| 9295 |
ALPINE VILLAGE RETIREMENT CENTER |
285190 |
706 JAMES STREET |
VERDIGRE |
NE |
68783 |
2013-03-28 |
323 |
E |
0 |
1 |
UVQR11 |
Licensure Reference Number: 175 NAC 12-006.184 Based on observations, record reviews, and staff interviews; the facility failed to secure potentially hazardous chemicals which had the potential of access for 13 (Residents 51, 5, 22, 13, 20, 28, 52, 26, 23, 12, 1, 67, and 68) out of 46 sampled residents identified as mobile, cognitively impaired and at risk for wandering. The facility had a total census of 46. Findings are: A. Observations during the initial facility tour conducted on 3/19/13 at 10:10 AM to 10:40 AM revealed an unlocked storage room labeled Oxygen Storage. Observation of the unlocked storage area revealed 2 unsecured cupboards containing 3 bottles of HBV Quat Disinfectant Cleaner, 1 bottle of Stain Blaster A Cleaner and a gallon container of Clorox Bleach. Observations of the Oxygen Storage room revealed the following: -On 3/20/13 at 9:35 AM, 12:55 PM and 2:45 PM the storage room was unlocked. Unsecured cupboards in the room contained 3 bottles of HBV Quat Disinfectant Cleaner, 1 bottle of Stain Blaster A Cleaner and a gallon container of Clorox Bleach. -On 3/21/13 at 7:44 AM the storage room was unsecured with 3 bottles of HBV Quat Disinfectant Cleaner, 1 bottle of Stain Blaster A Cleaner and a gallon bottle of Clorox Bleach stored in unlocked cupboards. During an interview on 3/21/13 from 8:05 AM to 5:20 AM, the Administrator confirmed the Oxygen Storage room was to be locked at all times and potentially hazardous chemicals should not have been left unsecured. B. Observations of the facility house-keeping cart revealed the following: -On 3/20/13 from 8:00 AM to 8:12 AM the housekeeping cart was observed unsupervised in the 300 wing corridor. The bottom shelf of the cart contained an aerosol container of Ocean Breeze Scent Air Freshener, one bottle of Stain Blaster A, one bottle of Humidifier Bacteriostatic Treatment and one bottle containing HBV Quat Disinfectant Cleaner. -On 3/21/13 from 7:39 AM to 7:54 AM and from 10:50 AM to 11:00 AM, the housekeeping cart was observed unsupervised in the 100 wing corridor. The bottom shelf of the cart contained an aerosol container of Ocean Breeze Scent Air Freshener, a bottle of Stain Blaster A, one bottle of Humidifier Bacteriostatic Treatment and a bottle of HBV Quat Disinfectant Cleaner. An interview with the Head Housekeeper on 3/21/13 from 11:05 AM to 11:10 AM revealed housekeeping staff were trained to keep the cart with them at all times and the carts were never to be left unattended in the hallways. During an interview on 3/21/13 from 11:10 AM to 11:20 AM, the Administrator verified housekeepers should not have left chemicals unsecured on their carts. Observations on 3/27/13 from 7:45 AM to 8:00 AM revealed the housekeeping cart unsupervised in the 300 wing corridor. The bottom shelf of the cart contained a bottle of Stain Blaster A, a bottle of Humidifier Bacteriostatic Treatment and a bottle of HBV Quat Disinfectant. During an interview on 3/27/13 at 9:00 AM, the Director of Nursing (DON) verified housekeepers should not have left chemicals unsecured on their carts. In addition, the DON identified Residents 51, 5, 22, 13, 20, 28, 67, 68, 52, 26, 23, 1 and 12 as mobile, cognitively impaired and at risk for wandering. C. Review of Medical Safety Data Sheets (MSDS) dated 6/4/1999 revealed the following; -HBV Quat Disinfection Cleaner; this product may cause upper respiratory tract, eye and skin irritation. If this product is swallowed it can lead to pain, vomiting, abdominal tenderness, and nausea, blood in vomitus and blood in feces. -Stain Blaster A; this product may cause respiratory tract, eye and skin irritation. In addition this product may cause an allergic skin reaction and asthmatic like reactions in sensitive individuals. -Clorox Bleach; this product is corrosive and harmful if swallowed. This product can cause severe irritation or damage to eyes, skin and mucous membranes. |
2016-09-01 |