QA Investigation Results

Pennsylvania Department of Health
COMMUNITIES OF DON GUANELLA AND AT DIVINE PROVIDENCE VILLAGE
Building Inspection Results

COMMUNITIES OF DON GUANELLA AND AT DIVINE PROVIDENCE VILLAGE
Building Inspection Results For:


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Initial Comments:
Name - Component - --

Based on an Emergency Preparedness Survey completed on April 24, 2024, at Communities Of Don Guanella And At Divine Providence Village, it was determined there were no deficiencies identified with the requirements of 42 CFR 483.475.




Plan of Correction:




Initial Comments:
Name - PROMPT (YELLOW COTTAGE) NOW SLOW 4/25/2013 Component - 01

Facility ID# 04811100
Component 01
Yellow Cottage

Based on a Medicaid Recertification Survey completed on April 24, 2024, at Communities Of Don Guanella And At Divine Providence Village, it was determined there were no deficiencies identified under the requirements of the Life Safety Code for an existing ICF/IID health care occupancy. Compliance with the National Fire Protection Association's Life Safety Code is required by 42 CFR 483.470(j).

This is a one-story, Type III (211), protected ordinary building, that is fully sprinklered.

State Plans approved as Prompt.





Plan of Correction:




Initial Comments:
Name - SLOW (ORANGE COTTAGE) Component - 02

Facility ID# 04811100
Component 02
Orange Cottage

Based on a Medicaid Recertification Survey completed on April 24, 2024, at Communities Of Don Guanella And At Divine Providence Village, it was determined there were no deficiencies identified under the requirements of the Life Safety Code for an existing ICF/IID Health care occupancy. Compliance with the National Fire Protection Association's Life Safety Code is required by 42 CFR 483.470(j).

This is a one-story, Type III (211), protected ordinary building, that is fully sprinklered.

State Plans approved as Slow.





Plan of Correction:




Initial Comments:
Name - SLOW (BLUE COTTAGE) Component - 03

Facility ID #04811100
Component 03
Blue Cottage

Based on a Medicaid Recertification Survey completed on April 24, 2024, at Communities Of Don Guanella And At Divine Providence Village, it was determined there were no deficiencies identified under the requirements of the Life Safety Code for an existing ICF/IID health care occupancy. Compliance with the National Fire Protection Association's Life Safety Code is required by 42 CFR 483.470(j).

This is a one-story, Type III (211), protected ordinary building, that is fully sprinklered.

State Plans approved as Slow.





Plan of Correction:




Initial Comments:
Name - PROMPT (GREEN COTTAGE) Component - 04

Facility ID# 04811100
Component 04
Green Building

Based on a Medicaid Recertification Survey completed on April 24, 2024, at Communities Of Don Guanella And At Divine Providence Village, it was determined there were no deficiencies identified under the requirements of the Life Safety Code for an existing ICF/IID health care occupancy. Compliance with the National Fire Protection Association's Life Safety Code is required by 42 CFR 483.470(j).

This is a one-story, Type III (211), protected ordinary building, that is fully sprinklered.

State Plans approved as Prompt.




Plan of Correction:




Initial Comments:
Name - IMPRACTICAL (PURPLE COTTAGE) Component - 05

Facility ID# 04811100
Component 05
Purple Cottage

Based on a Medicaid Recertification Survey completed on April 24, 2024, at Communities Of Don Guanella And At Divine Providence Village, it was determined there were no deficiencies identified under the requirements of the Life Safety Code for an existing ICF/IID health care occupancy. Compliance with the National Fire Protection Association's Life Safety Code is required by 42 CFR 483.470(j).


This is a one-story, Type III (211), protected ordinary building, that is fully sprinklered.

State Plans approved as Impractical.





Plan of Correction:




Initial Comments:
Name - SLOW (RED COTTAGE) Component - 06

Facility ID #04811100
Component 06
Red Building

Based on a Medicaid Recertification Survey completed on April 24, 2024, at Communities Of Don Guanella And At Divine Providence Village, it was determined there were no deficiencies identified under the requirements of the Life Safety Code for an existing ICF/IID health care occupancy. Compliance with the National Fire Protection Association's Life Safety Code is required by 42 CFR 483.470(j).

This is a one-story, Type III (211), protected ordinary building, that is fully sprinklered.

State Plans approved as Slow




Plan of Correction: