Inspection Reports for Symphony Square
35 Old Lancaster Rd, Bala Cynwyd, PA 19004, United States, PA, 19004
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Inspection Report
Monitoring
Census: 42
Capacity: 64
Deficiencies: 14
Jun 23, 2025
Visit Reason
The visit was an unannounced partial inspection conducted for monitoring purposes to review the facility's compliance and plan of correction implementation.
Findings
The inspection identified multiple deficiencies related to staff criminal background checks, staff orientation and training, medication administration and storage, record keeping, and preadmission screening. The facility submitted plans of correction for all deficiencies, which were accepted and later determined to be fully implemented.
Deficiencies (14)
| Description |
|---|
| Criminal background check was not completed prior to staff person A's physical start date. |
| Staff person B did not receive required fire safety and emergency preparedness orientation on their first day of work. |
| Direct care staff person B began providing unsupervised ADL services without completing required training and competency testing. |
| The home's record of direct care staff training did not include length of training. |
| Resident's medication record did not include a current list of medications; included discontinued medication and omitted current medication. |
| Staff person B administered medication without completing required medication administration training. |
| Medications were stored improperly, including expired eye drops and blister packs with torn slots taped over. |
| Prescribed medications were not available in the home when needed. |
| Individual controlled substance record was missing times for medication administrations. |
| Medication administration records lacked initials of staff administering medications. |
| Resident did not receive prescribed medication because it was not available in the home. |
| Resident preadmission screening form did not include determination that resident's needs can be met by the home. |
| Resident admitted to Secure Dementia Care Unit did not have a written cognitive preadmission screening completed within 72 hours prior to admission. |
| Entries in resident's controlled substance log were illegible due to numbers written over each other. |
Report Facts
License Capacity: 64
Residents Served: 42
Secured Dementia Care Unit Capacity: 16
Secured Dementia Care Unit Residents Served: 13
Hospice Current Residents: 10
Resident Age 60 or Older: 42
Residents with Mobility Need: 20
Residents with Physical Disability: 1
Total Daily Staff: 62
Waking Staff: 47
Inspection Report
Renewal
Census: 44
Capacity: 64
Deficiencies: 31
Apr 21, 2025
Visit Reason
The inspection was conducted as a renewal inspection of the facility's license.
Findings
The inspection identified multiple deficiencies related to resident privacy, contract signatures, staff training, medication administration, food safety, record keeping, and safety measures. All deficiencies had plans of correction accepted and were reported as implemented by August 13, 2025.
Deficiencies (31)
| Description |
|---|
| Assignment sheets for the secured dementia care unit were unlocked and accessible, exposing resident personal information. |
| Resident-home contract for resident #1 was not signed by the resident. |
| Resident privacy was violated when staff entered a resident's apartment and moved items without explanation. |
| Criminal background checks were not properly completed for certain staff members. |
| No staff trained in first aid and CPR were present during a night shift with 44 residents. |
| Staff person D did not receive required fire safety training during 2024. |
| First aid kit in the secured dementia care unit lacked tweezers. |
| Use of a common towel was observed in a shared bathroom without proper labeling or sanitary hand drying means. |
| Unlabeled and undated leftover food items were found in the kitchen refrigerator and freezer. |
| Food was stored in partially uncovered containers in the kitchen freezer. |
| Outdated or unlabeled frozen food items were found in the kitchen refrigerator. |
| The facility lacked a system to safeguard resident laundry from loss and timely return. |
| The home's written emergency procedures were not submitted annually to the local emergency management agency. |
| A cat present at the home did not have a current certificate of rabies vaccination. |
| Resident #1's annual medical evaluation was not completed timely. |
| Menus posted in the secured dementia care unit were outdated. |
| Resident #2's medication record did not include a current list of medications. |
| Staff persons administered medications after completing obsolete medication administration training. |
| Medications in the medication cart were not listed on the resident's current medication list. |
| Resident #5's glucometer was not calibrated to the correct time, causing inaccurate documentation. |
| Resident #6's narcotic inventory log was incomplete and illegible in parts. |
| Resident #4's narcotic medication administration did not match the inventory log. |
| Resident #3's medication administration record did not include specific administration times. |
| Resident #6's medication administration record lacked initials of staff administering narcotics at certain times. |
| Resident #4 was not administered prescribed medication as ordered on a specific date. |
| Staff person E administered insulin without completing required diabetes education within the past 12 months. |
| Resident #7's assessment and support plan did not reflect changes in dietary needs. |
| Resident #8's support plan was not signed by the assessor. |
| The gate to the outside from the secured dementia care unit courtyard was not locked with an electronic or magnetic locking system during generator testing. |
| Resident #1's initial support plan was not completed within 72 hours of admission to the secured dementia care unit. |
| Entries in resident records were illegible or overwritten, including narcotic logs and medical evaluations. |
Report Facts
Residents served: 44
License capacity: 64
Residents served in secured dementia care unit: 10
Secured dementia care unit capacity: 16
Total daily staff: 67
Waking staff: 50
Residents with mobility need: 23
Residents with physical disability: 2
Inspection Report
Follow-Up
Census: 44
Capacity: 64
Deficiencies: 11
Dec 18, 2024
Visit Reason
The inspection was conducted as a complaint and incident investigation with a partial, unannounced review to verify the implementation of a previously submitted plan of correction.
