Inspection Reports for Cortland Acres Nursing Home

An unannounced complaint survey was conducted at Cortland Acres Nursing Home due to complaints #36534, #38208, and Facility Reported Incident #37557.

The complaints and incident were unsubstantiated with no deficiencies cited during the investigation.

Complaint #36534, #38208, and Facility Reported Incident (FRI) #37557 were investigated and found unsubstantiated with no deficiencies cited.

An onsite revisit for the annual recertification and annual re-licensure survey dated 03/12/25 concluded on 04/22/25.

Cortland Acres Nursing Home is in substantial compliance with 42 CFR Part 483 Requirements for Long Term Care Facilities and 64 CSR 13 Legislative Rules West Virginia Division of Health Nursing Home Licensure Rule. The facility is in substantial compliance with the previously cited deficient practices.

The inspection was conducted to review the facility's compliance with Federal, State, and local Emergency Preparedness requirements.

The facility was found to be in compliance with all applicable Federal, State, and local Emergency Preparedness requirements.

Unannounced annual recertification/licensure, complaint and facility reportable incident survey conducted to assess compliance with 42 CFR Part 483 and West Virginia nursing home licensure rules.

The facility was found out of substantial compliance with multiple deficiencies including failure to follow physician orders for PICC dressing changes, incomplete and inaccurate care plans, failure to provide oxygen with physician orders, failure to ensure CPR was provided per resident wishes, pressure ulcer care deficiencies, food safety and quality issues, infection control lapses, inadequate showering and hygiene care, and incomplete nurse aide training.

Multiple complaints were substantiated including issues with care planning, food quality, infection control, and resident rights.

The inspection was conducted to assess compliance with fire safety, electrical safety, and patient care equipment maintenance standards in the nursing home facility.

The facility was found deficient in multiple areas including fire resistance of smoke barriers, sprinkler system installation, corridor door smoke resistance, electrical wiring safety, emergency generator labeling, and maintenance/testing of patient-care electrical equipment. Corrective actions were planned and/or implemented for all deficiencies.

The document is a Statement of Deficiencies and Plan of Correction for Cortland Acres Nursing Home, detailing compliance with regulatory requirements and life safety code standards.

The report identifies multiple deficiencies related to the NFPA 101 Life Safety Code standards, including issues with interior finishes, corridor separations, door construction, fire-rated construction, exit access, sprinkler system maintenance, signage, and electrical wiring compliance.

The inspection was conducted as an annual recertification and relicensure survey to assess compliance with 42 CFR Part 483 and West Virginia nursing home licensure rules.

The facility, Cortland Acres Nursing Home, was found to be in substantial compliance with the applicable federal and state regulations, with credible evidence accepted in lieu of an onsite revisit.

An unannounced annual recertification/licensure survey was conducted at Cortland Acres Nursing Home from 07/31/23 to 08/02/23 to assess compliance with 42 CFR Part 483 and West Virginia nursing home licensure rules.

The facility was found out of substantial compliance with deficiencies related to respiratory care, resident records, food safety, infection control, and quality of care. Specific issues included failure to change oxygen tubing timely, incomplete POST forms, unsanitary kitchen conditions, improper medication handling, and incomplete documentation of blood glucose monitoring.

The inspection was conducted to assess the facility's compliance with the National Fire Protection Association (NFPA) 101, Life Safety Code, 2012, and to verify compliance with Federal, State, and local Emergency Preparedness requirements.

The facility was found to be without waivers and in compliance with the NFPA 101 Life Safety Code, 2012, and all applicable Federal, State, and local Emergency Preparedness requirements.

An unannounced annual recertification, annual relicensure, and complaint investigation survey was conducted at Cortland Acres Nursing Home from March 28-30, 2022.

The survey identified deficiencies including failure to ensure residents were treated with dignity (privacy cover missing on urine collection bag), failure to post survey results accessibly, incomplete POST forms, unsanitary kitchen conditions with missing temperature logs, and incomplete documentation and education regarding influenza and pneumococcal vaccinations.

Complaint #26568, #26620, #26289, #26151, and #25908 were all unsubstantiated with no related or unrelated deficiencies cited.

The visit was conducted as an annual recertification survey to assess compliance with 42 CFR Part 483 Requirements for Long Term Care Facilities and West Virginia Nursing Home Licensure Rules.

