Failure to Maintain Kitchen Hood Suppression Systems
Penalty
No penalty information released
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 and inspect its kitchen hood suppression systems, which affected the entire facility. During a document review on March 17, 2025, it was found that the kitchen hood suppression system report from July 3, 2024, indicated a failure with the 'Cylinder'. Additionally, a subsequent report dated January 6, 2025, showed a failure of the 'Kitchen System'. An exit interview with the Administrator and Maintenance Director confirmed that corrective actions had not been completed.
Plan Of Correction
The kitchen hood suppression system repair is scheduled for 4/11/2025. Maintenance Director will report completion and compliance to QAPI committee.