|
Date of Survey
|
2007/05/17 (YYYY/MM/DD)
|
|
Deficiency Type
|
Fire Safety
|
|
Category
|
Fire Alarm Systems Deficiencies
|
|
Deficiency
|
an approved installation, maintenance and testing program for fire alarm systems.
|
|
Level of Harm
|
Minimal harm or potential for actual harm
|
|
|
Date of Survey
|
2007/05/17 (YYYY/MM/DD)
|
|
Deficiency Type
|
Fire Safety
|
|
Category
|
Building Contruction Deficiencies
|
|
Deficiency
|
approved construction type or materials.
|
|
Level of Harm
|
Minimal harm or potential for actual harm
|
|
|
Date of Survey
|
2007/05/16 (YYYY/MM/DD)
|
|
Deficiency Type
|
Health
|
|
Category
|
Nutrition and Dietary Deficiencies
|
|
Deficiency
|
Store, cook, and give out food in a safe and clean way.
|
|
Level of Harm
|
Minimal harm or potential for actual harm
|
|
|
Date of Survey
|
2007/05/16 (YYYY/MM/DD)
|
|
Deficiency Type
|
Health
|
|
Category
|
Resident Assessment Deficiencies
|
|
Deficiency
|
Make sure all assessments are accurate, coordinated by an RN, done by the right professional, and are signed by the person completing them.
|
|
Level of Harm
|
Minimal harm or potential for actual harm
|
|
|
Date of Survey
|
2006/06/01 (YYYY/MM/DD)
|
|
Deficiency Type
|
Fire Safety
|
|
Category
|
Exits and Egress Deficiencies
|
|
Deficiency
|
exits that are accessible at all times.
|
|
Level of Harm
|
Minimal harm or potential for actual harm
|
|
|
Date of Survey
|
2006/06/01 (YYYY/MM/DD)
|
|
Deficiency Type
|
Fire Safety
|
|
Category
|
Emergency Plans and Fire Drills Deficiencies
|
|
Deficiency
|
record of quarterly fire drills for each shift under varying conditions.
|
|
Level of Harm
|
Immediate jeopardy to resident health or safety
|
|
|
Date of Survey
|
2006/06/01 (YYYY/MM/DD)
|
|
Deficiency Type
|
Fire Safety
|
|
Category
|
Fire Alarm Systems Deficiencies
|
|
Deficiency
|
an approved installation, maintenance and testing program for fire alarm systems.
|
|
Level of Harm
|
Minimal harm or potential for actual harm
|
|
|
Date of Survey
|
2006/06/01 (YYYY/MM/DD)
|
|
Deficiency Type
|
Fire Safety
|
|
Category
|
Fire Alarm Systems Deficiencies
|
|
Deficiency
|
properly maintained smoke detectors.
|
|
Level of Harm
|
Minimal harm or potential for actual harm
|
|
|
Date of Survey
|
2006/06/01 (YYYY/MM/DD)
|
|
Deficiency Type
|
Fire Safety
|
|
Category
|
Furnishings and Decorations Deficiencies
|
|
Deficiency
|
exits that are free from obstructions and can be used at all times.
|
|
Level of Harm
|
Minimal harm or potential for actual harm
|
|
|
Date of Survey
|
2006/06/01 (YYYY/MM/DD)
|
|
Deficiency Type
|
Fire Safety
|
|
Category
|
Furnishings and Decorations Deficiencies
|
|
Deficiency
|
restrictions on the use of highly flammable materials.
|
|
Level of Harm
|
Minimal harm or potential for actual harm
|
|
|
Date of Survey
|
2006/06/01 (YYYY/MM/DD)
|
|
Deficiency Type
|
Fire Safety
|
|
Category
|
Medical Gases and Anesthetizing Areas Deficiencies
|
|
Deficiency
|
proper medical gas storage and administration areas.
|
|
Level of Harm
|
Minimal harm or potential for actual harm
|
|
|
Date of Survey
|
2006/06/01 (YYYY/MM/DD)
|
|
Deficiency Type
|
Fire Safety
|
|
Category
|
Miscellaneous Deficiencies
|
|
Deficiency
|
fire safety features required by current fire safety codes.
|
|
Level of Harm
|
Minimal harm or potential for actual harm
|
|
|
Date of Survey
|
2006/06/01 (YYYY/MM/DD)
|
|
Deficiency Type
|
Fire Safety
|
|
Category
|
Electrical Deficiencies
|
|
Deficiency
|
properly installed electrical wiring and equipment.
|
|
Level of Harm
|
Minimal harm or potential for actual harm
|
|
|
Date of Survey
|
2006/06/01 (YYYY/MM/DD)
|
|
Deficiency Type
|
Fire Safety
|
|
Category
|
Vertical Openings Deficiencies
|
|
Deficiency
|
protected exits that allow the resident to escape the building.
|
|
Level of Harm
|
Minimal harm or potential for actual harm
|
|
|
Date of Survey
|
2006/06/01 (YYYY/MM/DD)
|
|
Deficiency Type
|
Fire Safety
|
|
Category
|
Hazardous Area Deficiencies
|
|
Deficiency
|
construction that can resist fire for one hour or an approved fire extinguishing system.