The facility, Cortland Acres Nursing Home, was found to be in substantial compliance with the applicable federal and state regulations. A review of plans of correction and credible evidence was accepted in lieu of an onsite revisit, confirming compliance with previously cited deficient practices.

The inspection was conducted to assess the facility's compliance with the National Fire Protection Association (NFPA) 101, Life Safety Code, 2012, and to verify compliance with Federal, State, and local Emergency Preparedness requirements.

The facility was found to be without waivers and in compliance with the NFPA 101 Life Safety Code, 2012, and all applicable Federal, State, and local Emergency Preparedness requirements.

A COVID-19 Focused Infection Control Survey and Emergency Preparedness Survey was conducted by the state survey agency from 12/15 to 12/17/2020.

The facility was found in compliance with infection control regulations under 42 CFR §483.80 and related requirements, as well as CMS and CDC recommended practices to prepare for COVID-19.

A COVID-19 Focused Infection Control Survey and Emergency Preparedness Survey was conducted by the state survey agency on July 1, 2020.

The facility was found in compliance with 42 CFR 483.80 infection control regulations, 42 CFR 483.73 related to E-0024 (b)(6), and CMS and CDC recommended practices to prepare for COVID-19.

The visit was conducted as an annual recertification and relicensure survey to assess compliance with 42 CFR Part 483 Requirements for Long Term Care Facilities and West Virginia Nursing Home Licensure Rules.

The facility was found to be in substantial compliance with the regulatory requirements, and the plans of correction and credible evidence were accepted in lieu of an onsite revisit. The facility was also in substantial compliance with previously cited deficient practices.

An unannounced annual re-certification and annual re-licensure survey was conducted at Cortland Acres Nursing Home from 10/28/19 through 10/30/19.

The survey identified deficiencies related to resident rights including dignity during feeding, failure to notify resident representative of bed hold policy upon transfer, improper oxygen equipment maintenance, and incomplete pneumococcal immunization per CDC guidelines.

The inspection was conducted to evaluate compliance with NFPA 101 fire drill requirements, specifically to verify that fire drills are held at unexpected times under varying conditions, at least quarterly on each shift.

The facility failed to ensure that fire drills were held at unexpected times under varying conditions with adequate time separation between drills on the same shift. Several fire drills were conducted within 15 to 34 minutes of each other on the same shift, which does not meet NFPA 101 standards.

The visit was conducted as an annual recertification and relicensure survey to assess compliance with 42 CFR Part 483 and West Virginia nursing home licensure rules.

The facility was found to be in substantial compliance with the regulatory requirements, with plans of correction and credible evidence accepted in lieu of an onsite revisit. Previously cited deficient practices were addressed.

An unannounced annual recertification and relicensure survey was conducted at Cortland Acres Nursing Home from March 12, 2018 through March 14, 2018.

The facility failed to maintain an effective Infection Control Program, specifically failing to provide or maintain a barrier for a multi-dose eye drop medication bottle during administration, which could potentially affect multiple residents.

The inspection was conducted to assess compliance with NFPA 101 electrical systems maintenance and testing requirements, specifically focusing on hospital-grade receptacles at patient bed locations and portable patient-care related electrical equipment.

The facility failed to maintain and test electrical receptacles at patient bed locations and failed to complete electrical testing for portable patient-care related equipment, including oxygen concentrators, as required by NFPA 101 standards. The director of maintenance acknowledged these deficiencies.

The inspection was conducted as a complaint investigation, with review of plans of correction and credible evidence accepted in lieu of an onsite revisit for complaint investigation(s) concluding on 2017-03-09.

The facility was found to be in substantial compliance with 42 CFR Part 483 Requirements for Long Term Care Facilities and 64 CSR 13 Legislative Rules West Virginia Division of Health Nursing Home Licensure Rule, with previously cited deficient practices corrected.

Complaint References: #16659. The complaint investigation concluded on 2017-03-09 with the facility in substantial compliance.

An unannounced complaint survey was conducted at Cortland Acres Nursing Home from 03/05/17 to 03/09/17 due to complaint #16659, which was substantiated with related and unrelated deficiencies cited.

The facility failed to accommodate residents' bathing preferences, resulting in residents not receiving their desired frequency of tub baths. Additionally, a care plan for one resident requiring two-person assistance for repositioning was not followed, causing pain. The facility also inaccurately posted nurse aide staffing data for one night shift.

