Quail Park Retirement Village, Llc

87211 Reporting Requirements (a)Each licensee shall furnish to the licensing agency such reports as the Department may require, including, but not limited to, the following: (1) A written report shall be submitted to the licensing agency and to the person responsible for the resident within seven days of the occurrence of any of the events specified in (A) through (D) below. This report shall include the resident's name, age, sex and date of admission; date and nature of event; attending physician's name, findings, and treatment, if any; and disposition of the case. (D) Any incident which threatens the welfare, safety or health of any resident…etcThis requirement is not met as evidenced by: Facility failed to report incident of Resident (R1) being stuck in the elevator.

87468.1 Personal Rights of Residents in All Facilities (11) To have their visitors, including ombudspersons and advocacy representatives, permitted to visit privately during reasonable hours and without prior notice, provided that the rights of other residents are not infringed upon.This requirement is not met as evidenced by: Based on interviews Facility limited and prevented resident (R1) from receiving visitors which poses an immediate health, safety or personal rights risk to persons in care.

Based on observation, the licensee did not comply with the section cited above in 3 out of 6 resident's rooms were observed with unlocked medication, which poses an immediate health, safety or personal rights risk to persons in care.

Based on observation, interview, the licensee did not comply with the section cited above in 4 out of 4 areas; laundry room and maintenance rooms were unlocked with chemicals. Housekeeping cart had chemicals that were unlocked and several resident rooms had chemicals which poses an immediate health, safety or personal rights risk to persons in care.

Based on observation, the licensee did not comply with the section cited above in 1 out of 1 Ice machine observed to have brown and pink buildup in crevices; which poses an immediate health, safety or personal rights risk to persons in care.

87465(h)(6) (h) The following requirements shall apply to medications which are centrally stored: (6) The licensee shall be responsible for assuring that a record of centrally stored prescription medications for each resident is maintained ….This requirement was not met as evidenced by: Medication audit reviled (R1) resident’s medication was not logged in the centrally stored list.

87555 General Food Service Requirements (a) The total daily diet shall be of the quality and in the quantity necessary to meet the needs of the residents and shall meet the Recommended Dietary Allowances of the Food and Nutrition Board of the National Research Council. All food shall be selected, stored, prepared and served in a safe and healthful manner.This requirement was not met as evidenced by: Based on observation the facility had expired food in the kitchen

87465(h)(6) (h) The following requirements shall apply to medications which are centrally stored: (6) The licensee shall be responsible for assuring that a record of centrally stored prescription medications for each resident is maintained ….This requirement was not met as evidenced by: Based on records review a medication was not documented in the centrally stored prescription medications list.

87465(a)(4) Incidental Medical and Dental Care (a)A plan for incidental medical and dental care shall be developed by each facility... by compliance with the following: (4) The licensee shall assist residents with self-administered medications as needed.This requirement was not met as evidence by: Based on records reviewed and interviews,staff failed to administer medication to resident in care, which poses an immediate Health andSafety risk to the residents.

Based on observation, the licensee did not comply with the section cited above when LPA and Administrator observed at 09:40AM, cleaning chemical bottles stored and unlocked under R1’s accessible to residents in care this poses an immediate health, safety or personal rights risk to persons in care.

Based on observation, the licensee did not comply with the section cited above when LPA and Administrator observed R1’s medications stored in resident’s under bathroom sink and shelf unlocked accessible to residents in care this poses an immediate health, safety or personal rights risk to persons in care.

Incidental Medical and Dental Care Once ordered by the physician the medication is given according to the physician's directions.This requirement was not met as evidenced by: Based on interview conducted and record review, the licensee did not comply with the section cited above when R2 was administered one medication in the wrong dosage, two medication was not administered to R2 for six days and two medications was not administered to R2 for three days. Interview with Administrator confirmed staff had administered a wrong dosage for one medication, two medications were not administered for six days and two medications were not administered for three days which poses an immediate health, safety or personal rights ricks to persons in care.