Inspection Reports for
Polk Personal Care Center
301 NORTH STREET,, MILLERSBURG, PA, 17061
Back to Facility Profile13 Reports
Inspection Report — Sep 18, 2025
Renewal
Date: Sep 18, 2025
Visit Reason
The inspection was a renewal visit conducted by the Pennsylvania Department of Human Services, Bureau of Human Service Licensing to review compliance and verify the submitted plan of correction.
Findings
The facility had multiple deficiencies including staff qualification issues, incomplete annual training for direct care staff, failure to conduct fire drills during sleeping hours timely, incomplete annual medical evaluations, medication administration documentation errors, and incomplete resident support plans. All deficiencies had plans of correction submitted and were implemented by the time of the report.
Citations (6)
54a - Direct care staff person did not have a high school diploma, GED, or active registry status on the Pennsylvania nurse aide registry.
65f - Direct care staff did not receive required annual training on resident needs, dementia care, infection control, personal care, and safe management techniques.
132e - The facility failed to hold a fire drill during sleeping hours within the required six-month period.
141b1 - Annual medical evaluations for residents did not include special dietary needs and ability to self-administer medications.
187b - Medication administration record did not include the initials of the staff person who administered medication to a resident on a specified date and time.
227d - Resident support plans did not document how medical needs related to traumatic brain injury and hyperglycemia would be met.
Report Facts
Residents Served: 43
Current Hospice Residents: 1
Residents 60 Years or Older: 43
Residents with Mobility Need: 8
Inspection Report — Sep 4, 2024
Renewal
Date: Sep 4, 2024
Visit Reason
The inspection was conducted as a renewal visit combined with an incident review at Polk Personal Care Center on 09/04/2024.
Findings
The submitted plan of correction related to hot water temperature violations was found to be fully implemented. The facility corrected hot water temperatures exceeding 120°F in resident bathrooms by adjusting boiler settings and instituting weekly water temperature checks.
Citations (2)
Hot water temperature at the sink in the bathroom of room #333w measured 123.9 degrees Fahrenheit, exceeding the maximum allowed 120°F.
Hot water temperature at the sink in the bathroom of room #232w measured 124.4 degrees Fahrenheit, exceeding the maximum allowed 120°F.
Report Facts
Residents Served: 45
Current Hospice Residents: 5
Residents 60 Years or Older: 45
Residents with Mobility Need: 9
Total Daily Staff: 54
Waking Staff: 41
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Maintenance Supervisor | Notified of hot water temperature violations and responsible for adjusting boiler temperature |
Inspection Report — May 16, 2023
Renewal
Date: May 16, 2023
Visit Reason
The inspection was conducted as a renewal review of the Polk Personal Care Center to assess compliance with licensing requirements.
Findings
The facility was found to have multiple deficiencies including an expired boiler certificate, uncovered enabler bars posing entrapment hazards, lint accumulation in dryer vents, unlocked medications, and unsecured resident records. All deficiencies had plans of correction accepted and were implemented by early June 2023.
Citations (5)
Expired boiler certificate with expiration date of 4/1/2023.
Uncovered enabler bar with an opening posing a potential entrapment hazard.
Approximate 1/4 inch accumulation of lint in the lint trap of the right dryer in the basement.
Topical medications found unlocked, unattended, and accessible in an unmarked blue caddy in the second-floor west supply room.
Flow sheet binder containing resident records found unlocked, unattended, and accessible on shelves in supply rooms.
Report Facts
Residents Served: 50
Current Hospice Residents: 2
Total Daily Staff: 53
Waking Staff: 40
Inspection Report — Mar 14, 2022
Renewal
Date: Mar 14, 2022
Visit Reason
The inspection was conducted as a renewal inspection of the Polk Personal Care Center to assess compliance with licensing requirements.
Findings
Two deficiencies were identified: improper storage of poisonous materials with unlabeled spray bottles and snow and ice obstructing an emergency exit stairway. Both issues were corrected with new policies and removal of hazards by 04/15/2022.