Complaint #16659 was substantiated with related deficiencies cited at F246, F282, and F323, and one unrelated deficiency at F356.

The document is a plan of correction related to a Quality Indicator and Licensure Survey for Cortland Acres Nursing Home, accepted in lieu of an onsite revisit.

The facility is in substantial compliance with 42 CFR Part 483 Requirements for Long Term Care Facilities and 64 CSR 13 Legislative Rules West Virginia Division of Health Nursing Home Licensure Rule, with previously cited deficient practices addressed.

Unannounced annual Quality Indicator and State Licensure Surveys were conducted at Cortland Acres Nursing Home from January 9, 2017 through January 12, 2017 to assess compliance with state and federal regulations.

The survey identified multiple deficiencies including failure to timely report allegations of neglect, inadequate accommodation of resident needs, housekeeping and maintenance issues, inaccurate assessments, incomplete care plans, and infection control lapses related to nebulizer treatments.

The inspection was conducted to assess compliance with NFPA 101 Life Safety Code requirements related to building sprinkler coverage, corridor wall construction, and corridor door integrity.

The facility failed to provide complete sprinkler coverage in a family room closet, maintain corridor walls to resist smoke passage, and maintain corridor doors to resist smoke passage, with gaps found in several resident room doors. The maintenance director acknowledged these deficiencies and corrective actions were planned.

An unannounced revisit was conducted at Cortland Acres from December 14, 2015 to December 16, 2015 for the Quality Indicator Survey concluding on September 30, 2015.

The facility was found to have corrected the previously cited deficient practices as reflected on the CMS-2567B.

The inspection was conducted to assess compliance with NFPA 101 Life Safety Code standards, specifically regarding exit access accessibility and the maintenance of automatic sprinkler systems.

The facility failed to ensure exit access was readily accessible at all times due to a fence board blocking the exit discharge path. Additionally, the facility failed to maintain sprinkler pipes free from external loads, keep sprinkler heads free of foreign material, and maintain sprinkler heads intact.

An unannounced Quality Indicator Survey (QIS) was conducted to assess compliance with federal regulations related to resident care, financial management, assessments, care planning, infection control, and medication storage.

The survey identified multiple deficiencies including failure to notify resident or responsible party about personal funds nearing SSI limits, inaccurate resident assessments, incomplete care plans, inadequate pressure ulcer prevention and treatment, improper medication storage, and infection control lapses including improper wound care technique and unsanitary storage of resident care equipment.

The inspection was conducted as a complaint investigation, with review of plans of correction and credible evidence accepted in lieu of an onsite revisit for the complaint investigation concluding on 09/05/14.

The facility was found to be in substantial compliance with 42 CFR Part 483 Requirements for Long Term Care Facilities and 64 CSR 13 Legislative Rules West Virginia Division of Health Nursing Home Licensure Rule, and with previously cited deficient practices.

Complaint Reference: 11780. The complaint investigation concluded on 09/05/14 with the facility in substantial compliance.

An unannounced complaint survey was conducted at Cortland Acres from September 2, 2014 to September 5, 2014, triggered by Complaint #11780 which was substantiated with related deficiencies cited.

The facility failed to promote care that maintained residents' dignity and respect, evidenced by a nursing assistant pulling a resident backwards down the hall. Additionally, the facility failed to develop a comprehensive care plan for pain management for one resident despite medication administration records showing pain treatment.

Complaint #11780 was substantiated based on observations, clinical record reviews, resident and family interviews, staff interviews, and facility documentation.

The document is a plan of correction related to a prior Quality Indicator and Licensure Survey for Cortland Acres Nursing Home, accepted in lieu of an onsite revisit.

The facility was found to be in substantial compliance with 42 CFR Part 483 Requirements for Long Term Care Facilities and 64 CSR 13 Legislative Rules West Virginia Division of Health Nursing Home Licensure Rule, with previously cited deficient practices addressed.

Unannounced annual Quality Indicator and State Licensure Surveys were conducted at Cortland Acres Nursing Home from July 21, 2014 through July 24, 2014.

The facility was found deficient in medication administration, failing to administer all ordered doses of medication to a resident, and in medication storage practices, including unsecured medication carts and use of insulin vials beyond the recommended 28-day period.

