Inspection Reports for
Copper Springs – Meridian

.009.01 Criminal History and Background Check: two of five employees did not have a Department Criminal History and Background Check completed.

.009.06.c Use of Previous Criminal History and Background Check: four of nine employees did not have Idaho State Police background checks completed prior to working alone with residents.

.161.04 Designated Smoking Areas: the facility did not have designated smoking areas clearly marked, with no smoking signs posted in secured courtyards where residents were observed smoking (previously cited 6/5/2025).

.250.09 Resident Sleeping Rooms: water temperatures were not maintained between 105 to 120 degrees F, with temperatures ranging from 92 to 129 degrees in various buildings.

.250.12.j Resident Sleeping Rooms: eight resident rooms in building #2 lacked door latch or knob mechanisms to limit smoke passage and provide privacy.

.260.06 Toxic Chemicals: the facility was not maintained in a clean, safe, and orderly manner, including greasy shower floors, missing shower thresholds, damaged drywall, and a cabinet door taped together with clear adhesive tape.

.310.01.a Medication Distribution: medications in bubble packs were unsecured in memory care building #1's office, with doors left open and easy access through the kitchen entryway.

.310.04.e Psychotropic or Behavior Modifying Medication: psychotropic medication reviews for several residents did not include behavioral updates.

.330.04 Behavior Documentation: the facility did not document the number of insulin units given for some residents due to lack of a place in the computer system.

.330.13 Personnel Records: staff records lacked documentation of medication technician certifications, though trainings were completed.

.330.15 Fire and Life Safety Records: the facility did not provide documentation of the alarm system 5-year sensitivity testing (previously cited 6/5/2025).

.335.02 Standard Precautions: staff did not consistently use hand hygiene between medication passes and did not wear aprons while performing kitchen tasks after providing resident care.

.405.03 Telephone: oxygen tanks were not stored securely in racks or carts, with unsecured tanks observed in rooms in buildings #3 and #4.

.410 Requirements for Emergency Actions and Fire Drills: fire drills were not conducted at least six times per year with two during night hours, and records were not completed accurately (previously cited 6/5/2025).

.625 Orientation Training Requirements: seven of fourteen staff did not have 16 hours of job-related orientation training (previously cited 11/15/2024).

.161.04 Designated Smoking Areas: the gazebo designated as a smoking area was not clearly marked and the policy did not state this area as the designated smoking area.

.250.10.d Heating, Ventilation, and Air-Conditioning (HVAC): facility could not provide documentation that smoke/fire dampers in building 4 were tested or inspected within the last 4 years; 9 dampers would not close upon alarm activation; 3 dampers were observed fully closed in a corridor.

.330.15 Fire and Life Safety Records: facility could not provide documentation of internal investigation of fire suppression piping, pressure gauge replacement or calibration, or check valve internal investigation within the last 5 years.

.330.15.b Fire and Life Safety Records: facility could not provide documentation for annual and/or semi-annual inspection and testing of fire suppression wet systems located in buildings 1, 2, and 4.

.330.15.c Fire and Life Safety Records: portable fire extinguishers were missing the monthly inspection for April 2025 in all buildings.

.403 Fire and life safety standards: annual fire alarm inspection reports did not list locations of all devices tested; facility lacked documentation of monthly wet system pressure gauge checks; emergency lighting monthly testing was not conducted before August 2024 or after January 2025.

.404 Fire and life safety standards: annual fire alarm inspection reports did not list locations of all devices tested; facility lacked documentation of monthly wet/dry system pressure gauge checks; no documentation of repaired dry suppression system deficiencies or air leakage test within last 3 years; emergency lighting monthly testing was not conducted before August 2024 or after January 2025; only 1 of 2 semi-annual hood suppression inspections/testing documented; only 1 of 2 semi-annual hood cleaning inspections documented; stored items in room #217 closet were approximately 4 inches from sprinkler pendant instead of required 18 inches.

.405.01.a Electrical Installations and Equipment: a multi-plug adapter was in use in room #209 to power multiple devices, which is prohibited.

.405.02.c Prohibited Applications: in building 4 room #316 and building 1 riser room, microwaves and mini fridges were powered by RPTs, which is prohibited.

.405.04 Fuel-Fired Heating: gas fireplace in building 4 was not included in annual fuel-fired heating inspections/testing as required.

.410 Requirements for Emergency Actions and Fire Drills: facility failed to conduct fire drills bi-monthly with at least 6 drills including 2 during normal sleeping hours; last drills were December 31, 2024 for all 4 homes and February 23, 2024 for building 2.

.260.07 Toxic Chemicals: the facility did not secure cleaning chemicals in the laundry room accessible to cognitively impaired residents from 11/12/24 to 11/14/24, including disinfectant and laundry soap in unlocked laundry rooms.

.310.01.c Medication Distribution System: the facility's medication refrigerator temperatures were not monitored and documented daily, with multiple days missing documentation in September, October, and November 2024.

.310.01.g Medication Distribution System: the facility did not ensure all residents' as-needed (PRN) medications were available, including Resident #5's eye drops and an unsampled resident's ointment.

.320.08 Periodic Review: negotiated service agreements were not updated to reflect significant changes in residents' health and physical status, including diet changes, mobility, and need for shower assistance.

.451.01.c Menu: the facility's menu was not posted in the common areas of memory care buildings #1 and #3 for residents to view.

.600.02 Detached Buildings or Units: the facility did not ensure all buildings were staffed sufficiently at night, resulting in buildings being left unattended during staff switches and inadequate assistance for residents requiring two-person transfers.

.625 Orientation Training Requirements: four staff retained through the change of ownership did not have 16 hours of job-related orientation and infection control training.

.630 Training Requirements for Facilities Admitting Residents with a Diagnosis of Dementia, Mental Illness, Developmental Disability, or Traumatic Brain Injury: four retained staff did not have specialized training for residents with these diagnoses.