Inspection Reports for V Nicholas Adult Care Home #2
4304 El Camino Ave, Las Vegas, NV 89102, NV, 89102
Back to Facility ProfileDeficiencies per Year
4
3
2
1
0
Severe
High
Moderate
Low
Unclassified
Census Over Time
Census
Capacity
Inspection Report
Annual Inspection
Census: 5
Capacity: 6
Deficiencies: 0
Nov 20, 2024
Visit Reason
The inspection was conducted as a State Licensure annual survey in accordance with Nevada Administrative Code Chapter 449 for Residential Facility for Groups.
Findings
The facility received a grade of A with no regulatory deficiencies identified. Five resident files and two employee files were reviewed, and no further action was necessary.
Report Facts
Resident files reviewed: 5
Employee files reviewed: 2
Inspection Report
Annual Inspection
Census: 6
Capacity: 6
Deficiencies: 2
Nov 29, 2023
Visit Reason
The inspection was conducted as a State Licensure annual survey of the facility in accordance with Nevada Administrative Code Chapter 449 for Residential Facility for Groups.
Findings
The facility received a grade of A but was found deficient in ensuring physician's orders were followed for 2 of 6 residents regarding oxygen administration and blood glucose monitoring, and in documenting reasons and results for PRN medication administration for 1 of 6 residents.
Severity Breakdown
E: 1
D: 1
Deficiencies (2)
| Description | Severity |
|---|---|
| Failure to ensure physician's orders were followed for Resident #2 and Resident #6 regarding oxygen use and blood glucose monitoring. | E |
| Failure to document reasons and results for administration of PRN medication (Pregabalin) for Resident #3. | D |
Report Facts
Residents present: 6
Total licensed capacity: 6
Residents with physician order noncompliance: 2
Residents with PRN medication documentation deficiency: 1
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Maria T N Acoba | Administrator | Named in relation to findings and corrective actions regarding medication administration and physician order compliance |
Inspection Report
Annual Inspection
Census: 5
Capacity: 6
Deficiencies: 0
Nov 18, 2022
Visit Reason
This inspection was conducted as a State Licensure annual survey of the facility in accordance with Nevada Administrative Code Chapter 449 for Residential Facility for Groups.
Findings
The facility was found to have no regulatory deficiencies and received a grade of A. Five resident files and two employee files were reviewed during the survey.
Inspection Report
Annual Inspection
Census: 5
Capacity: 6
Deficiencies: 0
Nov 12, 2021
Visit Reason
This inspection was conducted as a state licensure annual survey of the facility in accordance with Nevada Administrative Code Chapter 449 for Residential Facility for Groups.
Findings
No regulatory deficiencies were identified during the survey. The facility received a grade of A and was provided guidance on compliance with certain state regulations related to discrimination, privacy, cultural competency, and complaint policies.
Report Facts
Resident files reviewed: 5
Employee files reviewed: 3
Inspection Report
Abbreviated Survey
Census: 6
Capacity: 6
Deficiencies: 4
Nov 10, 2020
Visit Reason
The inspection was a COVID-19 focused infection control survey conducted to assess the facility's compliance with infection control protocols during the pandemic.
Findings
The facility failed to implement safe infection control practices and lacked comprehensive policies for COVID-19 protection. Deficiencies included caregivers not wearing masks, failure to screen the inspector for COVID-19 symptoms, malfunctioning thermometer, lack of N95 masks and fit testing, and incomplete infection control policies.
Severity Breakdown
F: 4
Deficiencies (4)
| Description | Severity |
|---|---|
| Facility allowed Health Facility Inspector to enter without screening for COVID-19 symptoms and had malfunctioning thermometer. | F |
| Two caregivers were not wearing masks during the inspection. | F |
| No N95 masks on site and no staff medically cleared or fitted for N95 mask use. | F |
| Infection Control Program policies and procedures did not address emergency staffing plan, plan for positive COVID-19 cases, staff fit testing for N95 masks, respirator program, and new/re-admission of unknown COVID-19 status. | F |
Report Facts
Census: 6
Total Capacity: 6
PPE Inventory: 5
PPE Inventory: 150
PPE Inventory: 4
PPE Inventory: 6
PPE Inventory: 1
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Maria T. N. Acoba | Administrator | Named in relation to infection control deficiencies and corrective actions |
Inspection Report
Annual Inspection
Census: 6
Capacity: 6
Deficiencies: 3
Mar 5, 2020
Visit Reason
The inspection was an annual state licensure survey conducted to assess compliance with Nevada Administrative Code Chapter 449 for Residential Facility for Groups.
