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Community Care Facilities Licensing
FACILITY INSPECTION REPORT
HEALTH & SAFETY
NBIH-AY6QRA
FACILITY NAME
Lakeshore Care Centre		SERVICE TYPES
401 Long Term Care (Hospital Act)
FACILITY LICENSE #
LBAA-95YTUM
FACILITY ADDRESS
657 Gatensbury St		FACILITY PHONE
(604) 939-9277
CITY
Coquitlam		POSTAL CODE
V3J 5G9		MANAGER
Annie Kinamore
INSPECTION DATE
April 25, 2018		ADDITIONAL INSP. DATE (multi-day)
ADDITIONAL INSP. DATE (multi-day)
TIME SPENT (HRS.)
10
ARRIVAL
09:30 AM		DEPARTURE
01:00 PM		ARRIVAL
DEPARTURE
ARRIVAL
DEPARTURE
INSPECTION TYPE
Routine		# CHILDREN ENROLLED
Introduction

An unscheduled routine inspection was conducted to assess compliance with the Community Care & Assisted Living Act (CCALA), the Residential Care Regulation (RCR) and the relevant Director of Licensing Standards of Practice (DOLSP). 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
· Physical Facility
· Staffing
· Polices & Procedures
· Care & Supervision
· Hygiene and Communicable Disease Control
· Medication
· Nutrition and Food Services
· Program
· Records and Reporting
As part of the 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 www.fraserhealth.ca/residentialcare for:
· Additional resources and
Links to the Legislation (CCALA & RCR)
Contraventions
Previous Inspection - Contraventions observed on FIR #LCC-005 (2017 RCS inspection) 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: 39430 - RCR s.86(c) - A licensee must keep the following records in respect of each employee: (c) compliance with the Province's immunization and tuberculosis control programs.
Observation: A review of 6 staffing files found one with no record of compliance with the Province's immunization and tuberculosis control program.
Corrective Action(s): Please ensure, that for all staff, a record is kept showing compliance with the Province's immunization and tuberculosis control program.
Date to be Corrected: May 31 2018
Comments
Action Required by Licensee/ManagerAction Required by Licensing Staff
No action requiredNo action required
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Click here for a description of each "Category" of violation displayed.