Pennsylvania Department of Health
PENNSWOOD VILLAGE
Building Inspection Results

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Severity Designations


Minimal Citation - No Harm	Minimal Harm	Actual Harm	Serious Harm

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PENNSWOOD VILLAGE - 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 September 1, 2026, at Pennswood Village, it was determined there were no deficiencies identified with the requirements of 42 CFR 483.73.

Plan of Correction:

Initial comments:Name: MAIN BUILDING 01 (WOOLMAN & BARCLAY LEVELS) - Component: 01 - Tag: 0000
Facility ID# 164002Component 01Terrace Building, Preston Building, Woolman - Lower Level - Skilled Nursing, Barclay - Upper Level - Personal CareBased on a Medicare/Medicaid Recertification survey completed on September 1, 2026, it was determined that Pennswood Village was not in compliance with the following requirements of the Life Safety Code for an existing Nursing 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 II (222), fire resistive building, with a penthouse, that is fully sprinklered.

Plan of Correction:

NFPA 101 STANDARD Exit Signage:

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.

Exit Signage
2012 EXISTING
Exit and directional signs are displayed in accordance with 7.10 with continuous illumination also served by the emergency lighting system.
19.2.10.1
(Indicate N/A in one-story existing occupancies with less than 30 occupants where the line of exit travel is obvious.)

Observations:
Name: MAIN BUILDING 01 (WOOLMAN & BARCLAY LEVELS) - Component: 01 - Tag: 0293 Based on observation and interview, it was determined the facility failed to provide proper egress signage in accordance with NFPA 101, affecting one of two levels within the component. Findings include: Observation on September 1, 2026, at 10:50 a.m., revealed a missing exit sign over the rear egress door, outside of dining room. Exit interview with the Administrator and Maintenance Team on September 1, 2026, at 12:00 p.m., confirmed the missing egress signage inside the path of emergency egress.\'c2

Plan of Correction - To be completed: 09/16/2026

The facility has and shall continue to provide proper egress signage in accordance with NFPA 101.

Additional exit signs have been placed outside of the dining room and the egress door with proper directional signs illuminated. A work order was issued on September 16, 2026 and completed on September 16, 2026.

The Maintenance Manager/Designee has overseen completion of the installation and will continue to ensure that all fire exit signs are inspected on a monthly basis. Results of ongoing inspections will be reported to the Quality Assurance and Performance Improvement (QAPI) Team by the Maintenance Manager/Designee.

NFPA 101 STANDARD Hazardous Areas - Enclosure:

Hazardous Areas - Enclosure
Hazardous areas are protected by a fire barrier having 1-hour fire resistance rating (with 3/4 hour fire rated doors) or an automatic fire extinguishing system in accordance with 8.7.1 or 19.3.5.9. When the approved automatic fire extinguishing system option is used, the areas shall be separated from other spaces by smoke resisting partitions and doors in accordance with 8.4. Doors shall be self-closing or automatic-closing and permitted to have nonrated or field-applied protective plates that do not exceed 48 inches from the bottom of the door.
Describe the floor and zone locations of hazardous areas that are deficient in REMARKS.
19.3.2.1, 19.3.5.9

Area Automatic Sprinkler Separation N/A
a. Boiler and Fuel-Fired Heater Rooms
b. Laundries (larger than 100 square feet)
c. Repair, Maintenance, and Paint Shops
d. Soiled Linen Rooms (exceeding 64 gallons)
e. Trash Collection Rooms
(exceeding 64 gallons)
f. Combustible Storage Rooms/Spaces
(over 50 square feet)
g. Laboratories (if classified as Severe
Hazard - see K322)

Observations:
Name: MAIN BUILDING 01 (WOOLMAN & BARCLAY LEVELS) - Component: 01 - Tag: 0321 Based on observation and interview, it was determined the facility failed to maintain a hazardous area enclosure on 1 of 2 levels of the facility. Findings include: 1. Observation on September 1, 2026, between 10:30 a.m. and 11:45 a.m., revealed:Soiled room door, next to room W27, failed to self-close and latch. b) Office admin area, that doubles as document storage, had a door equipped with a damaged door closure. Exit interview with the Administrator and Maintenance Team on September 1, 2026, at 12:00 p.m., confirmed the above deficiencies.\'c2

Plan of Correction - To be completed: 09/24/2026

The facility has and shall continue to maintain hazardous area enclosure. A work order has been issued to repair the door to the Soiled Linen door next to W27 on September 16, 2026 and was completed on September 18, 2026. A work order has also been issued to replace the damaged door closer on the entrance to the Office Admin area. A work order has been issued on September 16, 2026 to be completed by September 23, 2026.

The Maintenance Manager/Designee will continue to oversee the inspection and repair of all hazardous area enclosures. Results of ongoing inspections and repairs will be reported to the Quality Assurance and Performance Improvement (QAPI) Team by the Maintenance Manager/Designee.

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