Findings
The facility received a grade of A. Deficiencies were identified related to failure to ensure annual Elder Abuse training for 1 of 2 employees, failure to ensure annual tuberculosis (TB) assessment for 1 of 2 employees, and failure to complete annual Activities of Daily Living screenings for 2 of 6 residents.
Severity Breakdown
Severity: 2: 3
Deficiencies (3)
| Description | Severity |
|---|---|
| Failure to ensure annual Elder Abuse training was completed for 1 of 2 employees (Employee #1). | Severity: 2 |
| Failure to ensure an annual tuberculosis (TB) assessment was completed for 1 of 2 employees (Employee #2). | Severity: 2 |
| Failure to complete annual Activities of Daily Living screenings for 2 of 6 residents (Resident #3 and #4). | Severity: 2 |
Report Facts
Number of residents present: 6
Total licensed capacity: 6
Number of employees reviewed: 2
Number of resident files reviewed: 6
Inspection Report
Annual Inspection
Census: 6
Capacity: 6
Deficiencies: 1
Apr 15, 2019
Visit Reason
The inspection was conducted as an annual State Licensure survey in accordance with Nevada Administrative Code Chapter 449 for Residential Facility for Groups.
Findings
The facility was found to have regulatory deficiencies including failure to ensure one of two employees completed the required eight hours of annual caregiver training. The facility received a grade of A overall.
Severity Breakdown
Severity: 2: 1
Deficiencies (1)
| Description | Severity |
|---|---|
| Failure to ensure one of two employees completed at least eight hours of annual caregiver training as required by Nevada Administrative Code. | Severity: 2 |
Report Facts
Resident files reviewed: 6
Employee files reviewed: 2
Deficiencies cited: 1
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Maria T Acoba | Administrator | Acknowledged the employee had not completed the required caregiver training and was responsible for corrective actions |
Inspection Report
Annual Inspection
Census: 6
Capacity: 6
Deficiencies: 1
Apr 10, 2018
Visit Reason
This inspection was conducted as a result of an annual initiated survey at the facility on 04/10/18 to assess compliance with state licensure requirements for a Residential Facility for Groups providing assisted living services.
Findings
The facility received a grade of A. One deficiency was identified related to failure to ensure one resident met tuberculosis testing requirements, specifically missing documented evidence of a 2018 TB test for Resident #3.
Severity Breakdown
Severity: 2: 1
Deficiencies (1)
| Description | Severity |
|---|---|
| Failure to ensure 1 of 6 residents met tuberculosis testing requirements; missing documented evidence of a 2018 TB test for Resident #3. | Severity: 2 |
Report Facts
Resident files reviewed: 6
Employee files reviewed: 2
Facility licensed capacity: 6
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Maria T Acoba | Administrator | Named as person responsible for corrective action and signature on report |
Inspection Report
Annual Inspection
Census: 5
Capacity: 6
Deficiencies: 0
Apr 10, 2017
Visit Reason
This inspection was conducted as an annual State Licensure survey of the facility to assess compliance with regulatory requirements.
Findings
The facility was found to have no regulatory deficiencies at the time of the survey and received a grade of A.
Inspection Report
Annual Inspection
Census: 6
Capacity: 6
Deficiencies: 2
Mar 10, 2016
Visit Reason
The inspection was an annual State Licensure survey conducted to assess compliance with regulations for a residential facility for elderly and disabled persons.
Findings
Two deficiencies were identified: the facility failed to maintain the exterior free from hazards, including a broken awning and cracked cinder block wall; and the facility failed to ensure one resident met tuberculosis testing requirements. Both deficiencies had a severity level of 2.
Severity Breakdown
Level 2: 2
Deficiencies (2)
| Description | Severity |
|---|---|
| Facility failed to ensure the exterior was free from hazards, including a broken awning and cracked cinder block wall. | Level 2 |
| Facility failed to ensure one resident met tuberculosis testing requirements; missing documentation of read dates for TB tests. | Level 2 |
Report Facts
Census: 6
Total Capacity: 6
Severity Level 2 Deficiencies: 2
Scope: 3
Scope: 1
Inspection Report
Annual Inspection
Census: 6
Capacity: 6
Deficiencies: 2
Mar 10, 2016
Visit Reason
This annual State Licensure survey was conducted to assess compliance with state regulations for a residential facility for elderly and disabled persons.
Findings
The facility received a grade of A but had deficiencies including exterior hazards such as a broken awning and cracked cinder block wall, and failure to document tuberculosis testing for one resident.
