Deficiencies per Year
8
6
4
2
0
Severe
High
Moderate
Low
Unclassified
Census Over Time
Census
Capacity
Inspection Report
Follow-Up
Census: 22
Capacity: 26
Deficiencies: 8
Oct 23, 2024
Visit Reason
The inspection was a partial, announced visit conducted due to a change in legal entity for the facility.
Findings
The facility had multiple deficiencies including unlocked poisonous materials accessible to residents, uncovered trash outside, missing emergency telephone numbers, clogged bathroom sink, lack of toilet paper in a resident's bathroom, failure to submit emergency procedures to the local agency since 2020, unlocked medications, and absence of a current weekly activity calendar. Plans of correction were submitted and accepted with ongoing monitoring and audits planned.
Deficiencies (8)
| Description |
|---|
| Unlocked poisonous materials accessible near resident bathroom sink. |
| Trash outside the home was placed on top of the trash receptacle, not inside a covered container. |
| No emergency telephone numbers posted by the telephone near the associate timeclock/storage area. |
| Bathroom sink in resident room was clogged and water would not drain. |
| No toilet paper in the bathroom of a resident. |
| Written emergency procedures had not been submitted to the local emergency management agency since 2020. |
| Unlocked, unattended, and accessible prescription and OTC medications in resident bathroom cabinet. |
| No current weekly activity calendar posted in a public and conspicuous place in the home. |
Report Facts
Residents Served: 22
Capacity: 26
Total Daily Staff: 22
Waking Staff: 17
Current Residents in Hospice: 5
Residents Age 60 or Older: 22
Residents Diagnosed with Mental Illness: 2
Inspection Report
Renewal
Census: 20
Capacity: 26
Deficiencies: 5
Jul 11, 2024
Visit Reason
The inspection was conducted as a renewal inspection of the facility license.
Findings
The inspection found multiple deficiencies including unsecured resident records, incomplete staff orientation on fire safety, unsafe positioning of a resident's mobility device, expired medication storage, and missing PRN medications. All deficiencies had plans of correction accepted and were implemented by the follow-up date.
Deficiencies (5)
| Description |
|---|
| Resident incident reports, laboratory reports, census sheets and bowel movement logs were left unlocked and accessible to unauthorized personnel. |
| Staff person A did not receive orientation on fire safety and emergency preparedness topics prior to or during the first work day. |
| Resident #1's bedside mobility device was not attached to the bed frame and positioned unsafely, creating a hazard. |
| Expired medication (Dental Gel 1% Sodium Fluoride) belonging to resident #1 was found in the medication cart. |
| Resident #2's prescribed PRN medications (Acetaminophen 325mg and Polyethylene Glycol) were not available in the home. |
Report Facts
License Capacity: 26
Residents Served: 20
Total Daily Staff: 40
Waking Staff: 30
Current Residents in Hospice: 1
Residents Diagnosed with Mental Illness: 20
Residents with Mobility Need: 20
Residents 60 Years or Older: 20
Inspection Report
Renewal
Census: 18
Capacity: 26
Deficiencies: 1
Apr 26, 2023
Visit Reason
The inspection was conducted as a renewal visit to review the facility's compliance and licensing status.
Findings
The facility was found to have fully implemented its submitted plan of correction. One deficiency was noted regarding the first aid kit missing a thermometer, which was corrected promptly with ongoing monthly audits established.
Deficiencies (1)
| Description |
|---|
| The first aid kit in the wellness office does not include a thermometer. |
Report Facts
License Capacity: 26
Residents Served: 18
Current Residents in Hospice: 5
Residents Age 60 or Older: 18
Residents with Mobility Need: 18
Total Daily Staff: 36
Waking Staff: 27
Inspection Report
Routine
Deficiencies: 0
Nov 7, 2022
Visit Reason
The inspection was conducted as a licensing inspection by the Pennsylvania Department of Human Services, Bureau of Human Service Licensing.
Findings
No regulatory citations were identified as a result of this inspection.
Inspection Report
Renewal
Census: 12
Capacity: 26
Deficiencies: 7
Dec 3, 2021
Visit Reason
The inspection was conducted as a renewal visit to review compliance with licensing requirements for the facility.
Findings
The inspection identified several deficiencies including missing direct care training certification for a staff member, absence of emergency telephone numbers near a nurse's station phone, incomplete first aid kit supplies, outdated furnace inspection documentation, delayed completion and filing of a resident's support plan, missing signature page for a support plan, and incorrect medication labeling. All deficiencies had plans of correction implemented by December 2021.
Deficiencies (7)
| Description |
|---|
| Missing certificate of completion/passing of Department-approved direct care training course for direct care staff person A hired on 09/09/2020. |
| No emergency telephone numbers including nearest hospital and fire department posted on or by the telephone near the nurse's station. |
| First aid kit in the nurse's station did not include adhesive tape. |
| Most recent documentation of furnace inspection was dated 10/23/2018, not current. |
| Resident #2's initial support plan was not completed until 03/28/2019, later found filed in thinned record. |
| Missing signature page for resident #2's 72 hour support plan dated 02/12/2019, later found filed in thinned record. |
| Pharmacy label for resident #1's medication was not updated to reflect order change from twice a day to once at bedtime on 07/21/2021. |
Report Facts
License Capacity: 26
Residents Served: 12
Current Hospice Residents: 5
Total Daily Staff: 24
Waking Staff: 18
Inspection Report
Renewal
Capacity: 26
Deficiencies: 0
Sep 22, 2021
Visit Reason
The document is a renewal application and license issuance for Brookdale Dublin Personal Care Home, confirming the facility's authorization to operate and advising that an annual inspection will be conducted within the next twelve months.
Findings
The Department has issued a regular license in response to the renewal application and notified the facility that an onsite inspection will be conducted within the next twelve months to ensure compliance with applicable regulations.
Report Facts
Maximum capacity: 26
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Jamie L. Buchenauer | Deputy Secretary | Signed letter regarding renewal application and inspection notification |
Inspection Report
Renewal
Census: 9
Capacity: 26
Deficiencies: 7
Feb 1, 2021
Visit Reason
The inspection was conducted as a renewal inspection of the Brookdale Dublin facility to review compliance and verify the implementation of the submitted plan of correction.
Findings
The inspection identified multiple deficiencies including sanitary conditions, lack of bedside tables, incomplete medical evaluations, medication labeling errors, medication storage issues, and incomplete medication administration documentation. The facility submitted and implemented plans of correction for all deficiencies.
Deficiencies (7)
| Description |
|---|
| Resident #3's medication administration record did not show use of a glucometer, and the home's backup glucometer was shared between residents. |
| No bedside table or shelf beside resident #4’s bed in their bedroom. |
| Resident #1 did not have a medical evaluation completed within 60 days prior to admission or within 30 days after admission. |
| Medication labels for residents #1 and #2 did not match physician orders in the medication administration record. |
| Medication prescribed for resident #2 was not available in the home on 2/1/21. |
| Resident #1's medication administration record did not include initials of staff who administered medication on 1/12/21 at 9:00pm. |
| Resident #1 admitted to Secure Dementia Care Unit did not have a medical evaluation completed within 60 days prior to admission. |
Report Facts
Residents Served: 9
License Capacity: 26
Current Hospice Residents: 4
Residents Age 60 or Older: 9
Residents with Mobility Need: 9
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