Nursing Investigation Results -

Pennsylvania Department of Health
HARRISON SENIOR LIVING OF CHRISTIANA
Building Inspection Results

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HARRISON SENIOR LIVING OF CHRISTIANA
Inspection Results For:

There are  39 surveys for this facility. Please select a date to view the survey results.

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HARRISON SENIOR LIVING OF CHRISTIANA - Inspection Results Scope of Citation
Number of Residents Affected
By Deficient Practice
Initial comments:Name: - Component: -- - Tag: 0000


Based on an Emergency Preparedness Survey completed on February 14, 2019, at Harrison Senior Living of Christiana, it was determined there were no deficiencies identified with the requirements of 42 CFR 483.73.


 Plan of Correction:


Initial comments:Name: 'A' BLDG - Component: 01 - Tag: 0000


Facility ID# 080502
Component 01
"Arbor" Building

Based on a Medicare/Medicaid Recertification Survey completed on February 14, 2019, it was determined that Harrison Senior Living of Christiana was not in compliance with the following requirements of the Life Safety Code for an existing health care occupancy. Compliance with the National Fire Protection Association's Life Safety Code is required by 42 CFR 483.90(a).

This is a two-story, Type V (000), unprotected wood frame structure, with a basement, which is fully sprinklered.



 Plan of Correction:


NFPA 101 STANDARD Building Construction Type and Height:Least serious deficiency but was found to be widespread throughout the facility and/or has the potential to affect a large portion or all the residents. This deficiency has the potential for causing no more than a minor negative impact on the resident.
Building Construction Type and Height
2012 EXISTING
Building construction type and stories meets Table 19.1.6.1, unless otherwise permitted by 19.1.6.2 through 19.1.6.7
19.1.6.4, 19.1.6.5

Construction Type
1 I (442), I (332), II (222) Any number of stories
non-sprinklered and sprinklered

2 II (111) One story non-sprinklered
Maximum 3 stories sprinklered

3 II (000) Not allowed non-sprinklered
4 III (211) Maximum 2 stories sprinklered
5 IV (2HH)
6 V (111)

7 III (200) Not allowed non-sprinklered
8 V (000) Maximum 1 story sprinklered
Sprinklered stories must be sprinklered throughout by an approved, supervised automatic system in accordance with section 9.7. (See 19.3.5)
Give a brief description, in REMARKS, of the construction, the number of stories, including basements, floors on which patients are located, location of smoke or fire barriers and dates of approval. Complete sketch or attach small floor plan of the building as appropriate.
Observations:
Name: 'A' BLDG - Component: 01 - Tag: 0161

Based on observation and interview, it was determined the facility failed to maintain building construction requirements, affecting the entire component.

Findings include:

1. Observation on February 14, 2019, at 1:00 PM revealed the building is a two-story, unprotected wood frame structure, with a basement, which is fully sprinklered. The building exceeds the maximum allowable story height for this type of construction.

Interview at the time of the exit conference with the Maintenance Director and Interim Administrator on February 14, 2019, at 2:00 PM confirmed the construction type is not allowed in health care.



 Plan of Correction - To be completed: 04/30/2019

K-0161- The building is a two-story unprotected wood frame structure, the facility requests FSES be conducted for building A.
NFPA 101 STANDARD Number of Exits - Story and Compartment:Least serious deficiency but was found to be widespread throughout the facility and/or has the potential to affect a large portion or all the residents. This deficiency has the potential for causing no more than a minor negative impact on the resident.
Number of Exits - Story and Compartment
Not less than two exits, remote from each other, and accessible from every part of every story are provided for each story. Each smoke compartment shall likewise be provided with two distinct egress paths to exits that do not require the entry into the same adjacent smoke compartment.
18.2.4.1-18.2.4.4, 19.2.4.1-19.2.4.4
Observations:
Name: 'A' BLDG - Component: 01 - Tag: 0241

Based on observation and interview, it was determined the facility failed to provide at least two exits, remote from each other, on each floor or fire section, affecting two of three floors within the component.

Findings include:

1. Observation on February 14, 2019, between 1:45 PM and 2:00 PM revealed the facility lacked two acceptable means of egress, from the 2nd floor and the basement.

