Jefferson County Department of Health

MORELAND BOARDING HOME

320 ELM ST BESSEMER 35022

Deducted	Remarks
3	4.2.8 Provide a supply of soap, single-use towels, and toilet tissue in the bathrooms at all times.//Provide paper towels in two of the four restrooms.
3	6.8.2 Label all toxic items not in original containers with the common name of the product.//Label spray bottles found in room #1 and in the kitchen pantry. Observed a total of 4 unlabeled bottles.
3	2.5.2 Complete and document an annual assessment of suitability and maintain a copy in the resident's file. 2.9.1 Update a Resident Agreement on the date of admission for each resident. 2.9.2 Provide documentation of a Resident Agreement that includes all required information.
3	7.7.1 (a) Store medications in separate containers and in a centralized, safe, secure, and organized manner. //Cease refilling medicine cups that are not designated for that particular resident.//Cease relabeling medicine cups for different residents.

Deducted	Remarks
1	4.11.2 Store garbage and refuse on the premises in a manner to make them inaccessible to insects and rodents. // Observed outside garbage cans with no lids.
2	6.1.1 Maintain all interior walls, ceiling and floors in good repair.// Observed holes in wall of residents room. Smoke detector hanging from ceiling in residents room (appears to still be functional).
3	2.9.4 Provide a current, signed Lease Agreement for verificaton of documentation. The record shall be provided to the resident upon admission and kept on file at the Communal Living Facility as part of the Resident's File. // PIC could not provide Lease Agreement for 4 out of 11 residents.
3	7.7.1 Store prescription medications in the original container and handle in accordance with current applicable laws and regulations. // Observed single use cups provided by Medical Management for residents medications with more than one residents names on the cups. Spoke with owner regarding not reusing medication cups for separate residents.
2	8.2.4 (h) Provide an appropriate and accurate ambient thermometer in all refrigerators and freezers. // Unable to locate an ambient temperature thermometer in the small refrigerator in dining area. ADPH 420-3-22-.03(1)(a) Cease the sale of commercially processed TCS food requiring refrigeration when past the date limit placed by the manufacturer or packager. // 3 gallon sized containers of milk (7/28) were past the date of expiration in the larger refrigerator.