Health inspection·June 18, 2025

F 0925 Make sure there is a pest control program to prevent/deal with mice, insects, or other pests. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observations, interviews and facility document review, the facility failed to ensure an effective pest control program was in place in three rooms (124 B, 126 B and 204 A/B) out of 11 rooms observed.Findings included:During an observation of room [ROOM NUMBER] B on 6/16/2025 at 08:46 A. M., there were three black live insects on the resident's overbed table near the resident's bed. In an immediate interview, the resident stated ants are always in her room, and that they never leave. She states she complains to the staff daily about issues including ants. She states she has seen big bugs in the facility as well. During a tour of room [ROOM NUMBER] on 06/17/2025 at 11:04 A. M., an observation of the bathroom revealed a live brown colored insect crawling on the wall under the sink, in the bottom right corner near where the floor tile meets the wall. In an interview with the resident explained there were insects in the facility and stated a roach was seen earlier crawling across the wardrobe header. The resident stated it went down to the side of the wardrobe cabinet and to the right on the floor. On 06/17/2025 at 11:07 A. M., an interview was conducted with Staff D, Licensed Practical Nurse (LPN)/Unit Manager. She stated that she had not seen any insects, but the residents had complained to her about ants. During an interview on 06/17/2025 at 11:11 A. M., with a random resident, he stated he saw flies on 06/16/2025. He stated that he didn't tell staff because it was a waste of time. During an interview with a random resident on 06/17/2025 at 02:03 P. M., he stated he saw a bug in the 100 hallway near room [ROOM NUMBER]. He stated he sighted it a week prior. The resident stated he notified staff, and the staff proceeded to smash the bug, by stomping on it.An observation of room [ROOM NUMBER] Bed B on 06/18/2025 at 08:07 A. M., revealed the room had a food tray with two small live insects on the table near the resident's bed. The resident confirmed that this was their breakfast tray. Observations of a cubby counter space in between the wardrobe section of the room showed a food tray. The observations revealed ants were on the tray with a tea bag and other items. There was a food plate from the prior day's dinner with no food on it. The plate had approximately forty to fifty live small insects crawling over the plate. An interview was conducted on 06/18/2025 at 08:09 A. M., with Staff C, Registered Nurse (RN)/UM, in 126 B. Staff C UM RN confirmed she saw the live ants on the overbed table and the wardrobe cubby. She stated that she would speak with maintenance. During a tour on 06/18/2025 at 08:22 A. M., observations of room [ROOM NUMBER] B revealed approximately five live small crawling insects, on a counter in a cubby in the wardrobe section connected to the wall near the window. The resident had items on the counter, including a plastic bag that the ants were crawling on. An interview on 06/18/2025 at 08:21 A. M., with Resident #16, he stated that ants are all over the room, on the floor, under the AC, and in the bathroom. He said that it was a waste of time to inform staff. On 06/18/2025 the nursing home administrator (NHA) provided the facility's Service Agreement for Commercial Pest Management, which revealed the facility has a signed service agreement with a pest control maintenance company. The service agreement was signed and dated 04/11/2024. The Residents Affected - Few Page 1 of 2 106116 106116 06/18/2025 Aviata at Bryan Dairy 9035 Bryan Dairy Rd Largo, FL 33777

F 0925 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few service agreement details that the service frequency is monthly. The service type was interior. The service for included Fly control. The service agreement shows a three-step process: 1. Inspect to pinpoint pest issues.2. Identify not only the pest, but the true cause of the problem.3. Treat in the most environmentally responsible way to eliminate/prevent any issues.Review of the facility's Pest Sighting Log for April, May, and June of 2025 revealed sightings of roaches, bugs and ants in hallways and resident's rooms.An interview was conducted on 6/18/2025 at 01:12 P. M., with the director of Maintenance (DOM). He stated the facility has a pest control company. He stated he makes sure that the company does what needs to be done and that he requests treatment for specific rooms as necessary. He stated he tries to ensure the company does not miss areas that staff has been alerted of need for treatment. He stated he is alerted about pest issues via staff, logs, and work book/orders. He stated that sometimes the roaches are gone when he checks for them. The DOM stated a specialized visit had been requested on 06/18/2025, but they had not been in yet. He stated the pest control company treats the exterior and the interior twice a month and does not go into resident rooms unless requested. He stated he had not heard reports of ants. Review of the facility's policy dated 11/30/2014, titled Pest Control revealed: The facility will maintain a pest control program, which includes inspection, reporting, and prevention.Procedure:1. A pest control contract will be maintained with a licensed exterminator.2. The contract will include routine quarterly inspections. 3. Treatment will be rendered as required to control the insects and vermin.4. Any unusual occurrence or sightings of insects should be reported immediately to the supervisor (See Policy - Maintenance Repair Request Form). Proper action will be taken.5. A copy of the company's Safety program, including MSDS (material safety data sheet) forms and certification of insurance will be on file in the facility.(Photographic evidence obtained) 106116 Page 2 of 2