Health inspection·December 7, 2023

F 0921 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Many Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public. Based on observation and staff interview, the facility failed to maintain a clean, safe, sanitary and well-maintained environment in resident common areas and resident rooms. This had the potential to affect all 115 residents living in the facility. Findings include: Interview was conducted on 12/04/23 at 12:30 P.M. with the Director of Environmental Services (DES) #422 who revealed the housekeeping staff were to make sure all floors in the resident common areas and resident rooms were kept clean. DES #422 explained the floor scrubber was broke so the staff were to use whatever equipment they had to keep the floors clean. Observations of the general facility environment and resident rooms were conducted on 12/05/23 from 12:00 P.M. and 12:25 P.M. with the Director of Maintenance (DM) #359 and revealed carpeted areas in resident rooms and common areas throughout the facility were covered in stains and/or various debris indicating the carpet was not being maintained in a clean manner. In addition, the following findings were observed: • Resident #52's bathroom door had a wire clothing hanger bent in half and stuck into the door in place of a functional door handle. The only way to open the door to the bathroom was to grab the bent, wire hanger. • Observation of the common area on the second floor revealed dried food and food crumbs on the table by the common area computer for resident use. The table lamp was unplugged and the electrical cord was laying on the open ground where the plug prongs were exposed to the environment and any traffic near the lamp. • Observation of the bottom of the door going into Resident #91's room and facing into the hallway revealed a moderate build up of brown, dried stains looking like dried on coffee stains. • Page 1 of 2 366079 366079 12/07/2023 Eliza Jennings Home 10603 Detroit Avenue Cleveland, OH 44102

F 0921 Observation of Resident #108's room revealed broken, missing window blinds. Level of Harm - Minimal harm or potential for actual harm • Residents Affected - Many Observation of Resident #101's room revealed a beside dresser drawer had a metal staple plate affixed onto it and an old, hinged metal hasp (parts used with a pad lock) approximately three to four inches long was sticking straight out posing risk for injury by the metal hasp. There was no pad lock in use on the drawer so the metal hasp with just sticking out at a 90 degree angle from the drawer. DM#359 verified the above findings at the time of the observations on 12/05/23 from 12:00 P.M. to 12:25 P.M. Review of the facility policy titled Safe Environment, revised 11/28/16, revealed the facility would provide a safe, functional, sanitary, and comfortable environment for residents, staff and the public. This deficiency represents non-compliance investigated under Complaint Number OH00148425 and continued noncompliance from the survey dated 11/16/23. 366079 Page 2 of 2