Findings
The inspection identified multiple deficiencies including unlocked medication and poisonous material storage areas, resident abuse incident, incomplete medical evaluations, improper medication storage and administration, incomplete mobility assessments, and incomplete resident records. The submitted plan of correction was determined to be fully implemented as of 05/07/2025.
Complaint Details
The inspection was complaint-related and incident-based, involving a physical altercation between residents resulting in injury and hospitalization. The complaint was substantiated as evidenced by the documented incident and subsequent hospital evaluation.
Deficiencies (11)
| Description |
|---|
| Medication room in the Memory Care Unit was unlocked, unattended, and accessible to all. |
| Resident abuse incident involving physical altercation resulting in hospital admission for subarachnoid hemorrhage. |
| Poisonous materials were unlocked and accessible to residents not assessed as capable of safe use. |
| Resident did not have access to an operable lamp or source of lighting at bedside. |
| Resident medical evaluation did not include medical information pertinent to diagnosis and emergency treatment, body positioning, and movement stimulation. |
| Medications in blister packs had openings taped, which is improper storage. |
| Medications prescribed to residents were not administered as ordered. |
| Resident mobility assessment did not include assessment of mobility needs. |
| Resident support plan did not address bladder management and dietary needs. |
| Dates of completion for resident medical evaluations were not legible. |
| Resident records did not include incident reports for individual residents. |
Report Facts
License Capacity: 64
Residents Served: 44
Memory Care Unit Capacity: 16
Memory Care Unit Residents Served: 12
Current Hospice Residents: 3
Staffing Hours - Total Daily Staff: 67
Staffing Hours - Waking Staff: 50
Inspection Report
Complaint Investigation
Census: 49
Capacity: 64
Deficiencies: 3
Aug 29, 2024
Visit Reason
The inspection was conducted as a complaint and incident investigation, as indicated by the inspection information on page 2.
Findings
The inspection found multiple deficiencies related to medical evaluations, support plans, and resident record content, including incomplete or incorrect documentation and missing diagnoses in support plans. Plans of correction were accepted and implemented by May 7, 2025.
Complaint Details
The inspection was triggered by a complaint and incident, as stated under Inspection Information on page 2. Substantiation status is not explicitly stated.
Deficiencies (3)
| Description |
|---|
| Resident medical evaluation form had incorrect and crossed-out dates without initials, missing examination date, and original evaluation date outside the required timeframe. |
| Resident support plan did not address several diagnoses listed on the resident's medical evaluation. |
| Resident record did not include race, religious affiliation, identifying marks, and had an incorrect admission date. |
Report Facts
License Capacity: 64
Residents Served: 49
Secured Dementia Care Unit Capacity: 16
Secured Dementia Care Unit Residents Served: 15
Current Hospice Residents: 4
Residents Age 60 or Older: 49
Residents with Mobility Need: 24
Residents with Physical Disability: 1
Total Daily Staff: 73
Waking Staff: 55
Inspection Report
Renewal
Census: 51
Capacity: 64
Deficiencies: 13
Jul 15, 2024
Visit Reason
The inspection was conducted as a renewal review of the facility's compliance with licensing requirements.
Findings
The inspection identified multiple deficiencies including failure to post current violation reports, delayed incident reporting, unsigned resident contracts, missing signed statements in resident records, incomplete criminal background checks, uncovered trash receptacles, damaged window blinds, incomplete medical evaluations, and medication record inaccuracies. Plans of correction were accepted and implemented by 10/08/2024.
