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Community Care Facilities Licensing
FACILITY INSPECTION REPORT
HEALTH & SAFETY
EJON-BHNTAZ

FACILITY NAME
Cabeldu
SERVICE TYPES
140 Community Living
FACILITY LICENSE #
0901267
FACILITY ADDRESS
6473 Cabeldu Cres
FACILITY PHONE
(604) 590-4988
CITY
Delta
POSTAL CODE
V4E 1R2
MANAGER
Wynn Konishi

INSPECTION DATE
November 01, 2019
ADDITIONAL INSP. DATE (multi-day)
November 06, 2019
ADDITIONAL INSP. DATE (multi-day)
TIME SPENT (HRS.)
3.5
ARRIVAL
10:30 AM
DEPARTURE
11:00 AM
ARRIVAL
11:30 AM
DEPARTURE
02:00 PM
ARRIVAL
DEPARTURE
INSPECTION TYPE
Routine
# OBSERVED IN CARE

Introduction

This is a routine inspection conducted with the Manager to assess compliance with the Community Care and Assisted Living Act (C.C.A.L.A.), the Residential Care Regulation (R.C.R.) and the relevant Director of Licensing Standards of Practice (D.L.S.P.). 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 the inspection.

The following areas were reviewed:

- Licensing
- Physical Facility
- Staffing
- Policies and Procedures
- Care and Supervision
- Hygiene and Communicable Disease Control
- Medication
- Nutrition and Food Services
- Program
- 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 Community Care Facilities Licensing website at https://www.fraserhealth.ca/health-topics-a-to-z/long-term-care-licensing#.XUHwhWyos2z for:

- Additional resources, and
- Links to the legislation (C.C.A.L.A. and R.C.R.).

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: 31290 - RCR s.22(1)(b) - A licensee must ensure that all rooms and common areas are (b) maintained in a good state of repair.
Observation: In one person in care's bedroom, the face plate for an electrical outlet was missing.
Corrective Action(s): Please ensure that a face plate is installed over the electrical outlet.
Date to be Corrected: November 8, 2019


Comments

The following was recommended:
- It was explained that the Medication Safety and Advisory Committee is required to review the medication policies, the medication training program, and any medication errors that have occurred. It was recommended that these 3 areas be included in the meeting minutes to ensure the review is taking place regularly.

This LO would like to thank the manager and staff for their assistance in completing this routine inspection.

This report was reviewed and discussed with the Manager.

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
Nov 08, 2019

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