Non-Functional Bathroom Ventilation and Inadequate Maintenance Documentation
Penalty
Summary
The facility failed to ensure that the bathroom ventilation systems in ten occupied resident rooms were functioning properly, as required by licensure regulations. Observations on two consecutive days revealed that the ventilation in rooms 103, 104, 105, 106, 107, 109, 110, 113, 115, and 117 was not operational, as demonstrated by a lack of air draw when tested with a piece of toilet paper. Additionally, all vents in these rooms had a visible white substance on the air grills, and a stale ammonia odor was present in the rooms, indicating inadequate ventilation and cleaning. Interviews with maintenance staff confirmed that the ventilation systems in the affected rooms were not working due to a switch being turned off, and that the vents had not been cleaned during the current month. Despite this, a review of the monthly maintenance checklist for May 2025 indicated that all fans were marked as clean, free of debris, and in working order. The administrator confirmed that the expectation is for vents to be cleaned monthly and checked daily, especially since a resident had previously turned off the switch, but these procedures were not followed.