Inspection Reports for Golden Valley Group Care II
1140 Manhattan Street, Reno, NV 89512, NV, 89512
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Inspection Report
Complaint Investigation
Census: 10
Capacity: 10
Deficiencies: 2
Nov 18, 2024
Visit Reason
The inspection was conducted as a complaint survey triggered by Complaint #NV00072222, which included allegations regarding meal information accuracy, provision of alternative meals, and caregiver presence.
Findings
The facility was found to have substantiated deficiencies related to inaccurate meal menus and failure to provide alternative meals for residents with special diets. One allegation regarding caregiver presence was not substantiated. The facility received a grade of A.
Complaint Details
Complaint #NV00072222 was investigated with three allegations: (1) Residents were not accurately informed of meals and meal substitutions (substantiated), (2) Alternative meals were not provided to residents (substantiated), and (3) A qualified caregiver was not always on premises (not substantiated due to lack of evidence).
Severity Breakdown
Level 1: 1
Level 2: 1
Deficiencies (2)
| Description | Severity |
|---|---|
| Facility failed to post written menus which accurately reflected the meals served to the residents. | Level 1 |
| Facility failed to ensure alternative meals were provided to residents with physician ordered special diets for 2 of 5 sampled residents. | Level 2 |
Report Facts
Sample size: 5
Severity Level 1 Deficiency Scope: 3
Severity Level 2 Deficiency Scope: 1
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Warlito Pizarro | Administrator | Named in relation to the findings on menu posting and special diet meal provision. |
Inspection Report
Annual Inspection
Census: 10
Capacity: 10
Deficiencies: 2
Aug 21, 2024
Visit Reason
The inspection was conducted as a State Licensure annual grading survey to assess compliance with Nevada Administrative Code Chapter 449 for Residential Facility for Groups.
Findings
The facility received a grade of A. Deficiencies were identified related to caregiver medication training and annual assessments of residents. Specifically, one employee lacked current medication management training, and one resident's initial Standard Physician Assessment and Placement Determination was not completed upon admission.
Severity Breakdown
Level 2: 2
Deficiencies (2)
| Description | Severity |
|---|---|
| Failure to ensure one of three employees completed annual medication management training as required. | Level 2 |
| Failure to obtain an initial Standard Physician Assessment and Placement Determination for one of ten residents upon admission. | Level 2 |
Report Facts
Number of residents present: 10
Total licensed capacity: 10
Number of employees reviewed: 3
Number of resident files reviewed: 10
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Warlito Pizarro | Administrator | Named as Administrator responsible for compliance and plan of correction |
| Employee #3 | Caregiver/Medication Technician who lacked current medication management training |
Inspection Report
Complaint Investigation
Census: 9
Deficiencies: 0
May 30, 2024
Visit Reason
The inspection was conducted as a complaint investigation triggered by allegations regarding Activities of Daily Living (ADLs) and medication administration at the facility.
Findings
The complaint allegations could not be substantiated due to lack of evidence. No regulatory deficiencies were identified and no further action was necessary.
Complaint Details
One complaint (#NV00070165) was investigated with allegations that two residents did not have ADLs performed and two residents were not administered medications on specified dates. The allegations were not substantiated.
Report Facts
Resident records reviewed: 9
Employee records reviewed: 3
Complaint count: 1
Inspection Report
Complaint Investigation
Census: 10
Deficiencies: 2
Dec 21, 2023
Visit Reason
The inspection was conducted as a result of a complaint investigation regarding an allegation that a resident was touched on the genitals by a caregiver.
Findings
The complaint could not be substantiated due to lack of evidence. However, deficiencies were identified including failure to ensure one employee met background check requirements and failure to investigate or report an allegation of sexual abuse of a resident by a caregiver.
Complaint Details
Complaint #NV00070004 alleged a resident was touched on the genitals by a caregiver; the allegation was not substantiated due to lack of evidence. The investigation included interviews and record reviews. The facility failed to investigate or report a sexual abuse allegation made by Resident #1, and the caregiver of concern continued to live and work in the facility until 12/15/23.
