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: 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 Taken By Licensee:

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

To Be Corrected By: November 15, 2023

Observations: Licensing tested the hot water at five water sources accessible to persons in care. The water temperature at one sink was 56° Celsius. This represents an immediate risk to the health and safety of persons in care and must be corrected immediately. Full compliance will not be achieved until the plan has been implemented and completed.

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: evidence that the person has complied with the Province’s immunization and tuberculosis control programs.

Corrective Actions Required: Ensure that all staff files contain evidence that the person has complied with the Province's immunization and tuberculosis control programs.

Corrective Actions Taken By Licensee:

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

To Be Corrected By: January 15, 2024

Observations: Licensing audited 20 staff files; four files did not contain evidence that the person had complied with the Province's immunization and tuberculosis control programs.

Description: A licensee must ensure that the performance of each employee is reviewed both regularly and as directed by the medical health officer under subsection (2) to ensure that the employee continues to meet the requirements of this regulation,

Corrective Actions Required: Ensure that the performance of each employee is reviewed both regularly and as directed by medical health officer under subsection (2) to ensure that the employee demonstrates the competence required for the duties to which the employee is assigned.

Corrective Actions Taken By Licensee:

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

To Be Corrected By: January 15, 2024

Observations: Licensing audited 20 staff files. 7 staff files were missing bi-annual performance reviews as indicated in the facility policy.