Island Health
1952 Bay Street Victoria, B.C. V8R 1J8 | Visit Official Website (opens in a new tab)
1952 Bay Street Victoria, B.C. V8R 1J8 | Visit Official Website (opens in a new tab)
Follow-Up
August 8, 2022
Contraventions:
A summary of the new or corrected contraventions found during the inspections are listed below.Code
Category/Description
3000 - RCR 22(1)(b)
Description: A licensee must ensure that all rooms and common areas are maintained in a good state of repair
Corrective Actions Required:
Corrective Actions Taken By Licensee:
Actions Required By Licensing: Follow Up Inspection to be conducted.
To Be Corrected By:
Observations: This contravention was carried over from the last Routine Inspection dated November 4, 2021. Manager stated that they have a construction staff installing wall boards to prevent continual wear and tear on the walls and to cover up the existing worn walls.
3010 - RCR 37(1)(e)
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:
Corrective Actions Taken By Licensee:
Actions Required By Licensing: Follow Up Inspection to be conducted.
To Be Corrected By:
Observations: This contravention was carried over from the last Routine Inspection dated November 4, 2021. Licensing reviewed forty staff files and fifteen files did not have record of immunization and nine files did not have TB test result.
3010 - RCR 40(1)(a)
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:
Corrective Actions Taken By Licensee:
Actions Required By Licensing: Follow Up Inspection to be conducted.
To Be Corrected By:
Observations: Licensing reviewed forty staff files and sixteen staff did not have regular performance reviews to ensure that staff continue to meet the requirements of this regulation
3060 - CCALA 7 (1)(b)(i)
Description: A Licensee must do all of the following: operate the community care facility in a manner that will promote the health, safety and dignity of persons in care.
Corrective Actions Required:
Corrective Actions Taken By Licensee:
Actions Required By Licensing: Follow Up Inspection to be conducted.
To Be Corrected By:
Observations: This contravention was carried over from the last Routine Inspection dated November 4, 2021. Licensing observed the utility doors on 3rd floor unlocked. Manager stated they were working on a proposal to have a caddy to carry all soil laundry to the utility room to avoid having the door unlocked.
3080 - RCR 69(3)(a)
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 reviewed medications and medications were safely and securely stored .
Actions Required By Licensing: No further action required; this contravention has been addressed.
To Be Corrected By:
Observations: