Inspection Reports for
Wesley Enhanced Living at Stapeley

The facility was found to have sanitary condition violations including liquid substance on the bathroom floor and mold-like substance on a pipe, and an outdated, unlabeled food item in the kitchenette refrigerator. Plans of correction were accepted and later verified as implemented.

The facility was found to be in compliance overall, with several deficiencies identified related to contract signatures, staff training, bathroom ventilation, facility maintenance, medication storage, and sanitary conditions. All deficiencies had plans of correction accepted and were implemented or scheduled for completion.

The submitted plan of correction was fully implemented as of the inspection date. A medication labeling discrepancy was identified and corrected, with new policies and staff training implemented to prevent recurrence.

The inspection found that the submitted plan of correction for the October 31, 2024 inspection was not implemented. Deficiencies included failure to update support plans reflecting residents' behavioral changes, inadequate supervision leading to resident altercation and injury, incomplete medication administration documentation, and insufficient staff training hours in dementia care.

The inspection was complaint-driven with findings substantiated by multiple violations related to medication management, staff training, safety hazards, sanitation, and documentation. Follow-up plans of correction were submitted with deadlines and enforcement actions pending.

Multiple violations were found including medication storage and labeling issues, training deficiencies, unsafe storage of poisonous materials, unsanitary conditions, fire safety concerns, and incomplete resident records. The facility was issued a provisional license with required plans of correction and follow-up inspections.

The complaint investigation was conducted on 09/26/2024 with findings including unlocked medications, expired eye drops, and issues with medication storage and labeling. Follow-up inspections and plan of correction submissions were scheduled.

Multiple violations were found including deficiencies in staff training, medication storage and administration, sanitary conditions, safety hazards, record keeping, and contract compliance. The facility was issued a first provisional license due to these violations and is subject to fines and ongoing monitoring until full compliance is achieved.

The inspection identified multiple deficiencies including failure to post the current license inspection summary, staff qualification issues, incomplete staff training, unsafe resident equipment, unsecured poisonous materials, unsanitary conditions, fire safety violations, and medication storage errors. Plans of correction were directed or accepted with specified completion dates.

The inspection was complaint-related, but no deficiencies or citations were found, indicating no substantiated issues.

No regulatory citations or deficiencies were identified during this unannounced partial inspection.

The facility was found to have multiple deficiencies related to staff training, medication storage, medication administration documentation, and following prescriber's orders. The submitted plan of correction was accepted and later determined to be fully implemented.

The facility had multiple deficiencies including lack of carbon monoxide detector near the kitchen stove, missing criminal background checks for staff, incomplete fire safety orientation for new staff, lighting issues on emergency exit routes, evacuation drills exceeding designated time, medication storage and administration errors, incomplete resident assessments and support plans. All deficiencies had plans of correction submitted and were implemented by April 21, 2023.

The visit was partially complaint-related, as indicated by the inspection reason 'Renewal, Complaint'. Specific substantiation status is not stated.

The facility was found to have implemented the plan of correction fully, with various deficiencies related to posting of rights poster, staff qualifications, first aid/CPR training, facility maintenance, hot water temperature, use of common towels, refrigerator/freezer temperatures, prohibited procedures, and documentation for secured dementia care unit admissions. All deficiencies were accepted with corrective actions and completion dates provided.

No inspection findings are reported in this document; it confirms the issuance of a regular license following the renewal application.

A written complaint was filed on 10/2/2020 regarding Resident #1's medications, visiting practices, and entry into the resident's room. The complaint was not acknowledged with a status report within 2 business days, nor was a written decision provided within 7 days. The complaint was substantiated by the findings.

The facility failed to provide a status report to the complainant and designated person within 2 business days after the complaint submission. Additionally, the facility did not provide a written decision explaining the investigation findings and actions taken within 7 days as required.

Violations of 55 Pa. Code Chapter 2600 were found related to abuse, annual training, sanitary conditions, and medication management. Plans of correction were approved with partial implementation progress noted as of August 9, 2019.

The facility received a provisional license due to violations found during the August 16, 2018 inspection. The letter notifies the facility of the provisional license issuance and the right to appeal.

No inspection findings are reported in this document. It is an administrative notice regarding license renewal and compliance requirements.

The complaint investigation was substantiated with findings of resident elopement, unsafe environmental conditions, and inadequate behavioral interventions. The facility was required to implement corrective actions including fencing, staff training, and updated risk assessments.

The investigation found violations related to resident elopement, inadequate supervision, and environmental hazards including unsecured exit doors and unsafe conditions. The facility was issued a provisional license with required corrective actions.

No regulatory violations with 55 Pa. Code Ch. 2600 (relating to Personal Care Homes) were identified as a result of this inspection.

The visit was complaint-related due to an incident where a staff member hit a resident's head. The report does not state substantiation status.

A violation of 55 Pa. Code Chapter 2600 was found involving a staff member hitting a resident's head while disposing of a personal product. The facility was required to correct the violation and conduct staff training on dignity and respect.

No inspection findings are reported in this document. It serves as a license renewal confirmation and notification of future inspection requirements.

The inspection identified violations related to incident reporting, environmental hazards, and support plan revisions. The facility submitted plans of correction to address these issues and ensure compliance with regulations.

Multiple violations of the Personal Care Homes regulations were found, including failure to provide immediate access to staff records, missing quality management plan, insufficient staff certified in first aid and CPR during the visit, missing direct care training records for certain staff, uncalibrated glucometers, lack of medication administration training records, incomplete preadmission screening forms, and missing preadmission screening for a resident admitted to the secured dementia care unit.

The Department confirms receipt of the renewal application and issues the license. It advises that an onsite annual inspection will be conducted within the next twelve months as required by regulation.

Multiple violations were found related to food labeling, refrigeration, medical evaluations, medication management, and resident support plans. Plans of correction were submitted and partially implemented as of the report date.

The revised license confirms the facility's maximum capacity of 79 residents and a secured dementia care unit capacity of 30. The license expiration date remains unchanged.