Deficiencies per Year
4
3
2
1
0
Severe
High
Moderate
Low
Unclassified
Inspection Report
Annual Inspection
Census: 39
Deficiencies: 3
Aug 2, 2017
Visit Reason
Annual licensure survey conducted from July 31 to August 2, 2017, to assess compliance with staffing, housekeeping, maintenance, and resident belongings release regulations.
Findings
The facility was found deficient in ensuring all employees had current first aid and CPR training, maintaining adequate housekeeping and maintenance, and properly releasing residents' personal belongings and funds to authorized estate representatives upon death.
Severity Breakdown
Class I: 1
Class III: 1
Deficiencies (3)
| Description | Severity |
|---|---|
| Failure to ensure at least one employee on duty at all times had current first aid and CPR training, with three of five employees lacking current certification. | Class I |
| Inadequate housekeeping and maintenance including personal belongings left behind furniture, carpet damage, torn furniture, missing bathroom fixtures, and dirty sink. | — |
| Failure to release residents' personal belongings and funds to the estate administrator or executor upon death for two residents. | Class III |
Report Facts
Census: 39
Deficiency count: 3
Days without CPR/first aid trained staff: 10
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Employee #18 | Resident Care Partner | Lacked current first aid and CPR training |
| Employee #19 | Licensed Practical Nurse | Lacked current CPR training; received inservice training completed August 18, 2017 |
| Employee #24 | Resident Care Partner | Lacked current first aid and CPR training |
| Employee #22 | Licensed Practical Nurse | Interviewed regarding failure to release residents' belongings to authorized estate representatives |
| Employee #29 | Spoke with administrator about resident's brother retrieving belongings |
Report
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WV507541-1DX211-State2567.pdf
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WV507541-1ZQK12-State2567.pdf
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WV507541-SFX412-State2567.pdf
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WV507541-ZK9011-State2567.pdf
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