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K0355
E

Failure to Maintain Monthly Fire Extinguisher Inspections

Allentown, Pennsylvania Survey Completed on 12-09-2024

Penalty

No penalty information released
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The penalty, as released by CMS, applies to the entire inspection this citation is part of, covering all citations and f-tags issued, not just this specific f-tag. For the complete original report, please refer to the 'Details' section.

Summary

The facility failed to maintain the required monthly inspections of portable fire extinguishers in accordance with NFPA 10 standards. During an observation on December 9, 2024, it was noted that the fire extinguisher in the 1st floor electrical room was missing 5 out of 11 monthly inspections for the year 2024. Additionally, the fire extinguisher located in the 1st floor corridor near the electrical room lacked the monthly inspection for November 2024. This deficiency was confirmed during an exit interview with the Facility Administrator, Director of Plant Operations, and Facilities Manager.

Plan Of Correction

The statements made in this Plan of Correction are not an admission to and do not constitute an agreement with the alleged deficiencies herein. To maintain compliance with all federal and state regulations, the facility has taken or will take the actions set forth in the following plan of correction. The following plan of correction constitutes the facilities allegation of compliance such that all alleged deficiencies cited have been or will be corrected by the date or dates indicated. 1. The Maintenance Director inspected the 2 identified fire extinguishers to ensure compliance. 2. The Maintenance Director/Designee will conduct an initial audit to verify that facility fire extinguisher inspections are current. 3. Nursing Home Administrator or Designee will re-educate the Maintenance Director on facility fire extinguisher inspection compliance. 4. The Maintenance Director/Designee will conduct weekly audits for four weeks and then monthly for two months thereafter to verify that facility fire extinguisher inspections are current. This plan of correction will be reviewed at the monthly Quality Assurance Performance Improvement meeting and changes will be made as needed.

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