Floors inside resident rooms stained and cracked. Floors shall be maintained in good repair.
1.0
2.
.1310- Walls peeling paint throughout establishment. The walls and ceilings of all rooms and areas shall be kept clean and in good repair. Establishment has started to renovate. Repeat.
1.0
7.
.1312(d)- Handwashing sinks are not present in the shower rooms throughout facility. Any area where personnel may be exposed to bodily excretions or secretions shall have handwashing facilities located in the same room or have a doorway connecting to an adjacent room or corridor containing handwashing facilities.
.1312(a)- Cleaning needed of residents rest rooms in rooms on the 4th and 3rd floor. All institutions shall be provided with toilet, handwashing, and bathing facilities that are conveniently located and readily accessible to residents and staff. These facilities, and laundry facilities when provided, shall be kept clean and in good repair. Repeat.
.1310- Peeling wallpaper in numerous rooms and peeling baseboards. Large dent/hole in room 220. Third floor Biohazard room has peeling paint/caulking. The walls and ceilings of all rooms and areas shall be kept clean and in good repair.
1.0
7.
.1312(d)- Handwashing sinks are not present in the shower rooms throughout facility. Any area where personnel may be exposed to bodily excretions or secretions shall have handwashing facilities located in the same room or have a doorway connecting to an adjacent room or corridor containing handwashing facilities.
.1312(a)- Tub in Rm 428 has green/pink buildup and requires cleaning. All institutions shall be provided with toilet, handwashing, and bathing facilities that are conveniently located and readily accessible to residents and staff. These facilities, and laundry facilities when provided, shall be kept clean and in good repair.
2.0
10.
.1312(d) All of the med rooms do not have hand soap and paper towels available. The kitchenette on the 4th floor does not have hand soap available at the hand sink. Handwashing facilities shall be supplied with soap and disposable towels or hand-drying devices.
1.5
20.
.1314(c) The ice chest cart on the 4th floor was left unattended. Ice shall be protected against physical, chemical, and biological contamination and shall be kept clean. Ice machines, buckets, and scoops shall be kept clean and in good repair. Ice machines and storage chests accessible to residents, guests, or the public shall provide ice through automatic ice dispensing equipment and shall not permit ice to be accessed using a scoop or bucket.
1.0
32.
.1319 (a) food debris underneath the chair cushions of the day room on the 4th floor. Room 315 has tears in the mattress cover. Furnishings in an institution, including furniture, curtains, rugs, and blinds, shall be kept clean and in good repair. Mattresses shall be kept clean, dry, and in good repair.
0.5
36.
.1319 Soiled laundry bins on all floors in soiled utility rooms observed without labels. Linens that are not clean shall be placed in a covered container or bag devoted to this purpose at the point of use and stored in the covered container or bag until sanitized in accordance with Paragraph (c) of this Rule to contain and minimize aerosolization of and exposure to any waste products. Such covered containers or bags shall be kept clean between uses and labeled to indicate the contents.
0.5
38.
.1320 (c) Observed microwaves in need of interior cleaning on the fourth and second floor. Non-food-contact surfaces of equipment shall be cleaned at such intervals as to keep them in a clean and sanitary condition.
.1310- Peeling wallpaper in numerous rooms and peeling baseboard of restroom observed in Rm 432. Third floor Biohazard room has peeling paint/caulking. The walls and ceilings of all rooms and areas shall be kept clean and in good repair.
1.0
5.
.1311- Observed air vents throughout the facility in need of cleaning. Air vents shall be maintained clean.
1.0
8.
.1312(d)- Handwashing sinks are not present in the shower rooms and med rooms throughout facility. Any area where personnel may be exposed to bodily excretions or secretions shall have handwashing facilities located in the same room or have a doorway connecting to an adjacent room or corridor containing handwashing facilities. Repeat
.1312 (a) Observed cleaning needing to be done to the bathrooms in room 401, 410, 420 had pink build up surrounding the shower drain, 312, 324, and 212. Bathrooms shall be maintained clean.
1.0
12.
.1312 (d) Observed rooms 410, 431, and 312 did not have soap available. Room 312 did not have paper towels available. All rooms shall be supplied with soap and sanitary towels or hand-drying devices.
1.5
34.
.1319(b) Observed soiled linen containers not labeled in the laundry room. Carts used for soiled laundry shall be labeled for soiled laundry use only.
