Andrea's Elderly Care Facility 1

This requirement is not met as evidenced by:Based on record review the license did not comply with the section cited above by not ensuring that quarterly drills for each shift and type of emergency is conducted. During today's record review the last emergency training was conducted on February 10, 2025 which poses an immediate health, safety or personal rights risk to persons in care.

Based on record review of 4 Out of 4 resident records the licensee did not comply with the section cited above by not ensuring that the centrally stored medication record are maintained by the facility. LIC/ DADM stated that he/she takes the record home to get updated and is not available at the facility when requested by the LPA during inspection, which poses/posed a potential health, safety or personal rights risk to persons in care.

Based on record review, the licensee did not comply with the section cited above, 1 out of 3 staff did not have the staff record at the facility, the designated administrator (DADM) stated that he/she took the file home to make a copy and did not return the record to the facility, which poses/posed a potential health, safety or personal rights risk to persons in care.

Based on record review and interview, the licensee did not comply with the section cited above. LN stated the facility does conduct drills but did not document the drills. This poses/posed a potential health, safety or personal rights risk to persons in care.

Based on record review and interview, the licensee did not comply with the section cited above. LPA observed R1 and R3 did not have a weight record. Resident R2 is missing two months of weight record documentation. This poses/posed a potential health, safety or personal rights risk to persons in care.