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Community Care Facilities Licensing FACILITY INSPECTION REPORT HEALTH & SAFETY

CJOS-BLKT32

FACILITY NAME The Salvation Army Buchanan Lodge		SERVICE TYPES 130 Long Term Care	FACILITY LICENSE # 2501002
FACILITY ADDRESS 409 Blair Ave			FACILITY PHONE (604) 522-7033
CITY New Westminster	POSTAL CODE V3L 4A4		MANAGER Blake Armstrong

INSPECTION DATE January 29, 2020	ADDITIONAL INSP. DATE (multi-day) February 07, 2020		ADDITIONAL INSP. DATE (multi-day)		TIME SPENT (HRS.) 7.25
ARRIVAL 10:00 AM	DEPARTURE 11:30 AM	ARRIVAL 09:30 AM	DEPARTURE 03:15 PM	ARRIVAL	DEPARTURE
INSPECTION TYPE Routine					# OBSERVED IN CARE

Introduction

An unscheduled routine was conducted to assess compliance with the Community Care and Assisted Living Act (CCALA), the Residential Care Regulations (RCR) and the relevant Director of Licensing Standards of Practice (DLSP). Evidence for this report was based on the licensing officer’s observations, review of the facility records, and information provided by the facility staff at the time of inspection. This LO returned for a scheduled second day to complete the inspection and for the Director of Residential Care to be present. The following areas were reviewed: · Licensing · Hygiene and Communicable Disease Control · Physical Facility · Medication · Staffing · Nutrition and Food Services · Policies and Procedures · Program · Care and Supervision · Records and Reporting As part of this Routine Inspection a Facility Risk Assessment Tool is completed and a copy is provided. The Risk Assessment includes non-compliance identified during the routine inspection, and a 3 year ‘historical’ review of the facility’s compliance and operation. Visit the CCFL website at :http://www.gov.bc.ca/residentialcarefacility · Additional resources, and · Links to the Legislation (CCALA and RCR)

Contraventions

Previous Inspection - Contraventions observed on FIR #VDAN-B942S2 have been corrected.

Current Inspection - Items reviewed comply with the Act, regulations & standards of practice except for those noted on supplementary pages.

Observed Violations

RECORDS AND REPORTING: 39130 - RCR s.78(1)(a) - A licensee must keep, for each person in care, a record showing the following information: (a) name, sex, date of birth, medical insurance plan number and immunization status. Observation: Upon review of 6 person in care records, it was observed that the immunization status is not recorded. Discussion with facility staff indicates that records are maintained for flu vaccines and pneumovax, though not for immunization recommended by the province's immunization control program. Corrective Action(s): Ensure that a record of immunization status is maintained for all persons in care. Date to be Corrected: 14 Feb 2020

Comments

This LO met with numerous staff members who were able to speak to the practices that occur in each of their departments and to the monitoring systems in place that assist in maintaining compliance with the Residential Care Regulations. Thank you to staff for your assistance in completing this inspection.

Action Required by Licensee/Manager	Action Required by Licensing Staff
No action required	No action required

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