Deficiencies per Year
8
6
4
2
0
Unclassified
Census Over Time
Census
Capacity
Inspection Report
Renewal
Census: 30
Capacity: 47
Deficiencies: 4
Aug 26, 2024
Visit Reason
The inspection was conducted as a renewal visit to review compliance and licensing status of the facility.
Findings
The submitted plan of correction was fully implemented and compliance was maintained. Several deficiencies were identified related to heat sources, furniture and equipment, combustible storage, and smoking area distance, all of which had corrective actions planned and implemented.
Deficiencies (4)
| Description |
|---|
| The wall-mounted heater by the laundry room was 178 degrees Fahrenheit and was not equipped with protective guards or insulation to prevent resident contact. |
| The panic bar on the emergency exit by the staff break room does not close and secure the door. |
| The furnace room had several plastic totes and cardboard boxes stored next to the furnace, which is combustible storage violation. |
| The smoking area is located in the courtyard along a common walkway, not at a safe distance from walkways and exits. |
Report Facts
License Capacity: 47
Residents Served: 30
Current Residents in Hospice: 6
Residents 60 Years or Older: 30
Residents with Mental Illness: 1
Residents with Mobility Need: 19
Residents with Physical Disability: 1
Total Daily Staff: 49
Waking Staff: 37
Inspection Report
Follow-Up
Census: 42
Capacity: 42
Deficiencies: 1
Apr 24, 2024
Visit Reason
The inspection was conducted as a follow-up review related to a change in legal entity and to verify the implementation of a previously submitted plan of correction.
Findings
The submitted plan of correction regarding a refrigerator/freezer temperature violation was found to be fully implemented. The freezer temperature issue was corrected promptly, and ongoing monitoring and staff education measures were established.
Deficiencies (1)
| Description |
|---|
| At 10:10 AM the temperature in the reach-in freezer measured 45 degrees Fahrenheit, exceeding the required maximum of 40°F for refrigerated food. |
Report Facts
License Capacity: 42
Residents Served: 42
Current Residents in Hospice: 9
Residents Age 60 or Older: 42
Residents with Mental Illness: 1
Residents with Mobility Need: 19
Residents with Physical Disability: 1
Total Daily Staff: 61
Waking Staff: 46
Inspection Report
Renewal
Census: 26
Capacity: 47
Deficiencies: 3
May 9, 2023
Visit Reason
The inspection was conducted as a renewal review of the facility license by the Pennsylvania Department of Human Services, Bureau of Human Service Licensing on 05/09/2023 and 05/10/2023.
Findings
The facility was found to have deficiencies related to criminal background checks and staff training topics. Plans of correction were accepted and implemented by 06/28/2023, with ongoing audits and quality improvement meetings planned to maintain compliance.
Deficiencies (3)
| Description |
|---|
| Staff person A, the home's administrator, had not had a criminal background check completed in accordance with the Older Adult Protective Services Act. |
| Direct care staff person B did not receive required training in multiple topics during the training year January to December 2022, including medication self-administration, resident needs, dementia care, infection control, personal care, safe management, and care for residents with mental illness or intellectual disability. |
| Staff persons B and C did not receive training in emergency preparedness, resident rights, Older Adult Protective Services Act, falls and accident prevention, and new population groups served during the training year January to December 2022. |
Report Facts
License Capacity: 47
Residents Served: 26
Current Hospice Residents: 4
Residents Diagnosed with Mental Illness: 1
Residents with Mobility Need: 2
Total Daily Staff: 28
Waking Staff: 21
Inspection Report
Follow-Up
Census: 31
Capacity: 47
Deficiencies: 4
Nov 21, 2022
Visit Reason
The inspection was a partial, unannounced follow-up visit triggered by an incident to verify the implementation of a previously submitted plan of correction.
Findings
The facility was found to have fully implemented the submitted plan of correction related to multiple deficiencies including failure to immediately report suspected resident abuse, failure to report incidents timely, lack of first day orientation for a staff member, and incomplete resident assessments. Continued compliance must be maintained.
Deficiencies (4)
| Description |
|---|
| Failure to immediately report suspected abuse of residents to the local Area Agency on Aging and Department as required. |
| Failure to report incidents or conditions to the Department within 24 hours as required. |
| Staff person B did not receive required first day orientation in general fire safety and emergency preparedness. |
| Resident #2 and Resident #3 assessments did not include all required information regarding assistance needs and behavioral issues. |
Report Facts
License Capacity: 47
Residents Served: 31
Current Hospice Residents: 4
Total Daily Staff: 48
Waking Staff: 36
Residents with Mobility Need: 17
Inspection Report
Complaint Investigation
Census: 33
Capacity: 47
Deficiencies: 2
May 3, 2022
Visit Reason
The inspection was conducted as a complaint investigation following allegations related to staff treatment of residents.
