Keystone Villa at Fleetwood

The third-floor medication cart was left unattended with an unlocked computer screen, making resident medical records visible and accessible.

A resident's morning medications were left in a cup on their dresser instead of being administered, despite the resident being unable to self-administer.

The home failed to report a resident incident involving unresponsiveness and oxygen equipment failure to the Department's regional office within the required 24-hour timeframe.

Staff failed to provide required assistance with activities of daily living, specifically regarding oxygen management and incontinence care, as indicated in resident support plans.

Multiple medication cart laptops were found unlocked, unattended, and accessible to residents' records in various hallways.

An unlabeled and undated bowl of salad and cooked chicken pieces were found in the third-floor recreation room refrigerator.

Prescribed medications for two residents, including APAP and Furosemide, were not available in the home at the time of inspection.

A resident's medication administration record failed to indicate the required blood pressure reading for a morning dose on 5/13/25.

A staff member engaged in a verbal argument with a resident during medication administration.

The refrigerator in the third-floor kitchenette lacked a thermometer.

Dryers in the second and third-floor resident laundries had full lint traps.

Medication administration for pain and anxiety was not documented on the Medication Administration Record at the time of administration.

The facility failed to follow prescriber orders, as a resident was not administered prescribed medication at the required hourly intervals during the 3rd shift.

A resident's call bell request was not answered for 33 minutes.

A resident's support plan lacked an adequate plan to address and prevent frequent falls and the need for toileting assistance.