Failure to Maintain Safe and Sanitary Environment
Penalty
Summary
The facility failed to maintain a safe, functional, and sanitary environment, as evidenced by multiple observations and staff interviews. In the 500 hall, the carpet was heavily soiled at the entrances to several rooms, with a three-foot-long stain at the start of the hallway and three ceiling vents covered in brown debris. The Environmental Director confirmed the lack of a carpet cleaning machine and was unaware of when the carpets were last shampooed, indicating that only a vacuum was available for cleaning. These conditions were directly observed and verified by staff. In a room shared by two residents with severe cognitive impairment and significant care needs, there was a baseball-sized hole in the wall near the bathroom door and missing baseboards along several walls. These environmental deficiencies were confirmed by a State Tested Nursing Assistant during the survey. The facility's own policy required a safe, clean, and comfortable environment, but these standards were not met, affecting the two residents directly and potentially impacting others in the same hall.