Severity Breakdown
Level 2: 2
Deficiencies (2)
| Description | Severity |
|---|---|
| Facility failed to ensure 1 of 5 employees met background check requirements; employee lacked documented evidence of clearance determination. | Level 2 |
| Administrator failed to complete an investigation or report an allegation of sexual abuse of a resident by a caregiver. | Level 2 |
Report Facts
Residents reviewed: 5
Employees reviewed: 5
Complaint count: 1
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Warlito Pizarro | Administrator | Named as Administrator responsible for oversight; noted in findings related to failure to investigate and report abuse. |
| Employee #5 | Caregiver | Employee who lacked documented background check clearance and provided care since hire date. |
Inspection Report
Annual Inspection
Census: 9
Capacity: 10
Deficiencies: 5
Sep 7, 2023
Visit Reason
The inspection was conducted as a result of a State Licensure annual grading survey combined with a complaint investigation at the facility on 09/07/23.
Findings
The facility received a B grade with several deficiencies identified including failure of the Administrator to provide adequate oversight, failure to ensure caregivers completed required medication training, missing resident records, incomplete physician placement determinations for multiple residents, and lack of initial Activities of Daily Living (ADL) assessments for one resident. One complaint was investigated but not substantiated due to lack of evidence.
Complaint Details
One complaint (#NV00069336) was investigated with allegations including improper meal provision, medication administration errors, inadequate bathing, and lack of supervision. The complaint was not substantiated due to lack of evidence.
Severity Breakdown
Level 2: 5
Deficiencies (5)
| Description | Severity |
|---|---|
| Administrator failed to provide oversight and direction to ensure residents received needed services and protective supervision. | Level 2 |
| Facility failed to ensure one caregiver completed required medication management training prior to administering medications. | Level 2 |
| Facility failed to maintain resident records for investigation; Resident #10's record was missing. | Level 2 |
| Facility failed to ensure Physician Placement Determination was completed upon admission for 4 of 9 sampled residents. | Level 2 |
| Facility failed to ensure an initial Activities of Daily Living (ADL) assessment was completed for 1 of 9 sampled residents. | Level 2 |
Report Facts
Licensed capacity: 10
Census: 9
Employees reviewed: 3
Resident files reviewed: 9
Complaint allegations: 4
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Warlito Pizarro | Administrator | Named in relation to oversight failures and medication training deficiency |
| Employee #3 | Medication Technician | Failed to complete required medication management training prior to administering medications |
Inspection Report
Complaint Investigation
Census: 9
Deficiencies: 4
May 25, 2023
Visit Reason
This inspection was conducted as a complaint investigation triggered by complaint #NV00068369 alleging resident neglect and inadequate staffing at the facility.
Findings
The investigation substantiated the complaint that the facility failed to provide sufficient staffing and appropriate care for residents, including lack of caregiver presence for over two hours. Additional deficiencies were cited related to staffing schedules, incomplete resident assessments, and missing physician placement determinations.
Complaint Details
Complaint #NV00068369 was substantiated for allegations of resident neglect and inadequate staffing, specifically no staff present inside while a caregiver was outside with another resident for over two hours.
Severity Breakdown
Level 2: 3
Level 1: 1
Deficiencies (4)
| Description | Severity |
|---|---|
| Failure to schedule sufficient number of caregivers to provide care and supervision for residents requiring two-person assistance. | Level 2 |
| Failure to maintain monthly written staff schedules for at least six months. | Level 1 |
| Failure to complete initial Activities of Daily Living (ADL) assessments at or prior to admission for some residents. | Level 2 |
| Failure to obtain completed Physician Placement Determination Statements for multiple residents to determine appropriate facility type and care. | Level 2 |
Report Facts
Residents present: 9
Resident records reviewed: 9
Employee records reviewed: 3
Complaints investigated: 1
Residents requiring two-person assistance: 2
Residents lacking initial ADL assessment: 2
Residents lacking completed Physician Placement Determination: 5
Inspection Report
Complaint Investigation
Census: 9
Deficiencies: 0
Apr 3, 2023
Visit Reason
The inspection was conducted as a result of a complaint investigation at the facility on 04/03/23, triggered by allegations related to resident neglect and lack of designee availability.