Severity Breakdown
Severity: 2: 2
Deficiencies (2)
| Description | Severity |
|---|---|
| Facility failed to ensure the exterior was free from hazards including a broken awning with splintered wood and protruding nails, and a cracked cinder block wall on the verge of collapse. | Severity: 2 |
| Facility failed to ensure 1 of 6 residents met tuberculosis testing requirements; missing documented read dates for TB tests. | Severity: 2 |
Report Facts
Resident census: 6
Total licensed capacity: 6
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Employee #2 interviewed regarding exterior hazards and TB testing documentation |
Inspection Report
Annual Inspection
Census: 5
Capacity: 6
Deficiencies: 1
Feb 18, 2015
Visit Reason
The inspection was conducted as an annual State Licensure survey to assess compliance with regulations for a residential facility for elderly and disabled persons.
Findings
The facility received a grade of A but was found deficient in maintaining cleanliness and proper upkeep of the premises, including the presence of a non-operating refrigerator and various items cluttering the backyard and patio areas.
Severity Breakdown
Severity: 2: 1
Deficiencies (1)
| Description | Severity |
|---|---|
| Facility failed to ensure the premises was clean and well maintained, with a non-operating refrigerator, shopping cart, buckets, boxes, ladder, paint supplies, small box of locks and nails, exercise weights, equipment, and a box of hangers found in the backyard and patio areas. | Severity: 2 |
Report Facts
Deficiency severity: 2
Deficiency scope: 3
Inspection Report
Annual Inspection
Census: 5
Capacity: 6
Deficiencies: 1
Feb 18, 2015
Visit Reason
This inspection was conducted as an annual State Licensure survey of the facility on 2/18/2015 by the Division of Public and Behavioral Health.
Findings
The facility received a grade of A but was found deficient for failing to ensure the premises were clean and well maintained, specifically due to various items stored in the backyard including a non-operating refrigerator and resident belongings.
Severity Breakdown
Severity: 2: 1
Deficiencies (1)
| Description | Severity |
|---|---|
| Facility failed to ensure the premises was clean and well maintained, with items such as a non-operating refrigerator, shopping cart, buckets, boxes, ladder, paint supplies, nails, locks, exercise equipment, and hangers found in the backyard. | Severity: 2 |
Report Facts
Licensed beds: 6
Census: 5
Severity level count: 1
Inspection Report
Enforcement
Deficiencies: 0
Apr 4, 2014
Visit Reason
The Health Division intends to impose sanctions on the facility due to repeat deficiencies identified in a prior survey dated 2/23/13, as part of regulatory enforcement actions.
Findings
The facility is being sanctioned with monetary penalties totaling $300.00 for repeat deficiencies, with severity and scope scores assigned as per Nevada Administrative Code. No daily penalty will be imposed at this time.
Report Facts
Monetary Penalties: 300
Working days until sanctions effective: 11
Penalty reduction percentage: 25
Days for penalty payment: 15
Inspection Report
Annual Inspection
Census: 5
Capacity: 6
Deficiencies: 3
Feb 19, 2014
Visit Reason
The inspection was conducted as a State Licensure annual grading survey to assess compliance with regulations for a residential facility for elderly and disabled persons.
Findings
The facility received a grade of A but had several deficiencies including failure to ensure caregivers completed required annual training, hazards in the backyard and pathways, and maintenance issues such as lint buildup, garbage accumulation, mildew in bathrooms, and damaged walls and doors.
Severity Breakdown
Severity: 2: 3
Deficiencies (3)
| Description | Severity |
|---|---|
| Failure to ensure 2 of 2 caregivers received 8 hours of annual training related to resident needs. | Severity: 2 |
| Facility failed to keep premises free from hazards including damaged outlet cover, pool skimmer cover, and a hole in the backyard pathway. | Severity: 2 |
| Facility failed to maintain cleanliness and upkeep including lint buildup in laundry, garbage accumulation, mildew on bathroom ceilings, damaged bathroom tiles, dirty walls, broken closet door, grease on oven hood, and dust on kitchen cabinets. | Severity: 2 |
Report Facts
Deficiencies cited: 3
Census: 5
Total capacity: 6
Inspection Report
Annual Inspection
Census: 5
Capacity: 6
Deficiencies: 4
Feb 19, 2014
Visit Reason
This inspection was a State Licensure annual grading survey conducted to assess compliance with regulatory requirements for the residential facility.
Findings
The facility received a grade of A but had several deficiencies including failure to ensure caregivers completed required annual training, presence of hazards such as damaged outlets and holes in pathways, and maintenance issues including lint buildup, refuse accumulation, mildew, damaged tiles, and unclean resident rooms.