Findings
The investigation found that staff person A spoke to multiple residents with dementia in a loud, demanding, and abrasive tone, violating resident dignity and respect. Additionally, a resident's assessment did not include the use of a wander guard system as ordered.
Complaint Details
The complaint investigation substantiated that staff person A violated resident dignity and respect by speaking inappropriately to residents with dementia. Protective Services and the Area Agency on Aging were notified, and staff person A was placed on administrative leave pending investigation.
Deficiencies (2)
| Description |
|---|
| Staff person A spoke to residents diagnosed with dementia in a loud, demanding, impatient, aggressive, and abrasive tone, telling residents to stop, sit down and don’t do that. |
| Resident #1’s assessment did not include the resident's use of the wander guard system ordered for safety. |
Report Facts
License Capacity: 47
Residents Served: 33
Current Residents on Hospice: 2
Residents 60 Years or Older: 33
Residents with Mobility Need: 8
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Executive Director | Notified about investigation and conducted in-service training related to the violation | |
| Staff person A | Subject of complaint for inappropriate treatment of residents; placed on administrative leave | |
| CSM | Completed RASP addendum and was in-serviced on assessment requirements |
Inspection Report
Renewal
Census: 35
Capacity: 47
Deficiencies: 7
Apr 27, 2022
Visit Reason
The inspection was conducted as a renewal inspection with an incident review, including an unannounced full inspection on 04/27/2022 and 04/28/2022.
Findings
The inspection identified multiple deficiencies including failure to provide required assistance with activities of daily living, inadequate quality management plan content, mistreatment of a resident by staff, incomplete criminal background checks, insufficient staff orientation and training, and medication labeling discrepancies. Plans of correction were submitted and accepted with completion dates mostly by 05/02/2022.
Deficiencies (7)
| Description |
|---|
| Resident #1 did not receive required 2-person assistance with transfers, toileting, ambulating, and hygiene as indicated in the assessment and support plan. |
| The home's quality management review did not address reportable incidents, conditions, and staff person training. |
| Staff person A treated resident #1 without dignity and respect, using rude language and inappropriate comments during hygiene care. |
| Agency staff person A had not had a Pennsylvania Criminal History Check completed since 01/22/2020. |
| Agency staff person A did not receive orientation on required fire safety and emergency preparedness training except for fire drills and evacuation procedures. |
| Agency staff person A did not complete any of the required orientation training within 40 scheduled working hours. |
| Resident #1's prescription medications Acetaminophen and Polyethylene Glycol had pharmacy labels inconsistent with physician orders. |
Report Facts
License Capacity: 47
Residents Served: 35
Total Daily Staff: 47
Waking Staff: 35
Current Hospice Residents: 2
Residents with Mobility Need: 12
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Staff person A | Named in multiple deficiencies including failure to provide required assistance, mistreatment of resident, incomplete criminal background check, and incomplete orientation and training. | |
| Executive Director | ED | Involved in investigation, staff education, and implementation of plans of correction. |
| Care Services Manager | CSM | Involved in staff education, audits, and implementation of plans of correction. |
| Regional Director of Care Services | RDCS | Provided new template for Quality Management Plan. |
Notice
Capacity: 47
Deficiencies: 0
Jul 11, 2021
Visit Reason
The document serves as a certificate of compliance and a license renewal notice for Clen-Moore Place, a Personal Care Home, confirming the facility's authorized capacity and informing that an annual inspection will be conducted within the next twelve months.
Findings
The Department issued a regular license in response to the renewal application and stated that an onsite inspection will be conducted within the next twelve months to ensure compliance with applicable regulations.
Report Facts
Maximum licensed capacity: 47
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Jamie L. Buchenauer | Deputy Secretary | Signed the license renewal notice and certificate of compliance |
Inspection Report
Renewal
Census: 34
Capacity: 47
Deficiencies: 1
May 11, 2021
Visit Reason
The inspection was conducted as a renewal visit to assess compliance with licensing requirements at Clen-Moore Place.
Findings
The facility was found to have inadequate staffing during the night shift to safely evacuate all residents in an emergency, particularly for residents requiring assistance with mobility. A plan of correction was submitted and fully implemented.
Deficiencies (1)
| Description |
|---|
| Inadequate staffing during the 11:00 PM to 7:00 AM shift to safely evacuate all residents, including those requiring two staff persons for transfer with a Hoyer lift. |
Report Facts
Residents present: 34
Licensed capacity: 47
Residents with mobility needs: 14
Staff scheduled during night shift: 2
Evacuation drill time: 305
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