Inspection·June 6, 2022

E 000 Initial Comments

E 000 During the recertification survey conducted on June 6, 2022 at Oak Hammock at The University of Florida Inc, a nursing home, Emergency Preparedness Plan was reviewed. Oak Hammock at The University of Florida Inc is in compliance with Emergency Preparedness per Code of Federal Regulations (CFR) 42, Part 483.73, Requirement for Long-Term Care Facilities.

K 000 INITIAL COMMENTS

K 000 An unannounced Fire & Life Safety recertification survey was conducted on June 6, 2022 at Oak Hammock at The University of Florida Inc, 2660 SW 53rd Lane, a nursing home in Gainesville, Florida 32608. The facility is not in compliance with 42 CFR 483.90 (a), and National Fire Protection Association (NFPA) 101 (2012 edition) and Tentative Interim Amendments (TIA's 12-1, 12-2, 12-3 and 12-4. NFPA 99 (2012 edition) and Tentative Interim Amendments (TIA's 12-2, 12-3, 12-4, 12-5 and 12-6 requirements for nursing homes. Initial Plan Review: 2004 Addition: 2016 New or Existing: Existing NFPA 220 Construction Type: II (111) Footage: 41,175 Fully Sprinkled Generator: 1000 KW Number of beds: 73 Census: 59 The following is description of the noncompliance: 06/23/2022 COMPLETED 06/06/2022 OAK HAMMOCK AT THE UNIVERSITY OF FLORIDA INC 2660 SW 53RD LN GAINESVILLE, FL 32608 PREFIX TAG ID PREFIX TAG PROVIDER'S PLAN OF ACTION DEFICIENCY) COMPLETION DATE

K 324 SS=F CFR(s): NFPA 101

K 324 7/9/22 Cooking Facilities Cooking equipment is protected in accordance with NFPA 96, Standard for Ventilation Control and Fire Protection of Commercial Cooking Operations, unless: * residential cooking equipment (i.e., small appliances such as microwaves, hot plates, toasters) are used for food warming or limited cooking in accordance with 18.3.2.5.2, 19.3.2.5.2 * cooking facilities open to the corridor in smoke compartments with 30 or fewer patients comply with the conditions under 18.3.2.5.3, 19.3.2.5.3, or * cooking facilities in smoke compartments with 30 or fewer patients comply with conditions under 18.3.2.5.4, 19.3.2.5.4. Cooking facilities protected according to NFPA 96 per 9.2.3 are not required to be enclosed as hazardous areas, but shall not be open to the corridor. 18.3.2.5.1 through 18.3.2.5.4, 19.3.2.5.1 through 19.3.2.5.5, 9.2.3, TIA 12-2 This REQUIREMENT is not met as evidenced by: Based on observation and staff interview, the facility failed to maintain and inspect kitchen hood system in the facility in accordance with LSC Sections. Failure to maintain cooking hood equipment endangers residents, staff, and other building occupants. The findings include:

K000 Preparation and execution of this plan of correction does not constitute admission or agreement by the provider of the terms or conclusions set forth in the statement of deficiencies. This plan of correction is prepared and/or executed solely because it is required by provisions of the Federal and State laws. SUMMARY OF DEFICIENCIES COMPLETED 06/06/2022 OAK HAMMOCK AT THE UNIVERSITY OF FLORIDA INC 2660 SW 53RD LN GAINESVILLE, FL 32608 PREFIX TAG ID PREFIX TAG DEFICIENCY) COMPLETION DATE

K 324 Continued From page 2 During the facility tour with the Maintenance Director on 6/6/22 from 2:00 PM to 5:00 PM, in the kitchen area, observed heavy grease build up on filters and fire suppression piping/nozzles, grease cup was full and large grease spill below the grease cup on the floor behind cooking equipment. Hoods, grease removal devices, fans, ducts, and other appurtenances shall be cleaned to remove combustible contaminants prior to surfaces becoming heavily contaminated with grease or oily sludge. During an interview with the Maintenance Director on 6/6/22 at 3:55 PM, she concurred with the observation and confirmed the findings. NFPA 101 (2012 Edition) 19.3.2.5.1., 9.2.3. NFPA 96 (2011 Edition) 11.4., 11.6.2. These findings were verified by the Maintenance Director at the times of observations and the Administrator at the exit conference on 6/6/22 at 5:00 PM.

