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Community Care Facilities Licensing
FACILITY INSPECTION REPORT
HEALTH & SAFETY
KBEL-D2NRJD

FACILITY NAME
Cascades Community & Retirement Living, The
SERVICE TYPES
110 Hospice
130 Long Term Care
FACILITY LICENSE #
TBIU-9KSNHS
FACILITY ADDRESS
45586 McIntosh Dr
FACILITY PHONE
(604) 795-2500
CITY
Chilliwack
POSTAL CODE
V2P 7W8
MANAGER
Patricia Giesbrecht

INSPECTION DATE
February 21, 2024
ADDITIONAL INSP. DATE (multi-day)
ADDITIONAL INSP. DATE (multi-day)
TIME SPENT (HRS.)
3.5
ARRIVAL
09:00 AM
DEPARTURE
12:30 PM
ARRIVAL
DEPARTURE
ARRIVAL
DEPARTURE
INSPECTION TYPE
Routine
# OBSERVED IN CARE

Introduction

An unscheduled routine inspection was completed to assess compliance with the Community Care and Assisted Living Act (CCALA) and the Residential Care Regulation (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.

Care systems reviewed during inspections include the following: Licensing, Physical Facility, Staffing , Policies and Procedures, Care and Supervision. Hygiene and Communicable Disease Control Medication, Nutrition and Food Services, Program, Records & Reporting.

As part of the routine inspection a Facility Risk Assessment Tool is completed and a copy of 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 www.fraserhealth.ca/residentialcare for additional resources and links to the legislation (CCALA & RCR)

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

Observed Violations
STAFFING: 32320 - RCR s.68(4) - A licensee must ensure that all employees comply with the policies and procedures of the medication safety and advisory committee.
Observation: Three medications belonging to two persons in care were located in their rooms, however the facility policy requires these medications be secured in the medication storage areas.
Corrective Action(s): This was corrected during the inspection by staff.
Date to be Corrected:


Comments


Action Required by Licensee/ManagerAction Required by Licensing Staff
No action requiredNo action required

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