Improper Storage of Combustibles and Electrical Panel Deficiencies
Penalty
Summary
Surveyors observed multiple deficiencies related to the facility's compliance with NFPA 54 and NFPA 70 standards for gas and electrical equipment. Specifically, combustible stock items were found stored within three feet of electrical panels in both the Physical Therapy storage area and the first floor mechanical room. Additionally, the electrical panel in the second floor electrical closet near Room #263 was found with its cover disassembled and resting on the floor. Two open blanks were identified in the electrical panel for the first floor auxiliary kitchen located in the first floor mechanical room. Furthermore, combustible items were stored on top of and within three feet of a transformer in the first floor mechanical room. These findings were confirmed by the facility Maintenance Director at the time of observation. All 175 residents of the facility could be affected by these deficiencies, as the improper storage of combustibles and unsecured electrical panels present a risk in the event of a fire caused by electrical sparks, arcing, or overheating.
Plan Of Correction
K511 – Utility's-Gas and Electric 1. The facility failed to ensure equipment using gas or gas related piping complies with NFPA 54 and electrical wiring and equipment complies with NFPA 70. a. The combustible stock items stored within 3' of the electrical panels in the Physical Therapy Storage have been removed. b. The electrical panel in the 2nd floor electrical closet by room #263 has been reassembled. c. The Electrical Panel for the 1st floor auxiliary kitchen in the 1st floor mechanical room with 2 open blanks has been corrected. d. The combustibles stored within 3' of the electrical panel in the 1st floor mechanical room have been removed. e. The combustibles stored on top of the transformer in the 1st floor mechanical room have been removed. 2. The maintenance director and staff will be educated on maintaining clearance of 3' of electrical panels and transformers, and the panels are properly assembled and maintained within the requirements of NFPA 54 and 70. 3. To ensure compliance is maintained, the maintenance director/designee will complete a random audit 5x a week for 4 weeks. Findings will be reported to the QAPI committee. 4. The facility Administrator will be responsible for assuring substantial compliance is attained through this plan of correction by 5/13/2025 and for sustained compliance thereafter.