K 372 Subdivision of Building Spaces - Smoke Barrie SS=E CFR(s): NFPA 101 Subdivision of Building Spaces - Smoke Barrier Construction 2012 EXISTING Smoke barriers shall be constructed to a 1/2-hour fire resistance rating per 8.5. Smoke barriers shall be permitted to terminate at an atrium wall. Smoke dampers are not required in duct penetrations in fully ducted HVAC systems where an approved sprinkler system is installed for smoke compartments adjacent to the smoke

K 324

K324 IMMEDIATE CORRECTIVE ACTION Vendor for hood cleaning was scheduled and service was completed. IDENTIFICATION OF RESIDENTS N/A SYSTEMATIC CHANGES Weekly Hood Filter Cleaning Checklist and Monthly Kitchen Equipment Inspection will be performed by Culinary Service Manager or designee. Hood cleaning vendor will be scheduled monthly. MONITORING Culinary Service Manager will perform monthly audit on Hood Filter Cleaning and Kitchen Equipment Checklists for completion. The results and findings will be reviewed and discussed in the QAPI Committee Meeting.

K 372 7/9/22 06/06/2022 2660 SW 53RD LN GAINESVILLE, FL 32608 PREFIX PREFIX COMPLETION DATE

K 372 Continued From page 3 K 372 barrier. 19.3.7.3, 8.6.7.1(1) Describe any mechanical smoke control system in REMARKS. This REQUIREMENT is not met as evidenced by: Based on observation and staff interview, the facility failed to properly maintain the required fire/smoke barriers penetrations, which have not been fire-stopped or cap-sealed per the requirements of NFPA 101. This condition could allow fire/smoke to travel from one smoke compartment to other smoke compartments, thus endangering occupants of the facility. The findings include: During the facility tour with the Maintenance Director on 6/6/22 from 2:00 PM to 5:00 PM, it was found that the smoke/fire walls were not properly protected with the required firestopping system in the following areas: 1) Communication/electrical room/next to kitchen - observed penetration at end cap of conduit 2) Communication/electrical room/across from room 1813 - observed penetration sealed with steel wool material at end cap of conduit During an interview with the Maintenance Director on 6/6/22 at 3:55 PM, she concurred with the observation and confirmed the findings. NFPA 101 (2012 Edition) 19.3.7.3, 8.5.6., 8.5.6.1. thru 8.5.6.6. These findings were verified by the Maintenance Director at the times of observations and the Administrator at the exit conference on 6/6/22 at IMMEDIATE CORRECTIVE ACTION Penetrations observed in Communication/Electrical Room near kitchen and Communication/Electrical Room adjacent room 1813 were sealed per NFPA 101 requirements. IDENTIFICATION OF RESIDENTS All Communications/Electrical closets have been checked for penetrations and have been found to be in compliance. SYSTEMATIC CHANGES Maintenance Manager will perform semi-annual penetration audit. I.T. will notify Maintenance of all scheduled work to be performed by outside vendors. MONITORING Maintenance Manager will perform semi-annual penetration audit. The results and findings will be reviewed and discussed in the QAPI Committee Meeting. 06/06/2022 OAK HAMMOCK AT THE UNIVERSITY OF FLORIDA INC 2660 SW 53RD LN GAINESVILLE, FL 32608 PREFIX TAG ID PREFIX TAG DEFICIENCY) COMPLETION DATE

K 372 Continued From page 4 5:00 PM.

K 372 SUMMARY OF DEFICIENCIES 106066 06/06/2022 OAK HAMMOCK AT THE UNIVERSITY OF FLORIDA INC 2660 SW 53RD LN GAINESVILLE, FL 32608 PREFIX TAG ID PREFIX TAG DEFICIENCY) COMPLETION DATE

E 000 Initial Comments

E 000 During the recertification survey conducted on June 6, 2022 at Oak Hammock at The University of Florida Inc, a nursing home, Emergency Preparedness Plan was reviewed. Oak Hammock at The University of Florida Inc is in compliance with Emergency Preparedness per Code of Federal Regulations (CFR) 42, Part 483.73, Requirement for Long-Term Care Facilities.

K 000 INITIAL COMMENTS

K 000 An unannounced Fire & Life Safety recertification survey was conducted on June 6, 2022 at Oak Hammock at The University of Florida Inc, 2660 SW 53rd Lane, a nursing home in Gainesville, Florida 32608. The facility is not in compliance with 42 CFR 483.90 (a), and National Fire Protection Association (NFPA) 101 (2012 edition) and Tentative Interim Amendments (TIA's 12-1, 12-2, 12-3 and 12-4. NFPA 99 (2012 edition) and Tentative Interim Amendments (TIA's 12-2, 12-3, 12-4, 12-5 and 12-6 requirements for nursing homes. Initial Plan Review: 2004 Addition: 2016 New or Existing: Existing NFPA 220 Construction Type: II (111) Footage: 41,175 Fully Sprinkled Generator: 1000 KW Number of beds: 73 Census: 59 The following is description of the noncompliance: 06/23/2022 REPORT OF DEFICIENCIES COMPLETED 06/06/2022 OAK HAMMOCK AT THE UNIVERSITY OF FLORIDA INC 2600 SW 53RD LN GAINESVILLE, FL 32608 PREFIX TAG ID PREFIX TAG DEFICIENCY) COMPLETION DATE

K 324 Cooking Facilities SS=F CFR(s): NFPA 101

K 324 7/9/22 Cooking Facilities Cooking equipment is protected in accordance with NFPA 96, Standard for Ventilation Control and Fire Protection of Commercial Cooking Operations, unless: * residential cooking equipment (i.e., small appliances such as microwaves, hot plates, toasters) are used for food warming or limited cooking in accordance with 18.3.2.5.2, 19.3.2.5.2 * cooking facilities open to the corridor in smoke compartments with 30 or fewer patients comply with the conditions under 18.3.2.5.3, 19.3.2.5.3, or * cooking facilities in smoke compartments with 30 or fewer patients comply with conditions under 18.3.2.5.4, 19.3.2.5.4. Cooking facilities protected according to NFPA 96 per 9.2.3 are not required to be enclosed as hazardous areas, but shall not be open to the corridor. 18.3.2.5.1 through 18.3.2.5.4, 19.3.2.5.1 through 19.3.2.5.5, 9.2.3, TIA 12-2 This REQUIREMENT is not met as evidenced by: Based on observation and staff interview, the facility failed to maintain and inspect kitchen hood system in the facility in accordance with LSC Sections. Failure to maintain cooking hood equipment endangers residents, staff, and other building occupants. The findings include:

K000 Preparation and execution of this plan of correction does not constitute admission or agreement by the provider of the terms or conclusions set forth in the statement of deficiencies. This plan of correction is prepared and/or executed solely because it is required by provisions of the Federal and State laws. SUMMARY OF DEFICIENCIES 106066 06/06/2022 OAK HAMMOCK AT THE UNIVERSITY OF FLORIDA INC 2660 SW 53RD LN GAINESVILLE, FL 32608 PREFIX TAG ID PREFIX TAG DEFICIENCY) COMPLETION DATE

K 324 Continued From page 2

K 324 During the facility tour with the Maintenance Director on 6/6/22 from 2:00 PM to 5:00 PM, in the kitchen area, observed heavy grease build up on filters and fire suppression piping/nozzles, grease cup was full and large grease spill below the grease cup on the floor behind cooking equipment. Hoods, grease removal devices, fans, ducts, and other appurtenances shall be cleaned to remove combustible contaminants prior to surfaces becoming heavily contaminated with grease or oily sludge.

K324 IMMEDIATE CORRECTIVE ACTION Vendor for hood cleaning was scheduled and service was completed. During an interview with the Maintenance Director on 6/6/22 at 3:55 PM, she concurred with the observation and confirmed the findings. IDENTIFICATION OF RESIDENTS N/A NFPA 101 (2012 Edition) 19.3.2.5.1., 9.2.3. NFPA 96 (2011 Edition) 11.4., 11.6.2. SYSTEMATIC CHANGES Weekly Hood Filter Cleaning Checklist and Monthly Kitchen Equipment Inspection will be performed by Culinary Service Manager or designee. Hood cleaning vendor will be scheduled monthly. These findings were verified by the Maintenance Director at the times of observations and the Administrator at the exit conference on 6/6/22 at 5:00 PM. MONITORING Culinary Service Manager will perform monthly audit on Hood Filter Cleaning and Kitchen Equipment Checklists for completion. The results and findings will be reviewed and discussed in the QAPI Committee Meeting.