0.0
36.
.1320 (c) Observed microwaves in need of interior cleaning on the fourth and second floor. Non-food-contact surfaces of equipment shall be cleaned at such intervals as to keep them in a clean and sanitary condition.
.1310- Peeling wallpaper in numerous rooms and peeling baseboard of restroom observed in Rm 432. Third floor Biohazard room has peeling paint/caulking. The walls and ceilings of all rooms and areas shall be kept clean and in good repair.
1.0
8.
.1312(d)- Handwashing sinks are not present in the shower rooms and med rooms throughout facility. Any area where personnel may be exposed to bodily excretions or secretions shall have handwashing facilities located in the same room or have a doorway connecting to an adjacent room or corridor containing handwashing facilities.
.1312(a)- Shower head in Rm 410 with unclean buildup. Tub in Rm 311 has green/pink buildup and requires cleaning. Paper towel dispenser in Rm 308 is nonfunctional. All institutions shall be provided with toilet, handwashing, and bathing facilities that are conveniently located and readily accessible to residents and staff. These facilities, and laundry facilities when provided, shall be kept clean and in good repair.
1.0
13.
General Comment: .1312(e)- Handwashing sinks in resident`s rooms (410, 311, 308) with a hot water temperature of 118F. Water heating facilities shall provide hot water within the temperature range of 100 degrees F to 116 degrees F at all lavatories and bathing facilities. Adjust temperature a few degrees lower to ensure hot water does not exceed 116F at these areas.
0.0
19.
.1314(b)- Ice machine on 3rd floor with microbial growth present on corner of ice shield. Ice machines, buckets, other containers, and scoops shall be cleaned on a regular schedule such that they are kept free of scum, rust, mold or other contamination. Clean ice machine more frequently.
1.0
24.
.1317(a)- A few lively roaches were observed throughout the facility today. Effective measures shall be taken to keep flies, rodents, cockroaches, and other vermin out of the establishment and to prevent their breeding or presence on the premises.
1.5
32.
1319(a)- Mattresses in Rm 308, Rm 208, and Rm 206 observed with unclean residue present/staining. All furniture, bed springs, mattresses, sleeping mats, draperies, curtains, shades, venetian blinds, or other furnishings in institutions shall be kept clean and in good repair. Mattresses shall be kept clean, dry and odor free.
1.0
36.
General Comment: 1320(c)- Microwave oven interior on the 3rd floor was soiled. The Non-food-contact surfaces of equipment shall be cleaned at such intervals as to keep them in a clean and sanitary condition.
0.0
General Comments
Areas inspected include all common areas, community restrooms, Rm 410, Rm 405, Rm 432, Rm 333, Rm 311, Rm 308, Rm 208, Rm 206, 230, shower rooms, soiled utility room, clean linen closets, laundry room, med rooms, and can wash. Inspection led by Cris LeClair.
2-3 patient/resident rooms appeared to have peeling walls. Floors, walls and ceilings shall be kept in good repair.
0.0
13.
Hot water in resident rooms on the second floor were reaching up to 128F. Lavatory and bathing hot water shall remain at a temperature between 100-116F.
1.0
28.
Water cups for residents were stored in boxes on the floor. All patient care items shall be stored at least eight inches above the floor to prevent water contamination from cleaning floors.
0.0
29.
Mop sink in the fourth floor janitor's closet was clogged/overflowing and not able to be used. Mop sinks shall be provided and accessible / able to be used. Plumber has been called to resolve this issue.
0.0
36.
Microwave oven interior on the third floor and refrigerator unit on the fourth floor were soiled. The Non-food-contact surfaces of equipment shall be cleaned at such intervals as to keep them in a clean and sanitary condition.
1.0
42.
After EHS thermometer was reading high in the 4th floor kitchenette refrigerator, milk closest to the door was tested and read at 52F. Potentially hazardous foods being held cold shall remain at 45F or below. Other foods farther into the center of the refrigerator were below 45F. Milk was voluntarily discarded. EHS recommends having this refrigerator adjusted.
2.0
General Comments
Due to COVID-19 event no occupied resident rooms, dining areas, or communal areas were inspected today.
Medical storage room had splatter / soil residue on the wall. Walls and ceilings shall be kept clean. Please clean this area.
1.0
5.
