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K0353
E

Sprinkler System Deficiency Due to Missing Escutcheons

Camp Hill, Pennsylvania Survey Completed on 01-27-2025

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 hardware components of the automatic sprinkler protection system, which affected one of seven smoke compartments. During an observation conducted on January 27, 2025, between 11:21 AM and 11:26 AM, it was noted that sprinkler heads in specific locations were missing an escutcheon. These locations included the Clean Utility Room next to the Arcadia Front Entrance, the Arcadia Restroom by the Med Prep Room, and the Arcadia Ice Machine Room, all situated on the first floor. An interview with the Senior Maintenance Director confirmed the absence of the escutcheons on the sprinkler heads.

Plan Of Correction

1-A: Completed 1/29/25. Replaced escutcheon for sprinkler head in clean utility room next to Arcadia front entrance. 1-B: Completed 1/29/25. Replaced escutcheon for sprinkler head in Arcadia rest room by med prep room. 1-C: Completed 1/29/25. Replaced escutcheon for sprinkler head in Arcadia Ice Machine room. 2. Maintenance Director completed a comprehensive sweep on 2/3/25 of sprinkler heads throughout the building and will conduct random audits monthly. 3. On 2/4/25, Maintenance Director ordered 10 escutcheons to have on hand to replace as needed. 4. Results will be reported to QAPI each quarter for review and effectiveness.

See complete original report
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