cms_GA: 163
Data source: Big Local News · About: big-local-datasette
| rowid | facility_name | facility_id | address | city | state | zip | inspection_date | deficiency_tag | scope_severity | complaint | standard | eventid | inspection_text | filedate |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 163 | HABERSHAM HOME | 115099 | HIGHWAY 441 NORTH, BOX 37 | DEMOREST | GA | 30535 | 2017-05-18 | 323 | E | 1 | 1 | KH1211 | > Based on observation, record review and staff interview, the facility failed to keep potentially harmful chemicals in a secured area on two of four halls on two of two units (East and West units). There were 18 residents on the West unit and 17 residents on the East unit that were independently mobile and had severe cognitive impairment. The facility census in both buildings was 83 residents. Findings include: During initial tour of the facility in the East unit building on 5/15/17 at 9:45 a.m., the following observation was made in the unlocked Storage room across from room 123: On a shelf just inside the door were three 3-liter jugs with screw-on tops, low enough to be accessible by a resident in a wheelchair, with labeling that included: Cen-Kleen IV One-Step Disinfectant-Cleaner-Fungicide-Mildew Stat-Virucide. Danger. This observation was verified during interview with Licensed Practical Nurse (LPN) Supervisor LL on 5/15/17 at 9:53 a.m., who stated they normally kept chemicals locked up, and that these chemicals were used to clean the whirlpool tub. Observation at this time revealed that there were seven residents in the hall where this Storage closet was located, and LPN LL stated that six of them were independently mobile. During initial tour of the facility in the West unit building on 5/15/17 beginning at 10:11 a.m., an unlocked Custodian Closet was observed across from room 410. Further observation revealed the following chemicals inside that had TwistNFill caps unless noted otherwise: 1. One 1-gallon jug of DMQ Damp Mop Neutral Disinfectant Cleaner that had a measuring cup on the top and a screw-on lid on the floor in this closet. The jug was approximately 1/3 full, and the labeling included Danger. 2. Two 2-liter jugs of Heavy Duty Multi-Surface Cleaner Concentrate on a shelf; one jug was full and one jug was approximately 1/3 full. 3. Three 2-liter jugs of Non-Acid Disinfectant Bathroom Cleaner Concentrate on a shelf. One jug was approximately 1/2 full, and two jugs were full. The jug labeling included Danger. 4. One full 2-liter jug of Glass Cleaner Concentrate on a shelf. The above observation of unlocked chemicals was verified by the Administrator on 5/15/17 at 10:28 a.m., who stated that the closet was supposed to be kept locked. Review of a Resident Responses Analyzer report compiled by the East wing MDS (Minimum Data Set) Coordinator that listed residents with a Brief Interview for Mental Status (BIMS) score of less than 8 (a score of 0 to 7 indicates severe cognitive impairment) on their most recent MDS assessment, and who were independently mobile, revealed the following: West unit: 300-hall: 9 residents met this criteria 400-hall: 9 residents met this criteria East unit: First hall: 8 residents met this criteria Dining room hall: 9 residents met this criteria Review of Safety Data Sheets for the above chemicals revealed: Cen-Kleen IV: If on skin or hair, remove immediately all contaminated clothing, rinse skin with water. Wash contaminated clothes before reuse. If in eyes, rinse cautiously with water for several minutes. If swallowed, do NOT induce vomiting. Causes serious eye irritation. Causes skin irritation. DMQ Damp Mop Neutral Disinfectant Cleaner: Causes skin irritation and causes serious eye damage. Corrosive. Harmful if swallowed. Inhalation of vapors or mist may cause respiratory irritation. If in eyes, IMMEDIATELY CALL A POISON CENTER OR PHYSICIAN. 3M Glass Cleaner Concentrate: Serious eye damage/irritation. Non-Acid Disinfectant Bathroom Cleaner Concentrate: Acute toxicity (oral); serious eye damage/irritation; skin corrosion/irritation. Harmful if swallowed. Causes serious eye damage. Causes severe skin burns and eye damage. Heavy Duty Multi-Surface Cleaner Concentrate: Causes serious eye damage. Causes skin irritation. (MONTH) cause an allergic skin reaction. For skin contact, immediately wash with soap and water. Remove contaminated clothing and wash before reuse. For eye contact, immediately flush with large amounts of water for at least 15 minutes. Immediately get medical attention. | 2020-09-01 |