|
|
Level of Harm
|
Minimal harm or potential for actual harm
|
|
|
Date of Survey
|
2006/06/01 (YYYY/MM/DD)
|
|
Deficiency Type
|
Fire Safety
|
|
Category
|
Smoke Compartmentation and Control Deficiencies
|
|
Deficiency
|
walls or barriers that prevent smoke from passing through and would resist fire for at least one hour.
|
|
Level of Harm
|
Minimal harm or potential for actual harm
|
|
|
Date of Survey
|
2006/06/01 (YYYY/MM/DD)
|
|
Deficiency Type
|
Fire Safety
|
|
Category
|
Corridor Walls and Doors Deficiencies
|
|
Deficiency
|
corridor and hallway doors that block smoke.
|
|
Level of Harm
|
Minimal harm or potential for actual harm
|
|
|
Date of Survey
|
2006/06/01 (YYYY/MM/DD)
|
|
Deficiency Type
|
Fire Safety
|
|
Category
|
Building Contruction Deficiencies
|
|
Deficiency
|
approved construction type or materials.
|
|
Level of Harm
|
Minimal harm or potential for actual harm
|
|
|
Date of Survey
|
2006/05/25 (YYYY/MM/DD)
|
|
Deficiency Type
|
Health
|
|
Category
|
Quality Care Deficiencies
|
|
Deficiency
|
Give professional services that meet a professional standard of quality.
|
|
Level of Harm
|
Minimal harm or potential for actual harm
|
|
|
Date of Survey
|
2006/05/25 (YYYY/MM/DD)
|
|
Deficiency Type
|
Health
|
|
Category
|
Pharmacy Service Deficiencies
|
|
Deficiency
|
Have drugs and other similar products available, which are needed every day and in emergencies, and give them out properly.
|
|
Level of Harm
|
Minimal harm or potential for actual harm
|
|
|
Date of Survey
|
2006/05/25 (YYYY/MM/DD)
|
|
Deficiency Type
|
Health
|
|
Category
|
Administration Deficiencies
|
|
Deficiency
|
Follow all laws and professional standards.
|
|
Level of Harm
|
Minimal harm or potential for actual harm
|
|
|
Date of Survey
|
2006/05/25 (YYYY/MM/DD)
|
|
Deficiency Type
|
Health
|
|
Category
|
Administration Deficiencies
|
|
Deficiency
|
Keep accurate and appropriate medical records.
|
|
Level of Harm
|
Minimal harm or potential for actual harm
|
|
|
Date of Survey
|
2005/04/18 (YYYY/MM/DD)
|
|
Deficiency Type
|
Fire Safety
|
|
Category
|
Vertical Openings Deficiencies
|
|
Deficiency
|
proper stairway enclosures and vertical shafts.
|
|
Level of Harm
|
Minimal harm or potential for actual harm
|
|
|
Date of Survey
|
2005/04/18 (YYYY/MM/DD)
|
|
Deficiency Type
|
Fire Safety
|
|
Category
|
Smoke Compartmentation and Control Deficiencies
|
|
Deficiency
|
walls or barriers that prevent smoke from passing through and would resist fire for at least one hour.
|
|
Level of Harm
|
Minimal harm or potential for actual harm
|
|
|
Date of Survey
|
2005/04/18 (YYYY/MM/DD)
|
|
Deficiency Type
|
Fire Safety
|
|
Category
|
Hazardous Area Deficiencies
|
|
Deficiency
|
construction that can resist fire for one hour or an approved fire extinguishing system.
|
|
Level of Harm
|
Minimal harm or potential for actual harm
|
|
|
Date of Survey
|
2005/04/18 (YYYY/MM/DD)
|
|
Deficiency Type
|
Fire Safety
|
|
Category
|
Exits and Egress Deficiencies
|
|
Deficiency
|
rooms that can be unlocked from inside without a key.
|
|
Level of Harm
|
Minimal harm or potential for actual harm
|
|
|
Date of Survey
|
2005/04/18 (YYYY/MM/DD)
|
|
Deficiency Type
|
Fire Safety
|
|
Category
|
Fire Alarm Systems Deficiencies
|
|
Deficiency
|
properly maintained smoke detectors.
|
|
Level of Harm
|
Minimal harm or potential for actual harm
|
|
|
Date of Survey
|
2005/04/18 (YYYY/MM/DD)
|
|
Deficiency Type
|
Fire Safety
|
|
Category
|
Miscellaneous Deficiencies
|
|
Deficiency
|
fire safety features required by current fire safety codes.
|
|
Level of Harm
|
Minimal harm or potential for actual harm
|
|
|
Date of Survey
|
2005/04/18 (YYYY/MM/DD)
|
|
Deficiency Type
|
Fire Safety
|
|
Category
|
Building Contruction Deficiencies
|
|
Deficiency
|
a two-hour-resistant firewall in common walls.
|
|
Level of Harm
|
Minimal harm or potential for actual harm
|
|