Description: A licensee must ensure that water accessible to a person in care, from any source, is not heated to more than 49° Celsius.

Corrective Actions Required:

Corrective Actions Taken By Licensee: Licensing audited six sinks in person in cares rooms. All six temperatures were in compliance.

Actions Required By Licensing: No further action required; this contravention has been addressed.

To Be Corrected By:

Observations:

Description: A licensee must ensure that all bathrooms have slip resistant material on the bottom of each bathtub and shower,

Corrective Actions Required:

Corrective Actions Taken By Licensee: Licensing observed a slip resistant mat on the second floor tub room.

Actions Required By Licensing: No further action required; this contravention has been addressed.

To Be Corrected By:

Observations:

Description: A licensee must ensure that all medications in the community care facility are safely and securely stored,

Corrective Actions Required:

Corrective Actions Taken By Licensee: Licensing audited three person in care's bedrooms and observed no medicated creams out.

Actions Required By Licensing: No further action required; this contravention has been addressed.

To Be Corrected By:

Observations:

Description: A licensee must not employ a person in a community care facility unless the licensee or, in the case of a person who is not the manager, the manager has obtained all of the following: a criminal record check for the person

Corrective Actions Required:

Corrective Actions Taken By Licensee: Licensing reviewed the employee file and observed a criminal record check.

Actions Required By Licensing: No further action required; this contravention has been addressed.

To Be Corrected By:

Observations:

Description: A licensee must ensure that all employees comply with the policies and procedures of the medication safety and advisory committee.

Corrective Actions Required:

Corrective Actions Taken By Licensee: Licensing audited eight person in care's Medication Administration Records between October 10 to 18, 2022. All records were signed or coded for.

Actions Required By Licensing: No further action required; this contravention has been addressed.

To Be Corrected By:

Observations:

Description: A licensee must require all persons admitted to a community care facility to comply with the Province’s immunization and tuberculosis control programs.

Corrective Actions Required:

Corrective Actions Taken By Licensee: Licensing reviewed the chart of one person in care, and observed a record for Tuberculosis control program.

Actions Required By Licensing: No further action required; this contravention has been addressed.

To Be Corrected By:

Observations:

Description: A care plan must include all of the following: a recreation and leisure plan

Corrective Actions Required:

Corrective Actions Taken By Licensee: Licensing reviewed a person in care's care plan and observed a recreation and leisure plan.

Actions Required By Licensing: No further action required; this contravention has been addressed.

To Be Corrected By:

Observations:

Description: A licensee must operate the community care facility in a manner that will promote the health, safety and dignity of persons in care

Corrective Actions Required: Ensure that the community care facility is operated in a manner that will promote the health, safety, and dignity of all persons in care.

Corrective Actions Taken By Licensee:

Actions Required By Licensing: Follow Up Inspection to be conducted.

To Be Corrected By: September 29, 2022

Observations: Licensing toured the facility. On the second floor the cupboard near the dining room containing cleaning agents and disinfectants was unlocked and accessible to person in care. One the second floor tub room cleaning agents and disinfectants were left beside the tub and on a shelf.