Deficiencies (13)
| Description |
|---|
| The home's current violation report, dated 10/18/2023, was not posted in a conspicuous and public place. |
| The home did not report an incident involving residents hitting each other to the department within 24 hours. |
| The resident-home contract for Resident #3 was not signed by the resident. |
| Resident #3's record did not contain a signed statement acknowledging receipt of resident rights and complaint procedures. |
| Staff Member A did not have a criminal background check completed prior to working scheduled hours. |
| Trash outside the home was not properly contained; recycling dumpsters were open and uncovered. |
| The window blinds in bedroom 134 were in disrepair and missing slats. |
| Resident #4's most recent annual medical evaluation was not completed as required. |
| Medication administration records for Residents #5 and #6 did not indicate diagnosis or purpose for medications. |
| Resident #6 was administered a medication not included on the medication administration record. |
| Medication administration records did not include administration times for Residents #5 and #6. |
| Resident #5 was not administered a prescribed medication on a specific date due to unavailability. |
| Resident #3 was not educated on the right to refuse medication if a medication error is suspected. |
Report Facts
License Capacity: 64
Residents Served: 51
Secured Dementia Care Unit Capacity: 16
Secured Dementia Care Unit Residents Served: 14
Current Hospice Residents: 2
Residents Age 60 or Older: 51
Residents with Mobility Need: 23
Residents with Physical Disability: 1
Total Daily Staff: 74
Waking Staff: 56
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Director of Business Administration | Named in multiple findings related to posting violation reports, contract signatures, signed statements, criminal background checks, and resident education | |
| Executive Director | Named in multiple findings related to education, audits, and oversight of corrections | |
| Director of Health and Wellness | Responsible for incident reporting, medication administration audits, and staff education | |
| Director of Maintenance | Responsible for trash receptacle oversight and window blind repairs |
Inspection Report
Complaint Investigation
Census: 51
Capacity: 64
Deficiencies: 7
Oct 18, 2023
Visit Reason
The inspection was conducted as a complaint investigation following concerns raised about the facility's compliance with reporting incidents and other regulatory requirements.
Findings
The inspection found multiple deficiencies including failure to report incidents timely to the Department, incomplete medical evaluations for residents, incomplete preadmission screening forms, and deficiencies in residents' support plans including dietary needs, medical/dental needs, and support plan signatures. Plans of correction were accepted and implemented by 11/17/2023.
Complaint Details
The visit was complaint-related, triggered by concerns about incident reporting and resident care documentation. The complaint was substantiated by findings of multiple regulatory violations.
Deficiencies (7)
| Description |
|---|
| Failure to report incidents such as resident injury and death to the Department within required timeframes. |
| Medical evaluations for residents 1 and 4 did not include medical information pertinent to diagnosis and treatment in case of emergency; missing medication regimen details for resident 4. |
| Resident 1’s preadmission screening form did not include assessment of capability to recognize and use poisons safely. |
| Support plan for resident 1 lacked documentation of dietary needs despite indication of a no-added sodium diet. |
| Support plan for resident 4 lacked documentation on how medical and dental needs will be met. |
| Resident 1 participated in support plan development but did not sign the support plan. |
| Resident 1’s written cognitive pre-admission screening for Secure Dementia Care Unit admission was not completed. |
Report Facts
License Capacity: 64
Residents Served: 51
Memory Care Unit Capacity: 16
Residents Served in Memory Care Unit: 13
Current Hospice Residents: 1
Resident Mobility Need: 25
Total Daily Staff: 76
Waking Staff: 57
Inspection Report
Renewal
Census: 50
Capacity: 64
Deficiencies: 5
Jun 14, 2023
Visit Reason
The inspection was conducted as a renewal visit to review compliance with licensing regulations for Symphony Square at Bala Cynwyd.
Findings
The inspection identified several deficiencies related to staff qualifications, preadmission screening, support plan signatures, medical evaluations, and admission support plans. All deficiencies had plans of correction accepted and were implemented by August 8, 2023.
