Transcription of Plan of Correction - | doh
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Plan of Correction - | doh
DEPARTMENT OF HEALTH AND HUMAN SERVICESCENTERS FOR MEDICARE & MEDICAID SERVICESSTATEMENT OF DEFICIENCIESAND PLANOF CORRECTIONNAME OF PROVIDER OR SUPPLIERJEANNE JUGAN RESIDENCE(X4) IDPREFIXTAG09E020 SUMMARY STATEMENT OF DEFICIENCIES(EACH DEFICIENCY MUST BE PRECEDED BY FULLREGULATORY OR LSC IDENTIFYING INFORMATION)F 000 INITIALCOMMENTSAn annual recertification survey was conductedJanuary 11 through 12, 2007. The followingdeficiencies were based on record review,observation and interviews with facility staff. Thesample included 10 residents based on a censusof 39 residents on the first day of survey andthree (3) supplemental 253 i (h)(2) HOUSEKEEPING/MAINTENANCESS=DThe facility must provide housekeeping andmaintenance services necessary to maintain asanitary, orderly, and comfortable REQUIREMENT is not met as evidenced byBased on observations during the environmentaltour, it was determined that facility staff failed toprovide housekeeping and maintenance servicesto maintain a sanitary and comfortableenvironment as evidenced by: soiled/dusty bedframes, a mechanical lift, floors, carpets, exteriorwi
F 253 Continued From page 1 2. The foot pedals and handles of the mechanical lift were soiled with debris in the laundry rooms in three (3) of three (3) observations at 11:15 AM on the Good Shepherd unit and two (2) of two (2) observations on the Sacred Heart unit at 10:00 AM on January 12, 2007. 3. Floor and carpet surfaces were sticky, soiled
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