White River Assisted Living and Memory Care

Facility did not initiate the fire alarm during the January swing shift fire drill.

Unapproved heater in use at the reception desk.

Missing documentation for annual/quarterly inspections, 5-year internal pipe/FDC testing, 3-year dry system test, and annual forward flow.

Facility unable to provide record of annual fire alarm system inspection and verification of deficiency corrections.

The exit in the East dining room was tied shut with a rope.

Facility unable to provide documentation of an annual 90-minute test of battery backup lights in the last 12 months.

Emergency light cord in the kitchen had exposed wires.

Facility unable to provide documentation for annual/semi-annual hood cleaning.

Missing service reports for kitchen suppression system for the past 12 months.

Facility unable to provide documentation for the last smoke detector sensitivity test report.

The exit gate outside on the east side has an extra latch on it.

Fire extinguishers throughout the facility only have January monthly sign offs.

Power strip in the kitchen was not properly mounted and was hanging by its cord.

Facility unable to provide documentation for annual fire door inspection.

Annual fire alarm inspection report showed multiple deficiencies.

Facility unable to provide documentation showing monthly testing of CO detectors performed in the past 12 months.

Exit inside and outside of TV room was blocked by chairs and a wheel chair.

Extension cord used in the kitchen to power two freezer appliances.

Escutcheon ring missing in hall outside med office; one in office taped to ceiling.

Smoke detector sensitivity report showed multiple detectors failed.

Emergency light outside of exit by room 208 did not function when tested.

Facility unable to provide documentation showing 30-second monthly testing of emergency lighting in the last 12 months.

Facility unable to provide documentation for completion of twelve planned and unannounced fire drills in the previous 12 months.

Multiple doors failing to close/latch properly (Kitchen, room 207, exit by 108, corridor C/D by 102); kitchen door has mechanical penetration.

Facility failed to ensure a sampled staff member completed required Home Care Aide (HCA) basic training in a timely manner (172 days after hire).

Facility failed to prevent video recording of the fireside living room where residents gathered, violating privacy rights.

Facility failed to secure a computer screen displaying resident medication records and failed to secure a medication room containing medical records.

Facility failed to assess a resident for the safe use of a quarter-length side rail installed on their bed.

Facility failed to submit background authorization forms for 6 of 11 sampled staff within one business day of their start date.

Facility failed to provide a lockable storage area for 7 of 19 sampled residents for their personal belongings.

Facility failed to complete and maintain documentation of facility orientation in employee files for two staff members.