Year (7) TRAINING WITHIN FIRST YEAR OF INITIAL LICENSURE OR APPROVAL. Within the first year of obtaining an initial license or approval, the licensee, administrator, resident manager, floating resident manager, and shift caregivers must complete the "DHS Six Rights of Safe Medication Administration" and a Fire and Life Safety training as available. The Department or LLA and the Office of the State Fire Marshal or the local fire prevention authority may coordinate the Fire and Life Safety training program.

During scheduled renewal inspection it was found that administrator did not complete the correct Fire and Life Safety Training.

Statement of Correction Written as Received: The training was done in the Care Partners site while the requirement is on Workday. This has been noted and acted upon. We'll be careful to not the Required Training Sites. (C02865)) Class unavailable for year 2024 after completing the preliquisites.

OAR 411-050-0715(3)(c) Fac Standards: Screens (c) All doors and windows that are used for ventilation must have screens in good condition.

During scheduled renewal if was found that the front windows open outward. However, they did not have screens.

Technical Assistance Provided. Written plan of correction not required.

OAR 411-050-0720(12) Facility: First Aid (12) FIRST AID. Current, basic first-aid supplies and a first-aid manual must be readily available in the home.

During scheduled renewal inspection it was found that there was no first aid manual available in the home.

Technical Assistance Provided. Written plan of correction not required.

OAR 411-050-0725(7)(a)(A)(i-vi) Safety: Emergency Plan (7) EMERGENCY PREPAREDNESS PLAN. A licensee or administrator must develop and maintain a written emergency preparedness plan for the protection of all occupants in the home in the event of an emergency or disaster.(a) The written emergency plan must:(A) Include an evaluation of potential emergency hazards including, but not limited to:(i) Prolonged power failure or water or sewer loss.(ii) Fire, smoke, or explosion.(iii) Structural damage.(iv) Hurricane, tornado, tsunami, volcanic eruption, flood, or earthquake.(v) Chemical spill or leak.(vi) Pandemic.

During scheduled renewal inspection it was found that the emergency preparedness plan had not been annually reviewed.

Technical Assistance Provided. Written plan of correction not required.

OAR 411-050-0735(3)(b) Facility Records: Verification Exclusion Lis (b) Verification of checking the Exclusion Lists must be clearly documented in the facility records.

During scheduled renewal inspection it was found that caregiver #2 did not have proof in records that the SAM and OIG exclusions search were done.

Statement of Correction Written as Received: Issue Rectified and forwarded to the inspector on 02/19/2025. Will be careful to follow through the Requirements

OAR 411-050-0735(4) Employment Applications: Abuse (4) EMPLOYMENT APPLICATION. An application for employment in any capacity in an AFH must include a question asking whether the person applying for employment has been found to have committed abuse. Employment applications must be retained for at least three years.

During scheduled renewal inspection it was found that caregiver #2 and #3's employment application did not include the required abuse question.

Technical Assistance Provided. Written plan of correction not required.