Restroom and utility kitchen vents had dust/soil residue building on them. Ventilation equipment shall be kept clean. Clean vent covers as needed.
1.0
34.
In the laundry room, soiled laundry containers were found with no labels. Soiled linen/laundry shall be clearly labeled and separated from clean laundry.
1.0
42.
General comment: While no potentially hazardous foods were found inside of the refrigerators, two utility kitchen refrigerators were holding around 48F. Please have refrigerators checked before storing potentially hazardous foods in them.
0.0
General Comments
Due to COVID-19 event no resident rooms, dining areas, or communal areas were inspected today.
Many walls throughout establishment having scuffing/staining and need to be cleaned or repainted. Rooms 303, 407, and 433 have damaged/peeling walls and need to be repaired (407 walls need to be cleaned as well). One large ceiling tile in 4th floor "clean linen" rooms is missing and needs to be replaced. Walls and ceilings shall be kept clean and in good repair.
1.0
5.
All HVAC filters throughout 3rd and 4th floor have heavy dust accumulation and need to be cleaned/changed. Vent cover exteriors in rooms 227 and 327 have black debris/buildup and need to be cleaned. Ventilation equipment shall be kept clean.
1.0
8.
Bath tubs in rooms 309, 327, and 415 are soiled and/or have pink growth inside of them. Room 329 bath faucet is clogged and is not producing water at a sufficient volume. 3rd floor shower room floor has some debris and needs to be cleaned. Toilet and bathing facilities shall be kept clean and in good repair.
1.0
13.
Vast majority of lavatories were 100-116F, but room 417 was at 117F and room 332 was at 98F. Monitor all lavatories to ensure temperatures remain 100-116F.
0.0
16.
Facility has a detailed written backup water supply plan template, but some parts such as number of residents and supplier names were not completely filled out. Water supply plan was completed during inspection. Also, the water supply plan states that 2 quarts (1.89 liters) of drinking water per patient will be supplied in an emergency. Nursing home rules call for 2 liters of drinking water per person. Edit this part of water supply plan.
0.0
32.
Some bed railing pads on 4th floor are beginning to wear/tear and need to be replaced. Furniture and furnishings shall be kept in good repair.
0.0
36.
Single-use bowls in utensil storage were found with soil/splash residue on them. These are food-contact items and shall be kept clean and protected from contamination. Bowls were discarded during inspection. 4th floor refrigerator interior has soil accumulation. Non food-contact surfaces shall be cleaned to prevent soil accumulation.
1.0
42.
All milk and dairy products in second floor satellite kitchen were at 48-49F. All potentially hazardous foods being held cold shall remain at 45F or below. Director removed all potentially hazardous foods from the refrigerator, and they will not be served to patients. Refrigerator temperature was adjusted during inspection.
Floors need cleaning in 214, 308 bathroom, 304. Repair floor tile around toilet in room 214.
1.0
3.
Repair wall damage/repaint in 308, 320, 304, 328, 417 and elsewhere as needed. Repair water damage in third and fourth floor clean linen rooms. Repair baseboard tile as needed throughout the facility.
1.0
4.
Replace burned out bulbs in the downstairs women`s restroom.
0.0
5.
AC filters need cleaning in rooms 308, 320, 304. Clean ceiling vent in 3rd floor clean linen room.
1.0
8.
Shower curtains need cleaning in rooms 224,320, and 328. Repair leaks in bathroom sink faucets in 104 and 320. Repair shower knob in room 320 tub. Re-grout tub at the floor in room 236. Remove floor mat stored on handsink in 3rd floor kitchenette, keep handwash sink accessible at all times. Repair tub faucet leak in 417.
1.0
9.
Tubs are being used for various storage (soiled linens, etc). Do not use tubs for storage.
0.5
10.
Bedpans must be labeled for each patient, may use room and bed numbers as identifier. Identify disposable wash basins and any other items that are reused and in shared rooms in the same manner.
0.5
13.
Hot water below 100F in several rooms, ranged from 95F to 116F. May consider adding a re-circulator to help keep water temps consistent throughout the building.
0.0
16.
Facility has water and food supply for three days on site for emergency plan but this is not part of the written plan. Also, make sure if food and water is supplied by Gordon foods that they will deliver on the weekends in case there is an unexpected problem with the water supply that arises on a weekend.
