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F0761
D

Failure to Maintain Medication Refrigerator Within Required Temperature Range

Duarte, California Survey Completed on 05-30-2025

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 medication refrigerator (MR) within the required temperature range of 36 to 46 degrees Fahrenheit, as evidenced by temperature logs and direct observation. The MR temperature log showed that on two consecutive days, the temperature was recorded at 48 degrees Fahrenheit, which is above the recommended range. Additionally, during an observation in the medication room, the MR temperature was found to be 34 degrees Fahrenheit, which is below the required minimum. Both the Licensed Vocational Nurse and the Director of Nursing confirmed that maintaining the MR temperature within the specified range is necessary to ensure the efficacy and stability of stored medications. A review of the facility's policy and procedure on temperature control confirmed that drugs requiring refrigeration must be stored between 36 and 46 degrees Fahrenheit, and that daily temperature logs should be maintained to ensure compliance. The failure to keep the MR within the recommended temperature range was directly observed and acknowledged by facility staff, with no indication in the report of corrective actions taken at the time of the survey.

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