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Community Care Facilities Licensing
FACILITY INSPECTION REPORT
HEALTH & SAFETY
AKUR-BLKVAJ

FACILITY NAME
River Road Residence
SERVICE TYPES
140 Community Living
FACILITY LICENSE #
1081406
FACILITY ADDRESS
20972 River Rd
FACILITY PHONE
(604) 466-0457
CITY
Maple Ridge
POSTAL CODE
V2X 1Z9
MANAGER
Mary Grace Oba

INSPECTION DATE
February 07, 2020
ADDITIONAL INSP. DATE (multi-day)
ADDITIONAL INSP. DATE (multi-day)
TIME SPENT (HRS.)
2.5
ARRIVAL
01:00 PM
DEPARTURE
03:30 PM
ARRIVAL
DEPARTURE
ARRIVAL
DEPARTURE
INSPECTION TYPE
Routine
# OBSERVED IN CARE

Introduction

An unscheduled routine inspection 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 (DOLSOP). 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.

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 w ww.fraserhealth.ca/residentialcare for:
· Additional resources, and
· Links to the Legislation (CCALA and RCR)

Contraventions
Previous Inspection - Contraventions observed on FIR # have been corrected.
Current Inspection - Items reviewed comply with the Act, regulations & standards of practice except for those noted on supplementary pages.

Observed Violations
PHYSICAL FACILITY, EQUIPMENT AND FURNISHINGS: 31300 - RCR s.22(1)(c) - A licensee must ensure that all rooms and common areas are (c) maintained in a safe and clean condition.
Observation: Inspection of the kitchen fridge determined thick layer of dust present on top of the fridge.
Corrective Action(s): Please ensure that common fridge is maintained in a safe and clean condition.
Date to be Corrected: February 28, 2020

POLICIES AND PROCEDURES: 33170 - RCR s.74(1)(b)(i) - Subject to subsection (2), a licensee may restrain a person in care (b) if there is agreement to the use of a restraint given in writing by both (i) the person in care, the parent or representative of the person in care or the relative who is closest to and actively involved in the life of the person in care.
Observation: Restraints are used for preventative measures to ensure PIC’s safety. No PIC consents were on file.
Corrective Action(s): Please ensure that the agreement(s) for the use of restraint is signed by the PIC or the relative who is closest to and involved in the life of the person in care
Date to be Corrected: February 28, 2020

POLICIES AND PROCEDURES: 33180 - RCR s.74(1)(b)(ii) - Subject to subsection (2), a licensee may restrain a person in care (b) if there is agreement to the use of a restraint given in writing by both (ii) the medical practitioner or nurse practitioner responsible for the health of the person in care.
Observation: No Physician or Nurse practitioner approval is in place for the restraints.
Corrective Action(s): Please ensure that for PIC’s who need on-going restraint have the agreement for the use of restraint signed by the medical practitioner or nurse practitioner responsible for the health of the person in care
Date to be Corrected: February 28, 2020

HYGIENE AND COMMUNICABLE DISEASE: 35030 - RCR s.54(1) - A licensee must establish a program to instruct, if necessary, and assist persons in care in maintaining health and hygiene.
Observation: Inspection of the tub/spa rooms determined that personal items were being left in the tub/spa rooms and were not labelled with individual person in care (PIC) names. Inspection of shared rooms determined that personal items were not labelled and were not being separated in the shared bathroom.
Corrective Action(s): Ensure that personal toiletries are labelled and separated with individual PIC's names.
Date to be Corrected: February 28, 2020


Comments

The Licensing Officer (LO) would like to thank the Manager and staff for their time and assistance in completing this routine inspection. The manager was made aware of the facility's Reportable Incident Policy needed to be revised to reflect Online RIFs as per CCFL from January 1st, 2020. The Manager informed LO that the head office was looking into this policy changes.

This report was reviewed and discussed with manager and senior staff. A copy of this report was left at the facility.

Please contact your Licensing Officer if you have any questions or concerns regarding this inspection report.

Action Required by Licensee/ManagerAction Required by Licensing Staff
Take corrective action to bring facility into compliance, Provide a written response to LicensingNo action required
Due Date
Feb 21, 2020

Click here for FAQ About Inspections.
Click here for a description of each "Category" of violation displayed.