Findings
The investigation reviewed resident and employee records and conducted interviews, concluding that the allegations could not be substantiated. No regulatory deficiencies were identified and no further action is required.
Complaint Details
Complaint #NV00068194 included two allegations: 1) a resident's condition was neglected causing a leg amputation, and 2) the facility did not have a designee available to instruct caregivers and address the resident's declining condition. Both allegations were not substantiated.
Report Facts
Resident records reviewed: 5
Employee records reviewed: 5
Complaints investigated: 1
Inspection Report
Complaint Investigation
Census: 9
Deficiencies: 4
Mar 3, 2023
Visit Reason
The inspection was conducted as a result of a complaint investigation at the facility on 03/03/23, triggered by two complaints alleging neglect and improper resident care.
Findings
The investigation found that the complaints could not be substantiated due to lack of evidence. However, deficiencies unrelated to the complaints were cited, including improper use of bedrails as restraints, failure to treat residents with respect and dignity, admission of residents requiring skilled nursing without proper waivers, and failure to maintain discharged resident files for the required period.
Complaint Details
Two complaints were investigated: Complaint #NV00066932 alleging failure to check blood glucose and administer insulin, dehydration, and resident eating cat food; and Complaint #NV00066622 alleging the facility gave away a resident's bed and refused to accept the resident back. Both complaints were not substantiated due to lack of evidence.
Severity Breakdown
Level 2: 3
Level 3: 1
Deficiencies (4)
| Description | Severity |
|---|---|
| Facility failed to ensure bedrails were not used as restraints for 1 of 8 sampled residents (Resident #2). | Level 2 |
| Administrator failed to ensure residents were spoken to in a dignified manner for 3 of 8 sampled residents (Residents #1, #2, and #4). | Level 3 |
| Facility failed to ensure residents receiving skilled nursing services were not admitted or allowed to remain without submitting waivers to the State Agency for 3 residents (Residents #2, #3, and #4). | Level 2 |
| Facility failed to ensure a discharged resident's file was retained for at least five years after the resident permanently left the facility (Resident #9). | Level 2 |
Report Facts
Sample size: 11
Complaints investigated: 2
Residents receiving skilled nursing care: 3
Inspection Report
Annual Inspection
Census: 8
Capacity: 10
Deficiencies: 4
Jan 9, 2023
Visit Reason
This inspection was a State Licensure annual grading survey conducted to assess compliance with Nevada Administrative Code Chapter 449 for Residential Facility for Groups.
Findings
The facility received an A grade but had several deficiencies including failure to maintain a complete first aid kit, incomplete medication reviews for some residents, lack of cultural competency training for one employee, and missing Standard Physician Assessments for most residents.
Severity Breakdown
Severity: 2: 4
Deficiencies (4)
| Description | Severity |
|---|---|
| Facility failed to maintain the contents of a first aid kit, lacking a shield or mask for CPR. | Severity: 2 |
| Administrator failed to ensure medication reviews were completed at least every six months for 2 of 8 sampled residents. | Severity: 2 |
| Facility failed to ensure all employees received cultural competency training within 30 days of hire for 1 of 4 sampled employees. | Severity: 2 |
| Facility failed to obtain a Standard Physician Assessment and Placement Determination for 7 of 8 residents. | Severity: 2 |
Report Facts
Residents reviewed: 8
Employee files reviewed: 4
Deficiencies cited: 4
Inspection Report
Re-Inspection
Census: 9
Capacity: 10
Deficiencies: 7
Sep 22, 2022
Visit Reason
This inspection was a required grading re-survey conducted to evaluate compliance with state licensure regulations for a residential facility for group beds for elderly and disabled persons and/or persons with mental illness.