The inspection was conducted to assess the facility's compliance with the provisions of NFPA 101, Life Safety Code, 2000.

Based on review of facility documentation, staff interview, observations, and performance testing, the facility was found to be without waivers and in compliance with the Life Safety Code.

This document is a Plan of Correction submitted by Cortland Acres Nursing Home in response to deficiencies cited during a prior inspection.

The document includes a summary statement of deficiencies related to resident rights and notification requirements, specifically regarding informing residents of their rights, services, charges, and Medicaid benefits.

The inspection was a Quality Indicator Survey conducted to assess compliance with regulatory requirements related to resident care and facility operations.

The facility was found deficient in updating and revising care plans for residents at risk of skin breakdown, specifically a post-surgical resident who developed bilateral heel pressure ulcers. The facility also failed to provide timely treatment and preventive interventions to avoid pressure sores, resulting in unstageable deep tissue injuries on the resident's heels.

The inspection was conducted to evaluate compliance with NFPA 101 Life Safety Code standards, specifically focusing on emergency generator equipment maintenance and the proper installation of Alcohol Based Hand Rub (ABHR) dispensers in corridors.

The facility failed to maintain battery-powered emergency lighting at the emergency generator transfer switch area and improperly installed four ABHR dispensers over or adjacent to ignition sources (light switches) in resident units A and B. The Maintenance Supervisor acknowledged these deficiencies.

The inspection was conducted to assess compliance with regulatory requirements, specifically focusing on the development of comprehensive care plans for residents with active pressure ulcers.

The facility failed to develop comprehensive care plans with measurable objectives and timetables related to the care and treatment of pressure ulcers for four of fourteen residents reviewed who had active pressure ulcers. The care plans for residents #77, #54, #31, and #82 did not address current skin integrity issues despite documented pressure ulcers.

A Comparative Federal Monitoring Life Safety Code Survey was conducted to assess compliance with 42 CFR Part 483, Requirements for Long Term Care Facilities, focusing on fire safety and life safety code standards.

The facility was found not in substantial compliance with Medicare and Medicaid participation requirements due to multiple life safety code deficiencies including improper flame spread ratings on exterior finishes, openings in ceiling tiles and walls, corridor partitions not resisting smoke passage, corridor doors failing to resist smoke passage and not closing properly, hazardous area doors held open, blocked exit doors, missing sprinkler escutcheon plates, missing no smoking/oxygen signs, and electrical wiring violations.

Routine inspection of Cortland Acres Nursing Home to assess compliance with healthcare regulations including resident care, safety, medication management, and facility conditions.

The facility was found deficient in multiple areas including improper use of physical restraints without physician orders, inaccurate resident assessments, incomplete and inaccurate care plans, failure to implement care plans, unsafe environmental conditions, improper medication orders and administration, failure to obtain ordered lab tests, and inadequate sanitization procedures in the kitchen.

The inspection was conducted to assess the facility's compliance with the provisions of NFPA 101, Life Safety Code; 2000 Existing Edition.

Based on review of facility documentation, staff interview, and observations, the facility was determined to be in compliance with the Life Safety Code provisions.

The inspection was conducted as a complaint investigation referenced by complaint #9322.

The complaint was unsubstantiated and no deficiencies were cited during the investigation.

Complaint reference #9322 was unsubstantiated with no deficiencies cited.

The inspection was conducted to assess compliance with NFPA 101 Life Safety Code standards, including fire alarm system maintenance, sprinkler system inspection, and door self-closing mechanisms in hazardous area enclosures.

The facility failed to maintain all doors for hazardous area enclosures to be self-closing, failed to maintain all components of the fire alarm system with two audio/visual devices not corrected, and failed to maintain, inspect, and test the sprinkler system per NFPA standards, including an obstruction to a sprinkler head's spray pattern.

The inspection was conducted to assess compliance with federal regulations regarding resident rights, self-determination, drug regimen, medication management, and resident call systems.

The facility was found deficient in multiple areas including failure to properly inform residents about Medicare payment discontinuation and appeal rights, failure to consider individual food preferences in care planning, use of unnecessary drugs including excessive dosages and lack of monitoring, failure of the pharmacist to report drug regimen irregularities, improper medication storage practices including undated multi-dose vials and expired medications, and a non-functioning bathroom call light in one resident room.

