Inspection Report
Renewal
Deficiencies: 2
Apr 18, 2018
Visit Reason
The inspection was a renewal inspection conducted to review compliance with regulatory requirements for Home Park Assisted Living.
Findings
The survey identified deficiencies including failure to conduct required annual resident assessments and service plans for the years 2016 and 2017, and concerns about cross contamination due to shared towels in a bathroom used by three residents.
Deficiencies (2)
| Description |
|---|
| Failure to conduct required annual resident assessments and service plans for years 2016 and 2017 for Residents #1 and #2. |
| One bathroom is utilized by three residents with shared towels on each towel bar, raising concerns of cross contamination. |
Report Facts
Number of residents sharing one bathroom: 3
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Jason George | Administrator | Signed off on resident service plans and present during survey observations |
| Harry Dziak | Survey Team Leader | Led the renewal inspection |
Inspection Report
Renewal
Deficiencies: 3
Apr 19, 2016
Visit Reason
The inspection was conducted as a renewal inspection of the Home Park Assisted Living facility to assess compliance with regulatory standards.
Findings
The report identifies three core issues related to minimum standards for disaster planning, employee files, and resident toilets and bathing facilities.
Deficiencies (3)
| Description |
|---|
| Minimum standards for all health care facilities: disaster plan |
| Employee files |
| Resident toilets and bathing |
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Jason George | Administrator | Administrator of the facility during the renewal inspection |
| Linda Egebjerg | Survey Team Leader | Led the renewal inspection survey |
Inspection Report
Renewal
Deficiencies: 9
May 5, 2015
Visit Reason
The inspection was conducted as a renewal inspection of the Home Park Assisted Living facility to assess compliance with licensing requirements and regulations.
Findings
The inspection identified multiple deficiencies including lack of updated written policies and procedures, incomplete staff background documentation, missing resident applications and incomplete resident service plan reviews, absence of medication disposal policies, missing physician orders for medications, lack of a written maintenance program, and excessively high water temperatures in bathroom sinks.
Deficiencies (9)
| Description |
|---|
| Policy/procedure manual has no documentation of review or revision in the past four years and lacks policies on assessment processes. |
| Five direct care staff files lack documentation of background checks. |
| Two residents do not have resident applications; three closed files lack sex and marital status information. |
| No evidence of required 60 day review of initial service plans in open and closed resident files. |
| Seven residents with more than one year residency did not have resident needs assessments and service plans reviewed and updated as required. |
| Facility has not developed or implemented a policy for lawful disposal of unused, outdated, discontinued or recalled medications. |
| Nine residents do not have physician orders for medications; medication orders signed by physicians are kept by pharmacy and not sent to the facility. |
| Facility does not have a written maintenance program as required. |
| Water temperatures in bathroom sinks are excessively high (west bathroom sink 129°F, east bathroom left sink 123.4°F, right sink 125.6°F). |
Report Facts
Number of direct care staff lacking background documentation: 5
Number of residents without applications: 2
Number of closed resident files missing sex and marital status: 3
Number of residents without physician medication orders: 9
Number of residents without required service plan reviews: 7
Water temperature in west bathroom sink (°F): 129
Water temperature in east bathroom left sink (°F): 123.4
Water temperature in east bathroom right sink (°F): 125.6
Inspection Report
Renewal
Deficiencies: 2
Apr 15, 2014
Visit Reason
The inspection was conducted as a renewal inspection of the Home Park Assisted Living facility to assess compliance with regulatory requirements.
Findings
The inspection identified deficiencies including the absence of a policy for screening, hiring, and assessing employees for risk to residents, and unsafe water temperature in a public/resident bathroom measured at 147 degrees Fahrenheit.
Deficiencies (2)
| Description |
|---|
| No policy was found regarding screening, hiring, and assessing employees for risk or threat to the health, safety or welfare of the residents. |
| Water in public/resident bathroom was very hot to the touch and steaming; thermometer reading was 147 degrees Fahrenheit. |
Report Facts
Water temperature: 147
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