Findings
The facility received a re-survey grade of B with multiple deficiencies identified including failure to ensure volunteer maintenance personnel had pre-employment physicals, expired food items in the kitchen, lack of exemption requests for residents with wounds, incomplete physical examinations upon admission and annually for some residents, inaccurate medication administration records, and failure to maintain separate locked resident files with required documentation.
Severity Breakdown
Level 1: 1
Level 2: 5
Level F: 1
Deficiencies (7)
| Description | Severity |
|---|---|
| Failed to ensure a volunteer maintenance personnel met pre-employment physical examination requirements. | Level 2 |
| Facility premises not kept free from offensive odors, hazards, obstacles, insects, rodents, and accumulation of dirt and garbage. | Level F |
| Facility failed to ensure expired foods were discarded, potentially affecting all residents. | Level 2 |
| Failed to obtain exemption request to retain a resident with wounds. | Level 2 |
| Failed to ensure physical examinations including review of systems were completed upon admission and annually for some residents. | Level 2 |
| Failed to ensure medication administration records were accurate for a resident. | Level 1 |
| Failed to maintain separate locked files for each resident containing all required records and evaluations. | Level 2 |
Report Facts
Deficiencies cited: 7
Residents reviewed: 9
Licensed capacity: 10
Census: 9
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Warlito Pizarro | Administrator | Named in relation to findings and corrective actions throughout the report. |
Inspection Report
Annual Inspection
Census: 10
Capacity: 10
Deficiencies: 4
Jul 14, 2016
Visit Reason
The inspection was conducted as a result of an annual State Licensure survey combined with a complaint investigation and re-licensure of the facility.
Findings
The facility received a grade of B with deficiencies identified in health and sanitation, medication administration records, medication storage, and resident tuberculosis testing documentation. Two complaints investigated were not substantiated.
Complaint Details
Two complaints (#NV00046023 and #NV00046033) alleging a resident was left soiled for an extended period were investigated and could not be substantiated.
Severity Breakdown
1: 1
2: 3
Deficiencies (4)
| Description | Severity |
|---|---|
| Facility failed to ensure the interior and exterior were clean and maintained, including trash bags in backyard, water damaged linoleum, and dirt buildup in resident's bedroom. | 2 |
| Medication administration records (MAR) were incomplete and inaccurate for 3 of 10 residents, with missing signatures and errors in medication administration documentation. | 1 |
| Medications were not securely stored; over-the-counter and prescription medications were found unsecured in resident rooms and common areas. | 2 |
| Resident files lacked required tuberculosis testing documentation for 2 of 10 residents. | 2 |
Report Facts
Residents present: 10
Licensed capacity: 10
Complaints investigated: 2
Resident files reviewed: 10
Employee files reviewed: 4
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Julieta Iban | Administrator | Administrator responsible for monitoring facility environment and resident requirements |
| Employee #3 | Acknowledged deficiencies in medication administration and medication storage; was counseled and sent to reorientation class on Medication Management | |
| Employee #2 | Owner | Acknowledged medication storage deficiencies and missing TB documentation; involved in corrective actions |
| Employee #1 | Counseled Employee #3 regarding medication administration record accuracy and responsible for monitoring MAR and medication management |
Inspection Report
Annual Inspection
Census: 10
Capacity: 10
Deficiencies: 4
Jul 14, 2016
Visit Reason
This inspection was conducted as an annual State Licensure survey combined with a complaint investigation regarding an allegation that a resident was left soiled for an extended period of time.
Findings
The facility received a grade of B. The complaint was not substantiated. Deficiencies were identified related to facility cleanliness and maintenance, incomplete medication administration records, unsecured medications, and missing tuberculosis testing documentation for some residents.
Complaint Details
Complaint #NV00046023 alleged a resident was left soiled for an extended period of time; the complaint was investigated and not substantiated after observation, interviews, and record review.