Interview at the time of the exit conference with the Maintenance Director and Interim Administrator on February 14, 2019, at 2:00 PM confirmed the facility failed to provide two exits, remote from each other, from each story.



 Plan of Correction - To be completed: 04/30/2019

K-0241- The A building basement and second floor do lack two acceptable means of egress, the facility requests that a FSES be conducted for A building
NFPA 101 STANDARD Vertical Openings - Enclosure:Least serious deficiency but was found to be widespread throughout the facility and/or has the potential to affect a large portion or all the residents. This deficiency has the potential for causing no more than a minor negative impact on the resident.
Vertical Openings - Enclosure
2012 EXISTING
Stairways, elevator shafts, light and ventilation shafts, chutes, and other vertical openings between floors are enclosed with construction having a fire resistance rating of at least 1 hour. An atrium may be used in accordance with 8.6.
19.3.1.1 through 19.3.1.6
If all vertical openings are properly enclosed with construction providing at least a 2-hour fire resistance rating, also check this
box.
Observations:
Name: 'A' BLDG - Component: 01 - Tag: 0311

Based on observation and interview, it was determined the facility failed to maintain the rating of vertical openings between floors, affecting one of three floors within the component.

Findings include:

1. Observation on February 14, 2019, at 1:40 PM revealed the attic door, located in the Administration Area, lacked a label indicating the fire resistance rating.

Interview at the time of the exit conference with the Maintenance Director and Interim Administrator on February 14, 2019, at 2:00 PM confirmed the attic door lacked a fire rating label.



 Plan of Correction - To be completed: 04/30/2019

K-0311- The attic door from the Administration area does lack a label indication proper fire resistance. The facility requests FSES be conducted for A building.
NFPA 101 STANDARD Sprinkler System - Maintenance and Testing:This is a less serious (but not lowest level) deficiency and affects more than a limited number of residents, staff, or occurrences. This deficiency is one that results in minimal discomfort to the resident or has the potential (not yet realized) to negatively affect the resident's ability to achieve his/her highest functional status. This deficiency was not found to be throughout this facility.
Sprinkler System - Maintenance and Testing
Automatic sprinkler and standpipe systems are inspected, tested, and maintained in accordance with NFPA 25, Standard for the Inspection, Testing, and Maintaining of Water-based Fire Protection Systems. Records of system design, maintenance, inspection and testing are maintained in a secure location and readily available.
a) Date sprinkler system last checked _____________________
b) Who provided system test ____________________________
c) Water system supply source __________________________
Provide in REMARKS information on coverage for any non-required or partial automatic sprinkler system.
9.7.5, 9.7.7, 9.7.8, and NFPA 25
Observations:
Name: 'A' BLDG - Component: 01 - Tag: 0353

Based on observation and interview, it was determined the facility failed to maintain sprinkler heads to be free of obstruction, in one of two smoke zones within the component.

Findings include:

1. Observation on February 14, 2019, at 12:45 PM revealed paintings were stored within eighteen inches of the sprinkler head, in the Storage Closet under the stairs, in the living room.

Interview at the time of the exit conference with the Maintenance Director and Interim Administrator on February 14, 2019, at 2:00 PM confirmed there was storage within eighteen inches of the sprinkler head.



 Plan of Correction - To be completed: 03/27/2019

K-0353- The closet was cleared on 2/14/2019 and will be inspected weekly by the Facilities Director or Designee to ensure there are no items stored in the closet where the sprinkler head is located. Signage was also placed on the door deterring storage in this closet. Documentation of weekly inspections will be maintained and reported monthly at the facility's Quality Assurance Process Improvement meeting.
Initial comments:Name: B & C BLDG - Component: 02 - Tag: 0000


Facility ID #080502
Component 02
"B" and "C" Buildings

Based on a Medicare/Medicaid Recertification Survey completed on February 14, 2019, at Harrison Senior Living of Christiana, it was determined there were no deficiencies identified under the requirements of the Life Safety Code for an existing health care occupancy. Compliance with the National Fire Protection Association's Life Safety Code is required by 42 CFR 483.90(a).

This is a three-story, Type II (222), fire resistive structure, without a basement, which is fully sprinklered.



 Plan of Correction:



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