Failure to Maintain and Inspect Emergency Generator
Penalty
Summary
The facility failed to maintain and inspect its emergency generator as required by NFPA standards. During a document review on February 3, 2025, it was discovered that the facility could not provide documentation of a 3-year, 4-hour load test of the emergency generator. This test is crucial to ensure the generator's capability to supply service within 10 seconds, as stipulated by NFPA 101 and NFPA 110. Further investigation revealed additional deficiencies in the facility's maintenance and testing procedures. The facility was unable to provide documentation for an annual 90-minute load bank test and an annual fuel quality test. These tests are essential to verify the reliability and efficiency of the emergency power system, which is critical for the safety and well-being of the residents. An exit interview with the Maintenance Director on February 4, 2025, confirmed the lack of documentation for these required tests and inspections. The absence of these records indicates a failure to adhere to the necessary maintenance protocols, potentially compromising the facility's ability to provide essential power in emergencies.
Plan Of Correction
Preparation and submission of this POC is required by State and Federal law. This POC does not constitute an admission for purposes of general liability, professional malpractice, or any other court proceedings. Documentation will be provided by outside contractor for 3-year, 4-hour load test of emergency generator. Submission of Load test paper documentation will be checked quarterly to ensure all proper documentation is maintained. Documentation provided by outside contractor for 3-year, 4-hour load test of emergency generator. Documentation provided by outside contractor for Annual load bank test of. Documentation provided by outside contractor, Ferguson & McCann for fuel quality test. All paperwork needed for these items will be reviewed monthly by maintenance designee to ensure this issue does not reoccur.