Health inspection·March 23, 2025

F 0921 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interview, and record review the facility failed to provide a clean, comfortable, and homelike environment for 9 (R3, R4, R5, R6, R7, R8, R10, R11, and R12) of 12 residents reviewed for environment. The findings include: On 3/22/25 at 10:04AM R8's room has four tiles missing from the main room floor. R8 was observed in the bed, opened her eyes but did not respond to the surveyor's question. On 3/22/25 at 10:06AM R3's room was observed. The top veneer finish lifts off to expose plywood/particle board underneath. A round hole was [NAME] key lock fell out. 2 window curtains in the room, one is hung and can slide to open and close, but second curtain is partially hung. Curtain hooks/clips observed on the window ledge. Trim boards look dirty with discolored, dark black/brown grime. Black, dark, spotted discoloration along floor trim and floor that is along wall. R3 said her window curtains have been like that for a couple weeks. R3 said she is unable to open or close the windows, they stay like that. R3 said the dresser in the room was her room mates, it's been like that for some time. R3 said housekeeping has not been in to clean her room today. R3 said that was my roommate's dresser. R3 showed surveyor her bathroom. R3 turned on the cold-water faucet and then the faucet for hot water. Only a dribble of hot water came out. R3 said it makes it hard to wash up. There are four missing tiles in R3's bathroom. R3 said the floor has a lot of wear and tear, it's been like that so long as I can remember. R3 said some rooms are better than others. R3 said yes, she has reported the faucet, curtain, and tiles, but the staff have a lot to do. On 3/22/25 at 10:13AM R4-R7 are roommates. Three residents were in the room during observation. No window curtain in the room. On 3/22/25 at 10:15 R12's room has 1 square tile near bathroom door lifted up and some pieces cracked. On 3/22/25 at 10:23AM R10's bathroom is observed and the toilet seat has a brown substance smeared on it. On 3/22/25 at 10:30AM V2 (Certified Nurse Assistant-CNA), said R12 walks into the bathroom and uses the toilet, but she still needs staff assistance with toilet hygiene. V2 said R11 walks around but needs staff assist with toilet cares. V2 said R2 is bed-bound and won't use the bathroom. R2, R10 and R11 are roommates. Page 1 of 2 145714 145714 03/23/2025 Oak Park Oasis 625 North Harlem Oak Park, IL 60302

F 0921 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some On 3/22/25 at 10:40AM V6 (Assistant Administrator) was asked about missing tiles in R12's room. V6 said I don't know what the plan is for flooring. At 10:44AM V6 said if R3's window curtains were up, we could close them, but it is not up (the hanging curtain mentioned above). V6 opened the hot water faucet in R3's bathroom and saw the water trickle. V6 saw the missing floor tiles in the bathroom. On 3/22/25 at 10:46AM V6 saw R4-R7's room without window curtains and said all rooms should have window curtains. On 3/22/25 at 10:48AM V3, Housekeeping, said all rooms are swept, mopped, and bathrooms cleaned every day. V3 said I have the 2nd floor until 1:00PM, the other housekeeper called off. V3 said when we do a deep cleaning of a room, we take the window curtains down to wash them. V3 said he has not gotten to clean any rooms on R10's side. On 3/22/25 V4 (Licensed Practical Nurse-LPN) observed R10's bathroom. V4 said it is not acceptable, housekeeping is responsible to clean it. V4 said we would clean the toilet before using it. On 3/22/25 at 11:59AM via phone interview, V7 (Housekeeping Director) said the resident rooms are to be cleaned daily. V7 said we should have two housekeepers on each floor. V7 was asked if the housekeepers are expected to use water from the resident sinks to clean. V7 said yes, they need the sink to wet the cloths. V7 said housekeeping should report when a water faucet needs repair. V7 said I take down the window curtains and wash them when we deep clean a room. V7 said we have extra and enough window curtains for all rooms. V7 said I can get curtains from the empty floor and use them in a needed room. V7 said if a curtain falls then housekeeping should fix it. There are communication sheets at each nurses' station for us to let maintenance know if something needs to be fixed, like faucets. On 3/22/25 at 1:17PM V9 (Maintenance Director) said work order forms are kept at each end of the hall. V9 said we pick them up or staff calls us to let us know of something that needs fixed. V9 said we check daily for hot water, cold water, and air temperatures. V9 said we can replace furniture with furniture from unoccupied floor/room. V9 said I was aware tiles need to be replaced. V9 said there are no tiles here, none are available in the facility to replace. V9 said the CNAs are supposed to let us know if furniture is damaged or if there are plumbing issues, because they would see it during patient care. V9 said we don't check every room everyday for plumbing problems, I have never checked that room. V9 said I don't keep the work request, we take care of the issue and don't keep the paper. On 3/22/25 at 2:08PM V6 was asked if the staff have a responsibility to make sure the residents have a clean and homelike environment. V6 responded absolutely. V6 was asked if missing curtains, missing floor tiles, feces smeared on toilet seats, and no hot/warm water available meets the criteria of clean and homelike environment. V6 responded absolutely not. The facility resident rights booklet page 3 states Your facility must be safe, clean, comfortable, and homelike. 145714 Page 2 of 2