Severity Breakdown
Level 1: 1
Level 2: 3
Deficiencies (4)
| Description | Severity |
|---|---|
| Facility failed to ensure the interior and exterior were clean and maintained, including five full trash bags and two broken bed frames in the backyard, water damaged linoleum floor in bathroom, and dirt buildup in a resident's bedroom. | Level 2 |
| Medication administration records (MAR) were incomplete and inaccurate for 3 of 10 residents, with multiple missed signatures for administered medications. | Level 1 |
| Medications were not stored securely; over-the-counter Dayquil was unsecured in a resident's room and inhalers and antibiotic cream were unsecured in a common area basket. | Level 2 |
| Resident files lacked required tuberculosis testing documentation for 2 of 10 residents, missing 2016 TB test and signs and symptoms review. | Level 2 |
Report Facts
Deficiencies cited: 4
Facility licensed capacity: 10
Census: 10
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Employee #3 acknowledged observations of facility cleanliness issues and medication administration record errors. | ||
| Owner | Employee #2, the Owner, acknowledged unsecured medications and confirmed missing tuberculosis documentation. |
Inspection Report
Annual Inspection
Census: 10
Capacity: 10
Deficiencies: 2
Aug 27, 2015
Visit Reason
The inspection was an annual State Licensure survey conducted to assess compliance with state regulations for a residential facility for elderly and disabled persons.
Findings
The facility received a grade of A but was found deficient in personnel background checks and medication storage practices, including failure to ensure background checks for one employee and failure to keep medications in a locked container.
Severity Breakdown
Severity: 2: 2
Deficiencies (2)
| Description | Severity |
|---|---|
| Facility failed to ensure 1 of 3 employees met background check requirements; missing documented evidence of State and FBI background check for Employee #2. | Severity: 2 |
| Facility failed to ensure medications were kept in a locked container; medication cabinet was found unlocked at 8:40 AM but locked at 10:48 AM on the day of inspection. | Severity: 2 |
Report Facts
Number of residents present: 10
Total licensed capacity: 10
Number of employees reviewed: 3
Number of resident files reviewed: 10
Inspection Report
Annual Inspection
Census: 10
Capacity: 10
Deficiencies: 2
Aug 27, 2015
Visit Reason
This inspection was conducted as an annual State Licensure survey of the facility on 8/27/15 by the Division of Public and Behavioral Health.
Findings
The facility received a grade of A but had deficiencies including failure to ensure one employee met background check requirements and failure to ensure medications were stored in a locked container.
Severity Breakdown
Severity: 2: 2
Deficiencies (2)
| Description | Severity |
|---|---|
| Failed to ensure 1 of 3 employees met background check requirements of NRS 449 (Employee #2). | Severity: 2 |
| Failed to ensure medications were kept in a locked container; medication cabinet was found unlocked at 8:40 AM but locked by 10:48 AM. | Severity: 2 |
Report Facts
Resident census: 10
Total licensed capacity: 10
Employee files reviewed: 3
Resident files reviewed: 10
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Employee #2 | Named in background check deficiency finding | |
| Employee #1 | Acknowledged medication storage deficiency |
Inspection Report
Re-Inspection
Census: 10
Capacity: 10
Deficiencies: 2
Oct 29, 2014
Visit Reason
This State Licensure survey was conducted as a required grading re-survey of the facility on 10/29/14.
Findings
The facility failed to ensure proper food temperatures were maintained and adequate storage and packaging of food were not met, as evidenced by observations of food at room temperature and improper storage of vegetables on the floor.
Deficiencies (2)
| Description |
|---|
| Storage of Food-Perishable foods refrigerated: Facility failed to ensure proper food temperatures were maintained. |
| Storage of Food-Adequate storage; Packaging: Facility failed to ensure food was properly stored and packaged, including a bin of potatoes and tomatoes located on the floor next to a broom. |
Report Facts
Severity: 2
Scope: 3
Inspection Report
Re-Inspection
Census: 10
Capacity: 10
Deficiencies: 2
Oct 29, 2014
Visit Reason
This document is a required grading re-survey conducted as a State Licensure survey to evaluate compliance with health regulations at the facility.