K 372 Subdivision of Building Spaces - Smoke Barrie SS=E CFR(s): NFPA 101

K 372 7/9/22 Subdivision of Building Spaces - Smoke Barrier Construction 2012 EXISTING Smoke barriers shall be constructed to a 1/2-hour fire resistance rating per 8.5. Smoke barriers shall be permitted to terminate at an atrium wall. Smoke dampers are not required in duct penetrations in fully ducted HVAC systems where an approved sprinkler system is installed for smoke compartments adjacent to the smoke SUMMARY OF DEFICIENCIES 106066 06/06/2022 2660 SW 53RD LN GAINESVILLE, FL 32608 PREFIX DEFICIENCY) (X8) COMPLETION DATE

K 372 Continued From page 3 barrier. K 372 19.3.7.3, 8.6.7.1(1) Describe any mechanical smoke control system in REMARKS. This REQUIREMENT is not met as evidenced by: Based on observation and staff interview, the facility failed to properly maintain the required fire/smoke barriers penetrations, which have not been fire-stopped and/or sealed per the requirements of NFPA 101. This condition could allow fire/smoke to travel from one smoke compartment to other smoke compartments, thus endangering occupants of the facility. The findings include: During the facility tour with the Maintenance Director on 6/6/22 from 2:00 PM to 5:00 PM, it was found that the smoke/fire walls were not properly protected with the required firestopping system in the following areas: 1) Communication/electrical room/next to kitchen - observed penetration at end cap of conduit 2) Communication/electrical room/across from room 1813 - observed penetration sealed with steel wool material at end cap of conduit During an interview with the Maintenance Director on 6/6/22 at 3:55 PM, she concurred with the observation and confirmed the findings. NFPA 101 (2012 Edition) 19.3.7.3, 8.5.6., 8.5.6.1. thru 8.5.6.6. These findings were verified by the Maintenance Director at the times of observations and the Administrator at the exit conference on 6/6/22 at IMMEDIATE CORRECTIVE ACTION Penetrations observed in Communication/Electrical Room near kitchen and Communication/Electrical Room adjacent room 1813 were sealed per NFPA 101 requirements. IDENTIFICATION OF RESIDENTS All Communications/Electrical closets have been checked for penetrations and have been found to be in compliance. SYSTEMATIC CHANGES Maintenance Manager will perform semi-annual penetration audit. I.T. will notify Maintenance of all scheduled work to be performed by outside vendors. MONITORING Maintenance Manager will perform semi-annual penetration audit. The results and findings will be reviewed and discussed in the QAPI Committee Meeting. 106066 06/06/2022 OAK HAMMOCK AT THE UNIVERSITY OF FLORIDA INC 2660 SW 53RD LN GAINESVILLE, FL 32608 PREFIX PREFIX COMPLETION DATE

K 372 | Continued From page 4 5:00 PM. | K 372 | |

K 000 INITIAL COMMENTS K 000 An unannounced Fire & Life Safety re-licensure survey was conducted on June 6, 2022 at Oak Hammock at The University of Florida Inc, 2660 SW 53rd Lane, state license: #130471032, a nursing home in Gainesville, Florida 32608, in accordance with National Fire Protection Association (NFPA) 1 and 101 (2018 edition) and applicable requirements of Florida State Fire Marshal's Rules and Regulations, Florida Administrative Code (F.A.C) 69A-3, F.A.C. 69A-53, F.A.C. 59A-4, and Florida Statutes (F.S.) 400 Part II, and F.S. 633.0215, adopting National Fire Protection Association (NFPA) 1 and 101 (2018 edition) known as the Florida Fire Prevention Code and all NFPA referenced standards and requirements adopted per NFPA 101, Chapter 2. Initial Plan Review: 2004 Addition: 2016 New or Existing: Existing NFPA 220 Construction Type: II (111) Footage: 41,175 Fully Sprinkled Generator: 1000 KW Number of beds: 73 Census: 59 The following is description of the deficiencies, found at the time of the visit:

K 324 NFPA 101 Cooking Facilities SS=F K 324 7/9/22 Cooking Facilities Cooking equipment is protected in accordance with NFPA 96, Standard for Ventilation Control and Fire Protection of Commercial Cooking Operations, unless: * residential cooking equipment (i.e., small appliances such as microwaves, hot plates, 35961003 06/06/2022 OAK HAMMOCK AT THE UNIVERSITY OF FLORIDA IN 2660 SW 53RD LN GAINESVILLE, FL 32608 PREFIX TAG ID PREFIX TAG DEFICIENCY) COMPLETE DATE