This document is a plan of correction related to a paper revisit survey of Cortland Acres Nursing Home.

The document includes a statement of deficiencies related to resident rights and notification requirements, specifically regarding informing residents of their rights and services in writing and orally.

The inspection was conducted to assess the facility's compliance with the provisions of NFPA 101, Life Safety Code; 2000 Existing Edition.

Based on review of facility documentation, staff interview, and observations, the facility was determined to be in compliance with the Life Safety Code requirements.

The inspection was conducted to assess compliance with federal regulations regarding resident rights, comprehensive care plans, accident prevention, and pharmacy services at Cortland Acres Nursing Home.

The facility failed to update comprehensive care plans for residents, including necessary safety measures such as padded bed rails, and did not ensure adequate supervision to prevent accidents. Additionally, the facility failed to secure the medication cart during medication pass, posing a risk to residents.

The visit was a paper revisit to follow up on previous deficiencies.

The document is a statement of deficiencies and plan of correction related to resident rights and notification requirements, but no specific findings or deficiencies beyond the initial comment are detailed.

The inspection was conducted to evaluate compliance with the NFPA 101 Life Safety Code Standard, specifically regarding the installation, testing, and maintenance of the fire alarm system and smoke detector sensitivity testing.

The facility failed to conduct required sensitivity testing of smoke detectors within the preceding five-year period, as evidenced by review of fire alarm inspection reports and staff interview confirming no sensitivity tests had been performed.

A standard certification survey and concurrent annual licensure inspection were conducted from 01/08/07 through 01/11/07.

The facility was found to be in substantial compliance with the health and physical environment portions of the Federal Medicare/Medicaid participation requirements and the State licensure rule, with no deficiencies cited.

The inspection was conducted as a complaint investigation referencing complaints #2-6303 and #2-6309, substantiating deficiencies in resident care and facility practices.

The facility was found deficient in multiple areas including failure to promptly notify the medical power of attorney or family of an accident involving a resident, failure to respect a deceased resident's personal property by clearing the room without family permission, inaccurate resident assessments regarding urinary catheter use, and inadequate monitoring of a resident's fluid intake leading to dehydration.

Complaint references #2-6303 and #2-6309 were substantiated with deficiencies cited related to notification failures, dignity violations, inaccurate assessments, and hydration monitoring.

Paper revisit to review the facility's plan of correction following previous deficiencies.

The document contains a statement of deficiencies related to resident rights and notification requirements, with a focus on informing residents of their rights and services. No new inspection findings are detailed beyond the plan of correction context.

The inspection was conducted as a comprehensive annual survey of Cortland Acres Nursing Home to assess compliance with federal regulations regarding resident rights, care planning, quality of care, meal frequency, infection control, and facility safety.

The facility was found deficient in multiple areas including failure to notify a resident's medical power of attorney about dental status, failure to develop and monitor a comprehensive care plan for pain management, failure to provide bedtime snacks to multiple residents, improper cohorting of residents with MRSA contrary to facility policy, and failure to maintain furniture in a cleanable condition.

The inspection was conducted as an annual survey to assess compliance with health and safety regulations, including life safety code standards and generator operational requirements.

The facility was found to have multiple deficiencies related to life safety code standards, including obstructions in designated means of egress due to storage of soiled linen and trash receptacles, and failure to properly exercise the diesel-powered emergency generator as required by NFPA standards.

The inspection was conducted as a complaint investigation referenced as #2-5187.

The complaint was substantiated; however, no deficiencies were cited in the facility.

Complaint reference #2-5187 was substantiated with no deficiencies cited.

The inspection was conducted to determine the facility's compliance with the Life Safety Code NFPA 101 - 2000 Existing.

Based on observation, performance testing, and review of facility documentation from 06/28/04 to 06/29/04, the facility was found to be in compliance with the Life Safety Code NFPA 101 - 2000 Existing.

The inspection was conducted as an annual survey of Cortland Acres Nursing Home to assess compliance with federal regulations regarding resident rights, care planning, dietary services, infection control, and other regulatory requirements.

The facility was found deficient in multiple areas including improper activation of medical power of attorney based on diagnosis, inadequate care plans for residents especially regarding behavior monitoring and weight loss, failure to follow physician orders for support hose, unsanitary food storage and handling practices, and inadequate infection control practices contaminating ice used by residents.