Deficiencies (5)
| Description |
|---|
| Direct care staff person A did not have a high school diploma, GED, or active registry status on the Pennsylvania nurse aide registry (CNA expired 4/29/2023). |
| Resident 1’s preadmission screening form did not include a determination that the needs of the resident can be met by the services provided by the home. |
| Residents 2 and 3 participated in the development of their support plans but did not sign the plans. |
| Resident 3 was admitted to the Secure Dementia Care Unit without a medical evaluation within 60 days prior to admission as required. |
| Resident 3’s initial support plan was not completed within 72 hours of admission to the secured dementia care unit. |
Report Facts
License Capacity: 64
Residents Served: 50
Secured Dementia Care Unit Capacity: 16
Secured Dementia Care Unit Residents Served: 12
Current Hospice Residents: 1
Residents Age 60 or Older: 50
Residents with Mobility Need: 18
Residents Diagnosed with Mental Illness: 1
Residents with Physical Disability: 1
Inspection Report
Renewal
Census: 46
Capacity: 64
Deficiencies: 0
Apr 25, 2022
Visit Reason
The inspection was conducted as a renewal licensing inspection of the facility Symphony Square at Bala Cynwyd.
Findings
No regulatory citations or deficiencies were identified during the inspection conducted on April 25-26, 2022.
Report Facts
Total Daily Staff: 60
Waking Staff: 45
License Capacity: 64
Residents Served: 46
Secured Dementia Care Unit Capacity: 12
Secured Dementia Care Unit Residents Served: 11
Hospice Residents: 1
Residents 60 Years or Older: 46
Residents with Mobility Need: 14
Notice
Deficiencies: 0
Jul 21, 2021
Visit Reason
The document serves to notify the facility that their request to waive the requirement for direct care staff to have a high school diploma, GED, or active registry status on the Pennsylvania nurse aide registry has been granted for six months.
Findings
The waiver is granted with conditions including the expectation that the staff member will begin certified nursing assistant training on August 16, 2021, and obtain certification and active registry status by February 16, 2022. The Department will review compliance annually during inspections.
Report Facts
Waiver effective period: 6
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Jeanne Parisi | Bureau Director, Human Services Licensing | Signed the waiver approval letter. |
Inspection Report
Follow-Up
Census: 40
Capacity: 64
Deficiencies: 1
Jun 16, 2021
Visit Reason
The visit was a monitoring inspection conducted on 06/16/2021 to review the facility's plan of correction submission.
Findings
The inspection found that the facility's submitted plan of correction regarding the calibration and documentation of a glucometer for resident #1 was fully implemented and compliant.
Deficiencies (1)
| Description |
|---|
| The glucometer for resident #1 was not calibrated with the correct date and time, and discrepancies were found between glucometer readings and the blood glucose log. |
Report Facts
License Capacity: 64
Residents Served: 40
Secured Dementia Care Unit Capacity: 16
Secured Dementia Care Unit Residents Served: 11
Current Hospice Residents: 2
Residents Age 60 or Older: 40
Residents with Mental Illness: 1
Residents with Mobility Need: 20
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Shawn Parker | Signed the letter confirming plan of correction implementation | |
| Director of Health and Wellness | Director of Health and Wellness (DHW) | Ordered new blood glucose monitor and involved in corrective actions |
| Memory Support Director | Memory Support Director (MSD) | In-serviced staff and involved in corrective actions |
Inspection Report
Original Licensing
Census: 38
Capacity: 64
Deficiencies: 4
Apr 6, 2021
Visit Reason
The inspection was conducted as a new licensing inspection for Symphony Square at Bala Cynwyd, a newly licensed Personal Care Home, to assess compliance with 55 Pa. Code Chapter 2600.
Findings
The facility was found to be in substantial compliance with regulations but the inspection was partial due to the new status of the residence. Several citations related to food storage, outdated food, and smoke detector placement were identified and corrective plans were accepted.
Deficiencies (4)
| Description |
|---|
| Open bags of brown sugar and cereal were not tightly sealed in the secured dementia care unit kitchenette. |
| Two half-full bags of unlabeled, undated cookie-dough were found in the freezer section of the refrigerator in the secured dementia care unit kitchenette. |
| Smoke detectors on the ceiling off the home's two elevators were more than 15 feet away from any resident's bedroom door. |
| No smoke detector was located in the hallway within 15 feet of resident bedrooms; smoke detectors were only inside each resident's living unit. |
Report Facts
License Capacity: 64
Residents Served: 38
Secured Dementia Care Unit Capacity: 16
Secured Dementia Care Unit Residents Served: 10
Total Daily Staff: 53
Waking Staff: 40
Residents with Mobility Need: 15
Residents 60 Years or Older: 38
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Adrianne Stevens | Administrator | Named as facility administrator |
| Youn Hie Chung | Lead Inspector | Lead inspector conducting the licensing inspection |
| Jamie Buchenauer | Deputy Secretary | Signed the licensing letter and certificate |
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