Caring for Generations, LLC

Based on observation and interview, the manager failed to ensure that hot water temperatures were maintained between 95º F and 120º F in areas of an assisted living facility used by residents. Findings Include: 1. During an environmental tour of the facility, the water temperature of the shared resident bathroom by the activity room measured 130.4º F. 2. In an exit interview, the findings were reviewed with E3 and E4 and no further information was provided. This is a repeat deficiency from the compliance inspection conducted on 2/14/2024.

Based on record review and interview, the manager failed to ensure a written service plan, when updated, was signed and dated by the manager, for two of two residents sampled. Findings include: 1. A review of R1's medical record revealed a service plan dated December 8, 2023 for personal care services. However, the service plan was not signed and dated by the manager. 2. A review of R2's medical record revealed a service plan dated January 19, 2024 for directed care services. However, the service plan was not signed and dated by the manager. 3. In an interview, E1 agreed the two service plans were not signed and dated by the manager.

Based on documentation review, record review, observation and interview, the manager failed to ensure a personnel record for each employee included documentation of the individual's completed orientation required by policies and procedures, for two of two personnel members sampled. Findings include: 1. A review of facility policy and procedures (reviewed March 9, 2020) revealed a policy titled, "Caregiver Orientation and Continuing Education." The policy stated "At the time of hire of a new employee the Manager or Manager's Designee will ensure that the employee receives the appropriate training and orientation needed..." The policy included a section titled, "Continuing Education," which read, "1. All caregivers are required to complete at least six hours of continuing education...on an biannual basis." 2. A review of E2's personnel record revealed E2 was hired as a caregiver on May 8, 2020. However, evidence of documentation of E2's completed continuing education in 2023 was not available for review. 3. A review of E3's personnel record revealed E3 was hired as a caregiver on June 4, 2021. However, evidence of documentation of E3's completed continuing education for 2023 was not available for review. 4. During a tour of the facility, the Compliance Officer observed E2 to be working and providing assisted living services to residents. 5. A review of facility staffing schedules revealed E2 and E3 were the only caregivers scheduled to work in 2023. 6. In an interview, E1 agreed E2 and E3 had not received continuing education as required by facility policy.

Based on record review and interview, the manager failed to ensure a resident's medical record contained documentation of notification of the resident of the availability of vaccination influenza (flu) and pneumonia were offered every 12 months, for two of two residents sampled. Findings include: 1. A review of R1's (admitted 2022) medical record revealed documentation of notification of the availability of the flu and pneumonia vaccine in 2022. However, evidence of documentation of the availability of the flu or pneumonia vaccine was offered or received in 2023 was unavailable for review. 2. A review of R2's (admitted 2021) medical record revealed documentation of notification of the availability of the flu and pneumonia vaccine in 2021. However, evidence of documentation of the availability of the pneumonia vaccine was offered or received in 2023 was unavailable for review. 3. In an interview E1 acknowledged R1's and R2's medical record did not contain evidence of documentation of the availability of the flu or pneumonia vaccine being offered annually.

Based on documentation review and interview, the manager failed to ensure a disaster drill for employees was conducted on each shift at least once every three months and documented. Findings include: 1. A review of facility staffing schedules revealed the facility had two shifts, day: 7:00 a.m. - 7:00 p.m. and night: 7:00 p.m.-7:00 a.m. 2. A review of facility documentation revealed documentation of disaster drills conducted on December 1, 2023, and September 1, 2023, at 9:00 a.m. However, evidence of documentation of disaster drills for day shift employees conducted in March or in January 2023 was not available for review. Further, documentation was available for review of a disaster drill conducted on June 1, 2023, at 8:30 p.m. However, evidence of documentation of disaster drills for night shift employees conducted in December, September or March 2023 was not available for review. 3. In an interview, E2 acknowledged a disaster drill for employees was not conducted on each shift at least once every three months and documented as required.

Based on observation, documentation review and interview, the manager failed to ensure the hot water temperature was maintained between 95 \'b0F and 120 \'b0F in areas of the assisted living facility used by residents. Findings include: 1. The Compliance Officer observed the hot water temperature measured at 144.8 \'b0F in a shared bathroom. In a private residential bathroom the hot water temperature was observed to measure 142.8 \'b0F. 2. A review of facility documentation revealed a document titled, "Hot Water Temperature Check Log," used for documenting the hot water temperature. Entries reflected monthly hot water checks in both bathrooms and in the kitchen to be consistently between 119 \'b0F and 118 \'b0F, with the last entry being made on January 1, 2024. 3. In an interview, E1 advised the hot water heater had been replaced in the last week of January, and E1 agreed the hot water temperatures were not maintained between 95 \'b0F and 120 \'b0F.