Inspection Reports for Tangonan Adult Residential Care Home
94-228 Moena Place, Waipahu, HI 96797, HI, 96797
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Inspection Report
Annual Inspection
Deficiencies: 7
May 28, 2025
Visit Reason
Annual inspection of Tangonan Adult Residential Care Home to assess compliance with state licensing regulations.
Findings
Multiple deficiencies were found including lack of documented inventory of personal items for residents, unclear diet orders, unsecured toxic chemicals, medication labeling discrepancies, incomplete transcription of medication instructions, and missing height and weight measurements for residents.
Deficiencies (7)
| Description |
|---|
| No documented evidence that the inventory of all personal items brought into the Type I ARCH by the resident was maintained for Resident #2 and Resident #3. |
| Resident #1's diet order was not clarified by the physician as required. |
| One comet bleach was found unsecured under the kitchen cabinet during the time of inspection. |
| Medication label for Metoprolol Succinate ER did not match the physician's order for Resident #1. |
| The 'hold for loose stools' instruction was not transcribed from the physician order to the medication administration records for Resident #1's stool softener. |
| No indication that Omeprazole DR medication was given before meals as ordered for Resident #1. |
| No documented evidence that height and weight measurements were taken for Resident #1 and Resident #4 during specified periods. |
Report Facts
Number of comet bleach found unsecured: 1
Inspection Report
Annual Inspection
Deficiencies: 15
May 17, 2024
Visit Reason
The inspection was conducted as the annual licensing survey of Tangonan Adult Residential Care Home to assess compliance with state regulations.
Findings
The inspection identified multiple deficiencies including an expired license initially posted, lack of documented annual tuberculosis clearance for a substitute caregiver, inaccurate level of care evaluations for residents, medication labeling and administration errors, unsecured medications, incomplete resident records, and missing immunization and tuberculosis documentation. Fire drills were conducted as required. Plans of correction were submitted for all deficiencies.
Deficiencies (15)
| Description |
|---|
| License expired on 8/31/23 was posted in a conspicuous place during inspection but was corrected by placing current license. |
| No documented evidence that the substitute caregiver has an annual tuberculosis clearance since 4/17/23. |
| Residents #1 to #5 were indicated as intermediate care facility (ICF) which indicates overcapacity; updated level of care evaluations requested. |
| Physician order and medication label for Fosamax oral tablet 70 mg do not match. |
| A box of labeled rectal suppositories and one syringe were left unsecured in the refrigerator. |
| Physician order and medication bottle for Calcium + D + K do not match; medication administration record transcription errors noted. |
| Physician order and medication administration record for Levothyroxine Sodium 88 mcg do not match. |
| No documented evidence of a tuberculosis report for Resident #1; no PPD reading found in resident's chart. |
| No documented evidence that heights and weights were taken for Residents #2, #3, #4, and #5. |
| No documented evidence of related charges for Resident #4 including charges for services not covered in the resident's binder. |
| No documented evidence that the general register was maintained to reflect discharge and readmission dates for Resident #4. |
| No documented evidence of current immunizations for pneumococcal and influenza for Resident #4 as recommended by ACIP. |
| Fire drills from May 2023 to April 2024 were conducted and documented consistently; no deficiencies noted. |
| Interim care plan for Resident #4 contains medication errors; medication transcription errors from December 2023 to May 2024. |
| No regular monitoring by the primary caregiver due to medication transcription errors on MARs from December 2023 to May 2024. |
Report Facts
Inspection Date: May 17, 2024
License Expiration Date: Aug 31, 2023
Substitute Caregiver TB Clearance Date: Apr 17, 2023
Resident Level of Care Evaluation Date: Aug 25, 2023
Physician Examination Date: May 6, 2024
Medication Dosage: 70
Medication Dosage: 600
Medication Dosage: 20
Medication Dosage: 88
Medication Dosage: 40
Medication Dosage: 10
Inspection Report
Annual Inspection
Deficiencies: 10
May 12, 2023
Visit Reason
The inspection was conducted as the annual survey of the Tangonan Adult Residential Care Home to assess compliance with state regulations.
Findings
Multiple deficiencies were identified related to medication orders, documentation, case management, and care planning. The facility was required to submit plans of correction for each deficiency, with emphasis on ensuring accurate medication orders, proper transcription, comprehensive assessments, and updated care plans.
Deficiencies (10)
| Description |
|---|
| Resident #1 had medication orders without physician authorization or clarification, including a bisacodyl suppository without a physician's order until 2/9/23. |
| Medication orders for cyanocobalamin lacked clarity on dosage units and were not updated or clarified by a physician or APRN. |
| Medication Gabapentin was restarted without documented physician or APRN consultation. |
| Medication lactulose was not transcribed to the MAR as ordered by the physician. |
| Medication melatonin was not transcribed to the MAR for the months of January 2023 to current. |
| Medication orders for blood sugar monitoring and other medications were incorrect or incomplete on the MAR. |
| Case management services lacked comprehensive assessment prior to resident's admission to expanded ARCH. |
| RN Case Manager (RNCM) care plan did not identify all medical or rehabilitative needs and lacked ongoing evaluation and monitoring. |
| RNCM failed to conduct face-to-face meetings and monthly progress notes were missing or incomplete. |
| Care plan problems were missing appropriate goals, including for a patient at risk for falls and with dementia-related impairments. |
Report Facts
Deficiencies cited: 10
Inspection Report
Annual Inspection
Deficiencies: 9
May 19, 2022
Visit Reason
The inspection was conducted as the annual survey of Tangonan Adult Residential Care Home to assess compliance with Chapter 100.1 regulations.
Findings
The report identifies multiple deficiencies related to medication administration, record keeping, case management, and care planning for Resident #1, including medication given beyond the prescribed duration, missing medication administration records, undocumented verbal orders, outdated emergency information, and gaps in nurse case management services.
Deficiencies (9)
| Description |
|---|
| Medication given for 12 days straight despite physician's order for 12 weeks. |
| Medication (Miconazole nitrate) not listed on medication administration record (MAR). |
| Medication (Levofloxacin 500mg) not included on MAR. |
| Verbal order for Levofloxacin 500mg not documented on physician's order sheet and not signed by physician. |
| Emergency information sheet is outdated. |
| Gap of six days in Registered Nurse Case Management (RNCM) services after original RNCM left and new RNCM started. |
| RNCM care plan does not include all resident's medication orders. |
| Diet listed on RNCM care plan is not the current diet ordered by physician. |
| RNCM training does not include training for albuterol inhaler. |
Report Facts
Medication duration: 12
Gap in RNCM services: 6
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