Oxygen Storage Signage Deficiency
Penalty
Summary
The facility failed to maintain proper oxygen storage requirements on the second floor west nursing station medical room. During an observation on January 22, 2025, it was noted that the entry door to the medical room lacked the required precautionary signage. The sign should have included the wording "CAUTION: OXIDIZING GAS(ES) STORED WITHIN, NO SMOKING." This omission indicates a failure to comply with safety protocols for storing oxidizing gases. Additionally, inside the room, there was an absence of signage to differentiate between "Empty" and "Full" oxygen cylinders. This lack of proper labeling could lead to confusion and mishandling of oxygen cylinders. The deficiency was confirmed during an exit interview with the Facility Administrator and Maintenance Director, who acknowledged the missing signage.
Plan Of Correction
Cautionary, (NO SMOKING), Empty, and Full signs have been placed in 2 west nsg station medical room. Maintenance Director conducted facility rounds and all other oxygen storage areas had appropriate signage. Maintenance Director or Designee will conduct in servicing for maintenance staff on importance of adherence to: 0923- Storage. The Maintenance team will conduct environmental rounds weekly x 4 weeks to ensure compliance with fire codes, and State, federal and local regulations. Results will be reported in monthly QAPI.