Citations (2)
Spray bottles containing clear liquid with handwritten labels were found outside original labeled containers in sitting/dining areas.
Emergency exit stairway near room 214 on the second floor was snow and ice covered.
Report Facts
Residents Served: 51
Current Residents in Hospice: 4
Residents with Mobility Need: 9
Total Daily Staff: 61
Waking Staff: 46
Resident Support Staff: 1
Notice — Mar 19, 2021
Date: Mar 19, 2021
Visit Reason
This document serves as a renewal notification and issuance of a regular license for Polk Personal Care Center, a Personal Care Home, following receipt of the renewal application dated December 2, 2020.
Findings
The Department has approved the renewal application and issued a regular license. The Department will conduct an onsite inspection within the next twelve months to ensure compliance with applicable regulations.
Report Facts
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Jamie L. Buchenauer | Deputy Secretary | Signed the renewal notification letter. |
Inspection Report — Dec 5, 2019
Renewal
Date: Dec 5, 2019
Visit Reason
The inspection was conducted as a licensing inspection by the Pennsylvania Department of Human Services, Bureau of Human Services Licensing, to assess compliance with 55 Pa.Code Ch. 2600 relating to Personal Care Homes.
Findings
The facility was found to be in compliance with the applicable regulations during the licensing inspection.
Notice — Nov 27, 2019
Date: Nov 27, 2019
Visit Reason
This document serves as a renewal notification and license issuance for Polk Personal Care Center to operate as a Personal Care Home pursuant to Title 55, PA Code, Chapter 2600.
Findings
No inspection findings are reported in this document. It confirms the issuance of a regular license and states that an onsite inspection will be conducted within the next twelve months as required by regulation.
Report Facts
Inspection Report — Dec 13, 2018
Annual Inspection
Date: Dec 13, 2018
Visit Reason
The inspection was conducted as the Department's Bureau of Human Services Licensing annual inspection of the Polk Personal Care Center to assess compliance with 55 Pa.Code Ch. 2600 relating to Personal Care Homes.
Findings
The facility was found to be in compliance with the applicable regulations during the annual inspection conducted on December 13 and 14, 2018.
Notice — Nov 30, 2018
Date: Nov 30, 2018
Visit Reason
This document serves as a renewal notification and certificate of compliance for Polk Personal Care Center to operate as a Personal Care Home under Pennsylvania regulations.
Findings
The Department of Human Services has approved the renewal application and issued a regular license for the facility. The Department will conduct an onsite annual inspection within the next twelve months as required by state code.
Report Facts
Inspection Report — Dec 12, 2017
Annual Inspection
Date: Dec 12, 2017
Visit Reason
The document reports the results of the Department of Human Services' annual licensing inspection of Polk Personal Care Center conducted on December 12, 2017.
Findings
The facility was found to be in compliance with 55 Pa.Code Ch. 2600 relating to Personal Care Homes.
Notice — Dec 1, 2017
Date: Dec 1, 2017
Visit Reason
This document serves as a renewal notification and license issuance for Polk Personal Care Center following the receipt of a renewal application dated November 30, 2017.
Findings
The Department advises that an onsite annual inspection will be conducted within the next twelve months to ensure compliance with Title 55, PA Code, Chapter 2600. No inspection findings are reported in this document.
Report Facts
Inspection Report — Dec 21, 2016
Annual Inspection
Date: Dec 21, 2016
Visit Reason
The inspection was conducted as part of the Department of Human Services' annual licensing inspections for the Polk Personal Care Center.
Findings
The facility was found to be in compliance with 55 Pa.Code Ch. 2600 relating to Personal Care Homes during the inspection conducted on December 21 and 22, 2016.
Notice — Dec 5, 2016
Date: Dec 5, 2016
Visit Reason
This document serves as a renewal notification and license issuance for Polk Personal Care Center to operate as a Personal Care Home under Pennsylvania regulations.
Findings
The Department of Human Services confirms receipt of the renewal application and states that an onsite inspection will be conducted within the next twelve months as required by law. No inspection findings are reported in this document.
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