The inspection was conducted as a complaint investigation referenced as #2-3281, which was substantiated with deficiencies cited.

The facility failed to verify that two registered long-term care nursing assistants (RLTCNAs) maintained active status with the State Nurse Aide Registry. The facility director of nursing was unaware of the delinquent status and there was no system in place to ensure RLTCNAs remained in good standing.

Complaint reference #2-3281 was substantiated with deficiencies cited.

The inspection was conducted to assess compliance with the Life Safety Code NFPA 101 - 1973 New, based on observation, performance testing, and review of facility documentation from 05/27/03 to 05/29/03.

The facility was determined to be in compliance with the Life Safety Code NFPA 101 - 1973 New during the inspection period.

Annual inspection of Cortland Acres Nursing Home to assess compliance with federal regulations including resident rights, quality of care, dietary services, pharmacy services, and infection control.

The facility was found deficient in multiple areas including failure to follow legal representative procedures for residents lacking capacity, failure to inform residents of medication reasons, inadequate advance directive processes, improper staff background checks, failure to maintain resident dignity, lack of resident participation in menu planning, inadequate activity programs for residents with specific needs, incomplete care plans, failure to follow physician orders for blood sugar monitoring and medication administration, improper dietary service practices including portion control and food temperature, and inadequate infection control measures.

This was a revisit to deficiencies written for complaint 2-2259, originally done in November 2002.

All three previously cited tags (F323, F225, and F309) were found to be back in compliance during the revisit.

This inspection was a follow-up related to a complaint investigation identified as complaint 2-2259.

The inspection was conducted to assess compliance with quality of care and resident safety regulations, including review of personnel files, medical records, accident reports, and staff interviews.

The facility failed to ensure that the plan of care was followed for one resident, resulting in pain due to improper handling by a CNA. Additionally, the facility failed to maintain a safe environment for one resident who fell on a floor mat, sustaining lacerations and fractures.

The inspection was conducted in response to complaint investigation CI# 2-2187.

The report includes a deficiency related to the facility's failure to properly inform residents of their rights and services as required by regulation 483.10(b)(5)-(10), with a severity level of 'SS=C'.

Complaint investigation CI# 2-2187.

The inspection was conducted to assess the facility's compliance with the provisions of NFPA 101, Life Safety Code; 1973 New Edition.

Based on review of facility documentation, staff interview, observations, and performance testing, the facility was determined to be in compliance with the Life Safety Code.

The inspection was conducted as a health survey of Cortland Acres Nursing Home to assess compliance with regulatory requirements.

No deficiencies were found as a result of the health survey.

The inspection was conducted based on review of facility documentation, staff interview, observations, and performance testing to determine compliance with NFPA 101 Life Safety Code and 483.70 Physical Environment provisions.

The facility was found to be in compliance with the provisions of NFPA 101 Life Safety Code, 1973 New Edition, and 483.70 Physical Environment based on documentation review, staff interview, observations, and performance testing.

The inspection was conducted as part of a routine annual survey to assess compliance with federal regulations regarding resident rights, quality of care, and dietary services at Cortland Acres Nursing Home.

The facility was found deficient in informing residents of their rights and services, improper administration of medications and water flush via gastrostomy tube for one resident, and failure to store food under sanitary conditions in one of two refrigerators containing resident food.

The inspection was conducted based on a review of facility documentation, staff interviews, and observations to determine compliance with the provisions of 483.70 Physical Environment.

The facility was found to be in compliance with the provisions of 483.70 Physical Environment.

The inspection was conducted to review facility documentation, staff interviews, and observations to determine compliance with the Life Safety Code, 1973 edition.

The facility was found to be in compliance with the provisions of the Life Safety Code, 1973 New edition, based on documentation review, staff interviews, and observations.

The inspection was conducted to assess compliance with federal regulations regarding resident rights, staff treatment of residents, quality of life, quality of care, dietary services, and other regulatory requirements at Cortland Acres Nursing Home.

The facility was found deficient in multiple areas including failure to report an allegation of verbal abuse to the Nurse Aide Registry, failure to accommodate residents' preferences regarding medication administration during meals, failure to provide necessary care for residents with mouth ulcers and nasal dryness, and failure to maintain sanitary conditions in food storage and preparation areas.