K 324 Continued From page 1 toasters) are used for food warming or limited cooking in accordance with 18.3.2.5.2, 19.3.2.5.2 * cooking facilities open to the corridor in smoke compartments with 30 or fewer patients comply with the conditions under 18.3.2.5.3, 19.3.2.5.3, or * cooking facilities in smoke compartments with 30 or fewer patients comply with conditions under 18.3.2.5.4, 19.3.2.5.4. Cooking facilities protected according to NFPA 96 per 9.2.3 are not required to be enclosed as hazardous areas, but shall not be open to the corridor. 18.3.2.5.1 through 18.3.2.5.4, 19.3.2.5.1 through 19.3.2.5.5, 9.2.3, TIA 12-2 This Statute or Rule is not met as evidenced by: Based on observation and staff interview, the facility failed to maintain and inspect kitchen hood system in the facility in accordance with LSC Sections. Failure to maintain cooking hood equipment endangers residents, staff, and other building occupants. The findings include: During the facility tour with the Maintenance Director on 6/6/22 from 2:00 PM to 5:00 PM, in the kitchen area, observed heavy grease build up on filters and fire suppression piping/nozzles, grease cup was full and large grease spill below the grease cup on the floor behind cooking equipment. Hoods, grease removal devices, fans, ducts, and other appurtenances shall be cleaned to remove combustible contaminants prior to surfaces becoming heavily contaminated with grease or oily sludge. During an interview with the Maintenance Director on 6/6/22 at 3:55 PM, she concurred with the

K 324

K000 Preparation and execution of this plan of correction does not constitute admission or agreement by the provider by the terms or conclusions set forth in the statement of deficiencies. This plan of correction is prepared and/or executed solely because it is required by provisions of the Federal and State laws.

K324 IMMEDIATE CORRECTIVE ACTION Vendor for hood cleaning was scheduled and service was completed. IDENTIFICATION OF RESIDENTS N/A SYSTEMATIC CHANGES Weekly Hood Filter Cleaning Checklist and Monthly Kitchen Equipment Inspection will be performed by Culinary Service Manager or designee. Hood STATE FORM notes C8KN21 COMPLETED 06/06/2022 GAINESVILLE, FL 32608 PREFIX PREFIX COMPLETE DATE

K 324 Continued From page 2 observation and confirmed the findings. NFPA 101 (2018 Edition) 19.3.2.5.1., 9.2.3. NFPA 96 (2017 Edition) 11.6.1., 11.6.1.1., 11.6.1.1.1., 11.6.2. These findings were verified by the Maintenance Director at the times of observations and the Administrator at the exit conference on 6/6/22 at 5:00 PM. Class III K 324 cleaning vendor will be scheduled monthly. MONITORING Culinary Service Manager will perform monthly audit on Hood Filter Cleaning and Kitchen Equipment Checklists for completion. The results and findings will be reviewed and discussed in the QAPI Committee Meeting. 7/9/22

