White Dove Assisted Living Home

Based on interview, record review, and documentation review, the manager failed to ensure policies and procedures were established and documented to protect the health and safety of a resident covering job descriptions, duties, and qualifications, including required skills and knowledge, education, and experience for employees and volunteers for four of four employees. The deficient practice posed a risk if the facility did not establish a procedure to ensure personnel members possessed the required skills and knowledge to perform required job duties. Findings include: 1. A review of facility documentation revealed no policy and procedure covering job descriptions, duties, and qualifications, including required skills and knowledge, education, and experience for employees and volunteers. 2. Review of personnel records for E1, E2, E3, and E4 showed no documentation of verification of the employees' skills and knowledge. 3. In an interview, E1 stated that the facility did not have a skills and knowledge section in their policies and procedures and there was no verification of skills and knowledge for E1, E2, E3, and E4.

Based on record review and interview, the manager failed to ensure that a caregiver's skills and knowledge were verified and documented before the caregiver provided physical health services for four of four employees. The deficient practice posed a risk as no qualified employee was present to meet a resident's needs. Findings include: 1. Review of personnel records for E1, E2, E3, and E4 showed no documentation of verification of the employees' skills and knowledge. 2. In an interview, E1 stated that there was no verification of skills and knowledge for E1, E2, E3, and E4.

Based on documentation review, observation, and interview, the manager failed to ensure there was a means of exiting the facility for a resident who did not have a key, special knowledge for egress, or the ability to expend increased physical effort, that provided access to an outside area, and controlled or alerted employees of the egress of a resident from the facility. The deficient practice posed a risk if the facility was unaware of the general or specific whereabouts of a resident. Findings include: 1. Review of the license issued by the Department revealed the facility was authorized to provide directed care services. 2. During an environmental inspection of the facility, the Compliance Officer observed three doors to the south of the facility that were not alarmed to notify employees of resident egress. 3. In an interview, E1 confirmed that the three doors to the south of the facility were not alarmed.

Based on observation and interview, the manager failed to ensure that a refrigerator contained a thermometer which was accurate to plus or minus 3\'b0 F, placed at the warmest part of the refrigerator. Findings include: 1. The Compliance Officer observed a refrigerator to the west of the kitchen which did not contain a thermometer. This refrigerator contained food for the residents. 2. In an interview, E1 acknowledged that the refrigerator to the west of the kitchen did not contain a thermometer.

Based on observation, record review, and interview, the manager failed to ensure that the premises and equipment used at the assisted living facility were free from a condition or situation that may cause a resident or other individual to suffer physical injury. The deficient practice posed potential dangers to residents. Findings include: 1. During an environmental inspection of the facility with E1, the Compliance Officer observed the following: -An unlocked shed containing unsecured items including medical equipment and exposed nails. 2. In an interview, E1 acknowledged the situations listed above may cause residents to suffer physical injury.

Based on observation and interview, the manager failed to ensure that oxygen container was stored in an upright and secured position. The deficient practice posed a potential explosion or leak of a compressed gas. Findings include: 1. The Compliance Officer observed an upright and unsecured oxygen tank in the garage of the facility. 2. The Compliance Officer observed this oxygen tank through an unlocked door which gave residents direct access to the oxygen tank. 3. In an interview, E1 confirmed that the oxygen tank was accessible to residents and was not in a secured position.

Based on observation and interview, the manager failed to ensure toxic materials stored by the facility were stored in a locked area and inaccessible to residents. The deficient practice posed a risk to the physical health and safety of a resident. Findings include: 1. During the environmental tour with E1, the Compliance Officers observed the following: -One can of Lysol spray unsecured in a common bathroom cabinet. -Containers of febreeze, pledge, and hydrogen peroxide found in a caregiver's bathroom which was accessible to residents. -Sheetrock, wood filler, and insecticide in a garage that was accessible to residents. -Liquid Nails found in a drawer in the main area of the home which was accessible to residents. -WD40 found in a hallway closet in a duffle bag which was accessible to residents. 2. In an interview, E1 acknowledged toxic materials were stored and unlocked in the described locations.