Findings
The facility received a re-survey grade of A but was found deficient in food storage practices, including failure to maintain proper refrigeration temperatures and improper storage of food items on the floor.
Severity Breakdown
Level 2: 2
Deficiencies (2)
| Description | Severity |
|---|---|
| Facility failed to ensure perishable foods were refrigerated at 40 degrees Fahrenheit or less; a plate of food was observed at room temperature on top of the microwave. | Level 2 |
| Facility failed to ensure food was properly stored; a bin of potatoes and tomatoes was located on the floor next to a broom. | Level 2 |
Report Facts
Licensed capacity: 10
Census: 10
Severity level: 2
Scope: 3
Inspection Report
Annual Inspection
Census: 8
Capacity: 10
Deficiencies: 13
Sep 9, 2014
Visit Reason
This document is a State Licensure survey conducted as an annual inspection of a residential facility for elderly and disabled persons with mental illness to assess compliance with regulatory requirements.
Findings
The facility was found deficient in multiple areas including administrator oversight, elder abuse training, staffing requirements, personnel background checks, health and sanitation, bedroom lighting, medication administration, medication education, medication storage, tuberculosis testing, and mental illness training. Deficiencies were addressed with plans for correction and follow-up.
Severity Breakdown
Severity: 2: 13
Deficiencies (13)
| Description | Severity |
|---|---|
| Administrator failed to provide oversight and direction to ensure residents received needed services and protective supervision. | Severity: 2 |
| Facility failed to ensure 1 of 2 caregivers had training to recognize and prevent elder abuse. | Severity: 2 |
| Facility failed to ensure a qualified caregiver was present at all times. | Severity: 2 |
| Facility failed to ensure 2 of 3 employees met background check requirements. | Severity: 2 |
| Facility failed to maintain clean and safe premises; multiple rooms had damage, stains, cobwebs, and debris. | Severity: 2 |
| Facility failed to ensure adequate lighting in 1 of 9 resident rooms. | Severity: 2 |
| Facility failed to ensure medication administration reviews were completed for 3 of 8 residents. | Severity: 2 |
| Facility failed to ensure administrator received medication administration training. | Severity: 2 |
| Facility failed to ensure 1 of 8 residents had medication that did not require assessment. | Severity: 2 |
| Facility failed to ensure 1 of 8 residents received medications as prescribed. | Severity: 2 |
| Facility failed to ensure medications were kept in original container until administered. | Severity: 2 |
| Facility failed to ensure 4 of 8 residents met tuberculosis testing requirements. | Severity: 2 |
| Facility failed to ensure 1 of 3 employees received mental illness training within 60 days of employment. | Severity: 2 |
Report Facts
Census: 8
Total Capacity: 10
Employee files reviewed: 3
Resident files reviewed: 8
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Patricia Alte | Owner | Named in relation to administrator responsibilities and oversight |
| Caregiver #1 | Mentioned in findings related to caregiver training, medication administration, and facility operations | |
| Caregiver #2 | Mentioned in findings related to elder abuse training, caregiver presence, and background checks | |
| Employee #2 | Mentioned in findings related to caregiver status and background checks | |
| Employee #3 | Mentioned in findings related to background checks, medication training, and mental illness training |
Inspection Report
Annual Inspection
Census: 8
Capacity: 10
Deficiencies: 13
Sep 9, 2014
Visit Reason
This document is a Statement of Deficiencies generated as a result of an annual State Licensure survey conducted on 9/9/2014 at Golden Valley Group Care 2, a residential facility for elderly and disabled persons.
Findings
The facility received a grade of D with multiple deficiencies identified including failure to provide adequate oversight by the administrator, lack of elder abuse training for caregivers, insufficient staffing, incomplete background checks, poor facility maintenance, inadequate lighting, medication administration issues, improper medication storage, incomplete tuberculosis testing documentation, and insufficient mental illness training for employees.
