| Survey Date | Inspection Type | Track ID | Deficiency | Severity and Scope | Class | Requirement Description | Correction Date |
| 04/16/2022 | Complaint | B3GW | None | None | None | NoneNone | None |
| 09/02/2021 | Monitor | SHCM | None | None | None | NoneNone | None |
| 07/21/2021 | Standard | NCRI | CZ814 | | U | BACKGROUND SCREENING CLEARINGHOUSE435.12 Care Provider Background Screening Clearinghouse.-
(2)(b) Until such time as the fingerprints are enrolled in the national retained print arrest notification program at the Federal Bureau of Investigation, an employee with a break in service of more than 90 days from a position that requires screening by a specified agency must submit to a national screening if the person returns to a position that requires screening by a specified agency.
(c) An employer of persons subject to screening by a specified agency must register with the clearinghouse and maintain the employment status of all employees within the clearinghouse. Initial employment status and any changes in status must be reported within 10 business days.
(d) An employer must register with and initiate all criminal history checks through the clearinghouse before referring an employee or potential employee for electronic fingerprint submission to the Department of Law Enforcement. The registration must include the employee's full first name, middle initial, and last name; social security number; date of birth; mailing address; sex; and race. Individuals, persons, applicants, and controlling interests that cannot legally obtain a social security number must provide an individual taxpayer identification number.
| 08/16/2021 |
| 07/21/2021 | Standard | NCRI | F0677 | D | | ADL CARE PROVIDED FOR DEPENDENT RESIDENTS§483.24(a)(2) A resident who is unable to carry out activities of daily living receives the necessary services to maintain good nutrition, grooming, and personal and oral hygiene; | 08/16/2021 |
| 07/21/2021 | Standard | NCRI | F0689 | J | | FREE OF ACCIDENT HAZARDS/SUPERVISION/DEVICES§483.25(d) Accidents.
The facility must ensure that -
§483.25(d)(1) The resident environment remains as free of accident hazards as is possible; and
§483.25(d)(2)Each resident receives adequate supervision and assistance devices to prevent accidents. | 08/16/2021 |
| 07/21/2021 | Standard | NCRI | F0695 | E | | RESPIRATORY/TRACHEOSTOMY CARE AND SUCTIONING§ 483.25(i) Respiratory care, including tracheostomy care and tracheal suctioning.
The facility must ensure that a resident who needs respiratory care, including tracheostomy care and tracheal suctioning, is provided such care, consistent with professional standards of practice, the comprehensive person-centered care plan, the residents' goals and preferences, and 483.65 of this subpart. | 08/16/2021 |
| 07/21/2021 | Standard | NCRI | F0812 | D | | FOOD PROCUREMENT,STORE/PREPARE/SERVE-SANITARY§483.60(i) Food safety requirements.
The facility must -
§483.60(i)(1) - Procure food from sources approved or considered satisfactory by federal, state or local authorities.
(i) This may include food items obtained directly from local producers, subject to applicable State and local laws or regulations.
(ii) This provision does not prohibit or prevent facilities from using produce grown in facility gardens, subject to compliance with applicable safe growing and food-handling practices.
(iii) This provision does not preclude residents from consuming foods not procured by the facility.
§483.60(i)(2) - Store, prepare, distribute and serve food in accordance with professional standards for food service safety. | 08/16/2021 |
| 07/21/2021 | Standard | NCRI | N0201 | J | 1 | RIGHT TO ADEQUATE AND APPROPRIATE HEALTH CAREThe right to receive adequate and appropriate health care and protective and support services, including social services; mental health services, if available; planned recreational activities; and therapeutic and rehabilitative services consistent with the resident care plan, with established and recognized practice standards within the community, and with rules as adopted by the agency.
| 08/16/2021 |
| 07/19/2021 | Fire/Life/Safety | NCRI | K0353 | E | 3 | SPRINKLER SYSTEM - MAINTENANCE AND TESTINGSprinkler System - Maintenance and Testing
Automatic sprinkler and standpipe systems are inspected, tested, and maintained in accordance with NFPA 25, Standard for the Inspection, Testing, and Maintaining of Water-based Fire Protection Systems. Records of system design, maintenance, inspection and testing are maintained in a secure location and readily available.
a) Date sprinkler system last checked _____________________
b) Who provided system test ____________________________
c) Water system supply source __________________________
Provide in REMARKS information on coverage for any non-required or partial automatic sprinkler system.
9.7.5, 9.7.7, 9.7.8, and NFPA 25
| 08/16/2021 |
| 06/30/2021 | Complaint | EZIG | None | None | None | NoneNone | None |
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