Severity Breakdown
Severity: 2: 4
Deficiencies (4)
| Description | Severity |
|---|---|
| Failed to ensure 2 of 2 caregivers received 8 hours of annual training related to providing for the needs of residents. | Severity: 2 |
| Failed to keep the backyard free of hazards and maintain outlets inside the home for 5 residents; observed damaged outlet cover and hole in backyard pathway. | Severity: 2 |
| Failed to maintain laundry room free of lint buildup and exterior premises free of refuse and garbage; observed lint behind washer/dryer and piles of branches, boxes, and garbage crates outside. | Severity: 2 |
| Failed to maintain interior cleanliness and maintenance; observed mildew on bathroom ceilings, damaged shower tiles, dirty walls, broken closet door, grease on oven hood, and dust on kitchen cabinets. This was a repeat deficiency from prior year. | Severity: 2 |
Report Facts
Licensed beds: 6
Residents present: 5
Employee files reviewed: 2
Resident files reviewed: 5
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Employee #1 | Administrator | Named in caregiver training deficiency and interview |
Inspection Report
Annual Inspection
Census: 5
Capacity: 6
Deficiencies: 3
Feb 22, 2013
Visit Reason
The inspection was an annual State Licensure survey conducted to assess compliance with state regulations for a residential facility for elderly and disabled persons.
Findings
The facility received a grade of A but was cited for deficiencies related to health and sanitation, medication destruction, and medication administration records. Deficiencies included failure to maintain clean premises, improper destruction of expired medication, and inaccurate medication administration records.
Severity Breakdown
F: 1
D: 1
C: 1
Deficiencies (3)
| Description | Severity |
|---|---|
| Facility failed to ensure the premises was clean and well maintained; vent in laundry room was dirty, accumulation of lint behind dryer, and discarded box spring and mattress on side of building. | F |
| Expired medication prescribed to resident #3 was solidified and discarded without proper destruction procedures. | D |
| Medication administration records (MAR) for residents #1, #2, #3, and #4 were not accurately signed for the date 2/22/13. | C |
Report Facts
Licensed capacity: 6
Census: 5
Severity 2 deficiencies: 2
Severity 1 deficiencies: 1
Inspection Report
Annual Inspection
Census: 5
Capacity: 6
Deficiencies: 3
Feb 22, 2013
Visit Reason
This document is the result of an annual State Licensure survey conducted at the facility on 2/22/2013 to assess compliance with state regulations for residential care facilities.
Findings
The facility received a grade of A but had several deficiencies including failure to maintain clean and well-maintained premises, failure to properly destroy discontinued or expired medications, and inaccurate medication administration records for multiple residents.
Severity Breakdown
Severity: 2: 2
Severity: 1: 1
Deficiencies (3)
| Description | Severity |
|---|---|
| Facility failed to ensure the premises was clean and well maintained; vent in laundry room was dirty, lint accumulation behind dryer, and discarded mattress and box spring outside. | Severity: 2 |
| Facility did not destroy medications after they were discontinued, expired, or after resident transfer (example: expired Lactulose medication). | Severity: 2 |
| Medication administration records (MAR) were inaccurate; 4 of 5 MARs inspected were not signed for the date of inspection. | Severity: 1 |
Report Facts
Licensed capacity: 6
Census: 5
MARs inspected: 5
MARs with deficiencies: 4
Inspection Report
Complaint Investigation
Census: 6
Capacity: 6
Deficiencies: 4
Apr 17, 2012
Visit Reason
This Statement of Deficiencies was generated as a result of a complaint investigation conducted in the facility from 2012-04-12 to 2012-04-17. Complaint #NV00031389 was substantiated.
Findings
The facility failed to ensure that 2 of 6 residents received medications as prescribed, including missing documentation and medication administration. Additionally, medication administration records were inaccurate or incomplete for some residents, and medications were not properly secured.
Complaint Details
Complaint #NV00031389 was substantiated based on findings related to medication administration and record-keeping deficiencies.
Severity Breakdown
Level 2: 2
Level 1: 2
Deficiencies (4)
| Description | Severity |
|---|---|
| Failed to ensure 2 of 6 residents received medications as prescribed (Resident #1 - Omeprazole and Resident #2 - Triamcinolone Acetonide). | Level 2 |
| Failed to ensure medication administration record (MAR) was accurate for 1 of 6 residents (Resident #2 - Triamcinolone Acetonide not listed on MAR). | Level 1 |
| Failed to ensure medication record was complete for 1 of 6 residents receiving PRN medications (Resident #1 - Clonazepam 1 mg). | Level 1 |
| Failed to ensure medications belonging to 1 of 6 residents (Resident #2) and the administrator were kept locked; medications observed unsecured on kitchen counter. | Level 2 |
Report Facts
Residents present: 6
Total licensed capacity: 6
Deficiency severity counts: 4
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Employee #1 | Interviewed and stated she had not given medication for the entire month (Resident #2 medication). |
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