Severity Breakdown
Level 2: 13
Deficiencies (13)
| Description | Severity |
|---|---|
| Administrator failed to provide oversight and direction to staff to ensure residents received needed services and protective supervision. | Level 2 |
| Facility failed to ensure 1 of 2 caregivers had training to recognize and prevent elder abuse. | Level 2 |
| Facility failed to ensure a qualified caregiver was present at all times; no caregiver on-site at one point. | Level 2 |
| Facility failed to ensure 2 of 3 employees met background check requirements. | Level 2 |
| Facility failed to maintain clean and safe premises; multiple maintenance and sanitation issues observed in resident rooms and common areas. | Level 2 |
| Facility failed to provide adequate lighting in 1 of 9 resident rooms. | Level 2 |
| Facility failed to ensure 3 of 8 residents received medication reviews at least once every 6 months. | Level 2 |
| Administrator failed to receive required annual medication administration training. | Level 2 |
| Facility failed to ensure 1 of 8 residents had medication that did not require an assessment. | Level 2 |
| Facility failed to ensure 1 of 8 residents received medications as prescribed; medication on-site not on current physician orders. | Level 2 |
| Facility failed to ensure medications were kept in original containers until administered. | Level 2 |
| Facility failed to ensure 4 of 8 residents met tuberculosis testing requirements; missing or incomplete TB skin test documentation. | Level 2 |
| Facility failed to ensure 1 of 3 employees received required mental illness training within 60 days of hire. | Level 2 |
Report Facts
Facility licensed capacity: 10
Census at time of survey: 8
Deficiency severity counts: 13
Medication cups observed: 6
Residents reviewed: 8
Employee files reviewed: 3
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Caregiver #1 | Owner and Caregiver | Acknowledged deficiencies in medication reviews, training, and staffing; occasionally took shifts to relieve staff |
| Caregiver #2 | Caregiver | Lacked elder abuse training and background check documentation; involved in medication cup washing |
| Employee #2 | Visitor | Was on premises but not a qualified caregiver during inspection |
| Employee #3 | Employee | Failed to receive required mental illness training within 60 days of hire |
Inspection Report
Complaint Investigation
Census: 9
Deficiencies: 0
Jul 10, 2014
Visit Reason
The inspection was conducted as a complaint investigation triggered by Complaint #NV00038280, which alleged incorrect billing of residents and failure to document expenses.
Findings
The complaint was investigated by reviewing resident contracts, receipt logs, and interviews with a resident, a family member, and the facility owner. The investigation found that the facility was correctly documenting expenses and billing residents for rent. No regulatory deficiencies were identified and the complaint was not substantiated.
Complaint Details
Complaint #NV00038280 contained one allegation regarding incorrect billing and undocumented expenses, which was not substantiated after investigation.
Report Facts
Sample size: 5
Inspection Report
Annual Inspection
Census: 9
Capacity: 10
Deficiencies: 3
Sep 5, 2013
Visit Reason
This document is a State Licensure annual grading survey conducted from 2013-08-29 to 2013-09-05 to assess compliance with state regulations for a residential facility for group beds for elderly and disabled persons and/or persons with mental illness.
Findings
The facility received a grade of A but had deficiencies related to tuberculosis testing and documentation for employees and residents, as well as failure to ensure required mental illness training for employees.
Severity Breakdown
Severity: 2: 3
Deficiencies (3)
| Description | Severity |
|---|---|
| Failed to ensure 2 of 3 employees complied with tuberculosis testing requirements, including missing signs and symptoms TB forms and pre-employment physical exam documentation. | Severity: 2 |
| Failed to ensure 2 of 8 residents complied with tuberculosis testing requirements, including missing TB signs and symptoms forms for 2012 and 2013. | Severity: 2 |
| Failed to ensure 2 of 3 employees received 8 hours of mental illness training within 60 days of employment as required. | Severity: 2 |
Report Facts
Number of residents present: 9
Total licensed capacity: 10
Number of employee files reviewed: 3
Number of resident files reviewed: 9
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