POLICIES AND PROCEDURES: 33230 - RCR s.85(1)(b) - A licensee must do all of the following: (b) review and, if necessary, revise the policies and procedures at least once each year.
Observation: Policies and procedures were observed to have been last reviewed in 2015.
Corrective Action(s): Please provide a plan that will ensure that appropriate review and if necessary revision of P&P takes place.
Date to be Corrected: Feb. 26, 2019
POLICIES AND PROCEDURES: 33280 - RCR s.85(1)(d) - A licensee must do all of the following: (d) ensure that policies are implemented by employees.
Observation: The administration of PRN medications was not documented with the "results" of the administration of medication repeatedly. This was of particular note for application of topical skin medications. The P&P for medication administration requires documentation of results of the administration. This is a repeat contravention from the March 2015 and Dec. 2017 inspections.
Corrective Action(s): Please provide a plan that will ensure that there is appropriate documentation of results of PRN administration as per policy
Date to be Corrected: Feb. 26, 2019
HYGIENE AND COMMUNICABLE DISEASE: 35020 - RCR s.49(1) - A licensee must require all persons admitted to a community care facility to comply with the Province's immunization and tuberculosis control programs.
Observation: No status of immunization consistent with the BC Program for Immunization was found for one PIC. This is a repeat contravention for Dec. 2017 inspection.
Corrective Action(s): Please ensure that this documentation is present for all PIC's admitted to this facility
Date to be Corrected: Feb. 26, 2019
NUTRITION AND FOOD SERVICES: 37210 - RCR s.67(1)(a) - A licensee must provide each person in care with (a) nutrition supplements required by the person in care's nutrition plan or ordered by the person in care's medical practitioner or nurse practitioner.
Observation: The approved meal supplement being used by one resident, ordered by a doctor was identified as being paid for by the resident.
Corrective Action(s): Please provide a plan that will ensure that as per the regulation above, the supplement is provided at no cost to the resident.
Date to be Corrected: Feb. 26, 2019
RECORDS AND REPORTING: 39290 - RCR s.80(1) - On admitting a person in care to a community care facility, a licensee must ensure that a short term care plan is developed that will guide caregivers in protecting and promoting the health and safety of the person in care.
Observation: There is a person in care (PIC) who comes to the facility on a regular basis every 2 weeks for 2-3 days for respite. There was no care plan for this resident.
Corrective Action(s): Please provide a plan that will ensure that a care plan appropriate for this PIC is developed and maintained.
Date to be Corrected: Feb. 26,2019
RECORDS AND REPORTING: 39470 - RCR s.87(c) - A licensee must keep a record of the following matters respecting food services: (c) the results of monitoring, by the licensee, of food services and nutrition care.
Observation: Food service audits were last identified in 2017
Corrective Action(s): Please ensure that there is a plan to complete regular food service and nutrition care audits.
Date to be Corrected: Feb. 26, 2019
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