| Waverly Seniors Village - Complaint Information |
| General Details | |
|---|---|
| Facility Type | Adult Residential Care - 100 |
| Investigation Completed | November 28, 2019 |
| Reason for Investigation | - Staffing - Policies and procedures - Care and supervision - Program |
| Report of Findings |
|---|
| Licensing received a complaint on September 17th, 2019 regarding care and supervision, staffing, and program. The following details were provided: - inadequate care being provided to persons in care - inadequate staffing levels for number of persons in care - inadequate staff qualifications - lack of recreation therapy program - lack of care conferences All areas of the complaint were fully investigated. Evidence was collection though facility records, Residential Contracts and Services, and emails. Licensing determined that following contraventions: - Residential Care Regulation (RCR) Section 37(1)(a) Character and skill requirements - RCR 40(1)(a) Continuing monitoring of employees - RCR 42(1)(a) Staffing coverage - RCR 45(a) Employee responsible for activities - RCR 55(1)(a)(i) Program of activities - RCR 81(4)(a) Care plan needed if more than 30 day stay - RCR 85(1)(d) Policies and procedures |
| Substantiated Contraventions: Evidence for this summary report is based on a combination of the Licensing Officer’s observations, a review of facility records and information provided by the facility staff at the time of the investigation. |
| Observed Violations/Contraventions: A summary of the violations found during the complaint investigation are listed below. |
| Code | Category/Description |
|---|---|
| 32010 - RCR s.37(1)(a) | A licensee must not employ a person in a community care facility unless the licensee or, in the case of a person who is not the manager, the manager has obtained all of the following: (a) a criminal record check for the person. Observation: Licensing determined that not all staff have criminal record checks. Corrective action: A corrective action plan is required. |
| 32100 - RCR s.40(1)(a) | A licensee must ensure that the performance of each employee is reviewed both regularly and as directed by the medical health officer under subsection (2) to ensure that the employee (a) continues to meet the requirements of this regulation. Observation: Licensing determined that staff have not received regular performance reviews. Corrective action: A corrective action plan is required. |
| 32170 - RCR s.42(1)(a) | A licensee must ensure that, at all times, the employees on duty are sufficient in numbers, training and experience, and organized in an appropriate staffing pattern, to (a) meet the needs of the persons in care. Observation: Licensing determined that the facility has been short-staffed for multiple positions.. Corrective action: A corrective action plan is to be submitted. |
| 32280 - RCR s.45(a) | A licensee, other than a licensee who provides a type of care described as Hospice, must (a) designate an employee, qualified by training or experience, to organize and supervise physical, social and recreational activities for persons in care. Observation: Licensing determined that the facility has no activity coordinator. Corrective action: A corrective action plan is to be submitted. |
| 33280 - RCR s.85(1)(d) | A licensee must do all of the following: (d) ensure that policies are implemented by employees. Observation: Licensing determined that staff are not implementing the facility’s policy for lift transfers. Corrective action: A corrective action plan is to be submitted. |
| 34740 - RCR s.81(4)(a) | A licensee must ensure that (a) the implementation of each care plan is monitored on a regular basis to ensure proper implementation. Observation: Licensing determined that 2 PICs did not receive part of the care outlined in their care plan. Corrective action: A corrective action plan is to be submitted. |
| 38010 - RCR s.55(1)(a)(i) | A licensee, other than a licensee who provides a type of care described as Hospice, must (a) provide persons in care, without charge, with an ongoing planned program of physical, social and recreational activities (i) suitable to the needs of the persons in care. Observation: Licensing determined that there have not been ongoing activities provided to meet the needs of PICs. Corrective action: A corrective action plan is to be submitted. |
| Actions Required by Licensee/Operator | |
|---|---|
| - Corrective action plan to be developed and submitted. |
| Action Required by Licensing Officer or Medical Health Officer | |
|---|---|
| - No further action required. All contraventions have been addressed. |
| Status Update |
|---|
| No further action required. All contraventions have been addressed. |
| Updated on November 28, 2019. |