0.0
26.
Cockroaches observed in 2nd floor kitchenette and rooms 404 and 214. Increase pest control measures.
1.0
27.
One patient has a dog that visits and a therapy dog makes visits. Make sure that vet records are available whenever animals/pets are on site.
0.0
32.
Repair/replace torn mattress in room 227 and worn mattresses as needed. Repair damaged cabinetry in kitchenettes. One room on the fourth floor had a broken nightstand, repair or replace.
1.0
35.
Shower rooms are being cleaned and disinfected twice a day by housekeeping but are required to be disinfected between each patient. Correct procedures to make sure requirements are being met.
Observed damaged floor in bathroom under toilet in room 229 and 322.
0.0
2.
Observed soiled floor inside bathroom room 229.
0.0
3.
Observed stained/ soiled wall room 308. Walls soiled in room 205. Caulk is missing around handsink in room 211 and walls are soiled behind the toilet. Observed soiled walls in room 205. Observed damaged wall under paper towel dispenser room 414. In room 433 baseboards are detached from wall. Walls shall be clean and in good repair.
1.0
8.
Observed missing shower head room 218. Shower curtain , tub, and sink are soiled room 414. Strong odor in communal shower on 4th floor- all shower mats/equipment inside needs cleaning. Bathtub is stained room 205. Observed mold on bathtub faucet and inside caulk room 305. Observed soiled toilet in form 231 and 229. Soiled bathtub room 322. Facilities shall be maintained clean and in good repair.
1.0
16.
The facility has a plan to receive water and food from Gordon food Service in the event of an emergency but does not have a detailed plan of how essential functions will be provided for residents that will remain in the facility at that time. A more detailed plan needs to be in place by the next inspection.
2.0
20.
Heavily soiled bedside commodes are cleaned outside. Bedside commodes, bedpans, urinals, emesis basins, wheel chairs shall be taken to a soiled utility room and not release onto the ground surface.
Observed trash buildup inside mop sinks in 3rd and 4th floor janitors closets. Solid waste shall be kept in leak proof garbage cans with tight fitting lids.
2.0
32.
Observed a few stained chairs in 1st floor activity room. Observed ripped pillow in room 229. Observed holes in fitted sheet and stained bed cover room 322.
0.0
General Comments
Observed dust buildup in AC vents in several rooms.
Crack in the ceiling above the toilet in the restroom in Room 316. Janitor's closet on the 4th floor in need of cleaning. Wall in the supply closet and broken tiles at the mop sink in the Janitor's closet on the 4th floor.
0.0
4.
Lighting in Room 211 and Room 229 has limited amount of light at the required intensity near the toilet and the shower. Lighting provided is currently at 4-8 foot candles in these areas. Lighting must be sufficient throughout at 10 foot candles 30 inches above the floor.
0.0
8.
Hallway shower room in need of cleaning; Shower head and shower curtain on the 2nd floor in need of cleaning. EHS observed the hallway shower room floor to be soiled and the shower equipment. One square tile coming off of the wall in Room 211. Shower soap bulk container on the floor, left opened without the dispensing pump. Bathroom door in Room 211 does not close properly. Please repair door. Shower curtain in need of cleaning and Rips in the shower bed located on the 3rd floor. Please ensure all equipment is clean and in good repair. Sink in the biohazard room is clogged. Shower hook on wall is loose on the wall in Room 316. Please ensure all items are clean and in good repair.
1.0
13.
Hot water temperature in lavatory and bathing facilities are 88-90F at the 3rd floor shower room. Water temperature appears to vary throughout the building please check to ensure water temperature is between 100 and 16 throughout.
0.0
16.
The facility has a plan to receive water and food from a company in the event of an emergency but does not have a detailed plan of how essential functions will be provided for residents that will remain in the facility at that time. A more detailed plan needs to be in place by the next inspection.
1.0
20.
Bedside commodes being cleaned outside. Bedside commodes, bedpans, urinals, emesis basins, wheel chairs shall be taken to a soiled utility room and not release onto the ground surface.
2.0
33.
Soiled linen cart not labeled in laundry room. Soiled linen transported in cart without being bagged. Please ensure soiled linens are properly bagged inside of the carts.
1.0
35.
Brushes in drawer in beauty salon with hair still in them. Please ensure that hair in brushes are disposed and brushes are properly cleaned and disinfected before using and the drawer must be properly cleaned and sanitized.
