Health inspection·April 17, 2025

F 0584 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely. Based on observation and interviews, the facility failed to provide a clean and sanitary environment in the laundry room. As evidenced improper storage of chemicals-detergent, bleach, iron sour, softener-were being stored on the floor, washer bases rusted, washers draining into a two-compartment sink, soiled garbage can pallets, a large hole in the wall, and dry drainage residue on one of the washers. (Photographic evidence obtained). The findings included: On 04/17/25 at 09:38 AM A laundry tour was conducted with the Director of Environmental Services, and the facility's administrator; observation in the dirty laundry side, the washer bases were rusted, the washers were draining into a two-compartment sink that had visible dirt and grime. Four chemicals-detergent, bleach, iron sour and softener were stored directly on the floor. The garbage can pallets were soiled garbage. A large hole was observed in the wall, and one washer had dry drainage residue, with no clear source identified. Interview on 04/17/25 at 09:45 AM, the Director of Environmental Services, revealed he has been in his position for two months and acknowledged the identified concerns related to the four chemicals-detergent, bleach, iron sour, and softener-were being stored on the floor instead of on a pallet; the rusty bases of the washers, the washers draining into a two-compartment sink, which had visible dirt and grime on its surface. soiled garbage can pallets, a large hole in the wall, and dry drainage residue on one of the washers. Review of the facility's policy titled - Laundry Area Cleaning of. Effective Date: June 11, 2009. Revision Dated October 30, 2014 revealed: POLICY All laundry areas will be scheduled for routine cleaning. PURPOSE To provide a systematic approach to maintaining the cleanliness of the laundry. PROCESS 1. Daily: Page 1 of 3 105610 105610 04/17/2025 Palm Garden of Aventura 21251 E Dixie Highway North Miami Beach, FL 33180

F 0584 1.1 Sanitize folding tables and linen shelves Level of Harm - Minimal harm or potential for actual harm 1.1.1 Team members shall use appropriate PPE (Personal Protection Equipment) 1.2 Wash and polish washer Residents Affected - Few 1.3 Clean dryer lint screens every two hours and as needed 1.4 Spot clean soiled linen room walls 1.5 Clean and sanitize soiled linen hampers 1.6 Dust mop and sanitize laundry room floors 1.7 Clean and sanitize clean linen carts 2. Weekly: 2.1 Sanitize chemical boxes and hose lines 2.2 Sanitize washer plumbing fixtures and hose lines 2.3 High Dusting 2.3.1 Doorways 2.3.2 Fans 2.3.3 Tops of dryers 2.3.4 Pipes 3. Monthly: 3.1 Wall washing 3.2 Sanitize linen racks in laundry and in linen closets. 105610 Page 2 of 3 105610 04/17/2025 Palm Garden of Aventura 21251 E Dixie Highway North Miami Beach, FL 33180

F 0755 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. Based on Observation, interview and record review the facility failed to follow pharmaceutical procedures and facility policy during medication administration for Residents (#4, #50). There were 108 residents residing in the facility at the time of the survey. The findings included: On 4/15/25 at 8:00 AM during medication administration observation with Licensed Practical Nurse (LPN), (Staff A), the medications for Resident #4 were observed signed off as given prior to the resident receiving the medications. On 4/15/25 at 9:50 AM during medication administration observation with Licensed Practical Nurse (Staff B), the medication for Resident #50 was observed signed off as given prior to administration. Interview on 04/15/25 at 08:06 AM LPN, Staff A stated no one told her that she is not allowed to sign off on the medications before they were given to the residents. Stated she signed off on the medication ahead of time to get herself familiar with the resident's medication. Interview 04/15/25 at 09:50 AM LPN, Staff B stated the only reason he signed off on Resident #50's medication before it was given, was because it was only one medication the resident was receiving via Percutaneous Gastrostomy Tube (PEG). Interview on 04/17/25 at 07:25 AM Director of Nursing (DON) stated regarding medication administration policies, all of our nurses have received medication administration in -services, we will be re-educating our nurses on correct medication procedures from the start of medication preparation to what happens after the medication is administered to the residents. It is our policy here at the facility that the nurses can only sign off on the medications as given, after they are administered to the residents. Review of the facility policy and procedures titled General Dose Preparation and Medication Administration revision date 11/15/24 states: facility staff should refer to facility policy regarding medication administration and should comply with applicable law and state operations manual when administering medications. 105610 Page 3 of 3