K 372 NFPA 101 Subdivision of Building Spaces - SS=E Smoke Barrie Subdivision of Building Spaces - Smoke Barrier Construction K 372 2015 EXISTING Smoke barriers shall be constructed to a 1/2-hour fire resistance rating per 8.5. Smoke barriers shall be permitted to terminate at an atrium wall. Smoke dampers are not required in duct penetrations in fully ducted HVAC systems where an approved sprinkler system is installed for smoke compartments adjacent to the smoke barrier. 19.3.7.3, 8.6.7.1(1) Describe any mechanical smoke control system in REMARKS. 2015 NEW Smoke barriers shall be constructed to provide at least a one hour fire resistance rating and constructed in accordance with 8.5. Smoke barriers shall be permitted to terminate at an atrium wall. Smoke dampers are not required in duct penetrations of fully ducted HVAC systems. 35961003 06/06/2022 OAK HAMMOCK AT THE UNIVERSITY OF FLORIDA IN 2660 SW 53RD LN GAINESVILLE, FL 32608 | --- | --- | --- | --- | --- | | K 372 | Continued From page 3<br>18.3.7.3, 18.3.7.4, 18.3.7.5, 8.3<br>Describe any mechanical smoke control system in REMARKS.<br><br>This Statute or Rule is not met as evidenced by:<br>Based on observation and staff interview, the<br>facility failed to properly maintain the required<br>fire/smoke barriers penetrations, which have not<br>been fire-stopped or smoke-sealed for the<br>requirements of NFPA 101. This condition could<br>allow fire/smoke to travel from one smoke<br>compartment to other smoke compartments, thus<br>endangering occupants of the facility.<br><br>The findings include:<br><br>During the facility tour with the Maintenance<br>Director on 6/6/22 from 2:00 PM to 5:00 PM, it<br>was found that the smoke/fire walls were not<br>properly protected with the required firestopping<br>system in the following areas:<br><br>1) Communication/electrical room/next to kitchen<br>– observed penetration at end cap of conduit.<br>2) Communication/electrical room/adjacent from<br>room 1813 - observed penetration sealed with<br>steel wool material at end cap of conduit.<br><br>During an interview with the Maintenance Director<br>on 6/6/22 at 3:55 PM, she concurred with the<br>observation and confirmed the findings.<br><br>NFPA 101 (2018 Edition) 19.3.7.3, 8.5.6., 8.5.6.1.<br>thru 8.5.6.6.<br><br>These findings were verified by the Maintenance<br>Director at the times of observations and the<br>Administrator at the exit conference on 6/6/22 at<br>5:00 PM. | K 372 | IMMEDIATE CORRECTIVE ACTION<br>Penetrations observed in<br>Communication/Electrical Room near<br>kitchen and Communication/Electrical<br>Room adjacent room 1813 were sealed<br>per NFPA 101 requirements.<br><br>IDENTIFICATION OF RESIDENTS<br>All Communications/Electrical closets<br>have been checked for penetrations and<br>have been found to be in compliance.<br><br>SYSTEMATIC CHANGES<br>Maintenance Manager will perform<br>semi-annual penetration audit. I.T. will<br>notify Maintenance of all scheduled work<br>to be performed by outside vendors.<br><br>MONITORING<br>Maintenance Manager will perform<br>semi-annual penetration audit. The results<br>and findings will be reviewed and<br>discussed in the QAPI Committee<br>Meeting. | | | STATE FORM notes C8KN21 35961003 06/06/2022 OAK HAMMOCK AT THE UNIVERSITY OF FLORIDA IN 2660 SW 53RD LN GAINESVILLE, FL 32608 PREFIX TAG ID PREFIX TAG DEFICIENCY) COMPLETE DATE

K 372 Continued From page 4

K 372

K 711 SS=F NFPA 101 Evacuation and Relocation Plan

K 711 7/9/22 Evacuation and Relocation Plan There is a written plan for the protection of all patients and for their evacuation in the event of an emergency. Employees are periodically instructed and kept informed with their duties under the plan, and a copy of the plan is readily available with telephone operator or with security. The plan addresses the basic response required of staff per 18/19.7.2.1.2 and provides for all of fire safety plan components per 18/19.2.2, 18.7.1.1 through 18.7.1.8, 18.7.2.1.2, 18.7.2.2, 18.7.2.3, 19.7.1.1 through 19.7.1.8, 19.7.2.1.2, 19.7.2.2, 19.7.2.3 This Statute or Rule is not met as evidenced by: Based on record review and staff interview, the facility failed to maintain the fire plan approval in the facility in accordance with F.A.C. 59A-4.126 The findings include: During the record review with the Maintenance Director on 6/6/22 at 11:30 AM, the facility failed to produce documentation for fire plan approval from the local AHJ. The last approval date was not available. During an interview with the Maintenance Director on 6/6/22 at 11:35 AM, she concurred with the record review and confirmed the findings. F.A.C. 59A-4.126 These findings were verified by the Maintenance Director at the times of record review and the

K711 IMMEDIATE CORRECTIVE ACTION Documentation for Fire Plan Approval Letter has been obtained and placed in CEMP Binder. IDENTIFICATION OF RESIDENTS N/A SYSTEMATIC CHANGES Maintenance Manager will obtain Fire Plan Approval Letter upon completion of Annual Inspection by Gainesville Fire Rescue. MONITORING Maintenance Manager or designee will provide Fire Plan Approval Letter at QAPI Committee Meeting. STATE FORM notes C8KN21 35961003 06/06/2022 OAK HAMMOCK AT THE UNIVERSITY OF FLORIDA IN 2660 SW 53RD LN GAINESVILLE, FL 32608 PREFIX TAG ID PREFIX TAG DEFICIENCY) COMPLETE DATE

K 711 Continued From page 5 Administrator at the exit conference on 6/6/22 at 5:00 PM. Class III

K 711 STATE FORM notes C8KN21