0.0
40.
Refrigerator inside of the OT Gym illustrates "Residents Only" EHS observed lunch bags inside of the refrigerator. Please store employee items separate from Residents food.
0.5
General Comments
Cigarette smoke from the outside is moving into other occupied portions of the building such as the 1st floor hallway and the 1st floor lobby.
EHS observed a live bug in the janitorial closet on the 4th floor, live bug crawling on the floor in the lobby. Please consult with a license pest control operator to treat all areas for pests. Please increase the sanitation to help with this issue.
shower chair in the shower room on the 4th floor needs cleaning underneath. In room 222 the water does not come on in the shower, in room 227 the cold water does not work in the shower, the sink in the 4th floor staff bathroom is slow to drain and is not working well, in room 431 the hot water in the tub is not working. These items need to be repaired.
1.0
13.
all water temps in the rooms checked were between 100-116 degrees.
0.0
16.
The facility has a plan to receive water and food from a company in the event of an emergency but does not have a detailed plan of how much water would be provided for each resident. A more detailed plan needs to be in place by the next inspection.
0.0
19.
ice machine on the 2nd floor had a Styrofoam cup being used as a scoop. This was removed. Use the ice scoop to prevent contamination of hands. Also the ice machine has mold build up and needs cleaning. On the 3rd and 4th floors, the ice scoop holders need to be cleaned.
1.0
30.
several medicine carts had plastic cups stacked above the rim. Don`t stack cups above the rim to prevent contamination. This was seen on the last inspection. Spoons were stored with the food contact surfaces facing up. The spoons should be stored with the handles up.
1.0
35.
the vinyl pillow in room 431 has several tears in it and needs to be replaced. In rooms 417,431 and 326 the bed pans were not labeled. The bed pans not labeled was seen on the last inspection. These were labeled during inspection.
1.0
43.
the refrigerator in the kitchen area on the third floor has a thermometer that is not working properly. Replace this thermometer.
0.0
General Comments
rooms checked today: 207,209,222,227,311,315,326,329,416,417,418,431 In room 315 there was a build up of dust on the blinds that needs cleaning.
public restroom hand wash temps were only 85 degrees. Lavatory sink temps should be at least 100 degrees.
1.0
14.
did not see disinfectant in all of the common area shower rooms. A pine scented cleaner was being used but it is not a disinfectant. Make sure all staff are using the disinfectant in the showers, tubs, and patient bathrooms.
1.0
16.
Sufficient back up water supply plan is in place for this facility.
0.0
28.
house keeping closet had many items on the floor and was able to be swept. Make sure all that in storage rooms all items are up off of the floor.
0.5
30.
plastic cups were stacked too high on the medicine carts on levels 3 and 4. The cups should be flush with the side pockets that they are in or be kept in the protective sleeves. Staff educated on this today.
0.0
35.
bed pans were not labeled in the following rooms: Room 222 for the A patient, room 234 both patients, room 311 both patients, room 422 both patient. Make sure all bed pans are labeled for all patients. Fitted sheet on bed A in room 230 has a small hole in it. The fitted sheet on bed B in room 109 had a tear in it. Also the vinyl pillow on bed B in room 109 had several tears in it.
Hand sinks are required inside all medication rooms. Install sinks with hot & cold water and soap & towel dispensers. Repair the sink in the laundry room. Re-caulk around base of all toilets in patient rooms as needed.
1.0
13.
Hot water at the lavatory in the staff restroom should be 100 degrees minimum. It was 76 degrees.
1.0
24.
Roach was observed in 2nd floor kitchenette and roach droppings were noted inside lower cabinet. Clean the cabinets and notify exterminator.
1.5
28.
A few items were on the floor in the supply room. Recommend additional shelving in this room. Items in the clean linen room are stored to close to the floor. The bottom shelf should be elevated at least 8" above the floor.
0.5
32.
Remove/replace damaged cabinets in the Activity Room. The fabric on the chair in Room 115 is soiled. Clean fabric or replace furniture if uncleanable.
1.0
General Comments
The medication cart on 3rd floor was sitting in the hallway unlocked. I walked right up to it and opened drawers. Several bottles of Jevity nutrition supplements were outdated. The use by date stamped on the bottles was July 1, 2014.
