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Based on observation, the facility failed to maintain corridor doors. This was evidenced by 2 doors that were obstructed from latching and 1 door that was obstructed from closing. This affected 3 floors in 2 of 2 buildings and could result in the spread of smoke or fire to other locations of the facility.

Findings:

During a facility tour with staff, from 5/4/10 - 5/6/10, the doors in the facility were observed.

Modesto Campus:

1. On 5/4/10 at 12:11 p.m., the door to the sterile elevator was equipped with a self closing device, on the 3rd floor, in the Labor and Delivery department. The door was released from its magnetic holder and allowed to close. The door failed to latch. The door was obstructed from latching by the door frame.

2. On 5/5/10 at 10:06 a.m., the doors to the elevators in the basement labeled HB001-E were equipped with self closing devices. The doors were released from their magnetic holders and allowed to close. The doors failed to latch. The doors were obstructed from latching by the door frame.

Manteca Campus:

1. On 5/6/10 at 8:56 a.m., the door to Room 3001, 3rd floor, was obstructed from closing. The door was held in the open position by tape that was stuck to the door and the adjacent wall.

Based on document review and interview, the facility failed to conduct their fire drills under varying times and conditions. This was evidenced by 4 of 4 NOC shift fire drills for 1 of 2 buildings that were conducted at the end of each quarter, each beginning at 5:30 a.m. This could result in a delayed response to a fire emergency if staff were unfamiliar with fire drill procedures at varied times.

Findings:

During document review, on 5/5/10 at 3:00 p.m., the Manteca Campus fire drill records were observed. 4 of the past 4 NOC shift fire drills, for the Manteca Campus, were conducted during the last month of each quarter. All four fire drills were conducted at 5:30 a.m.

During an interview Staff indicated that they were aware of this pattern and had implemented a new fire drill schedule to create more variance in times and conditions. The new fire drill schedule was implemented in April 2010.

Based on observation, the facility failed to maintain their supervised alarms for the automatic sprinkler system. This was evidenced by the post indicator valve (PIV) for 1 of 2 buildings that failed to initiate an alarm or visual signal when the valve was closed. The PIV controls the water flow for the sprinkler system from the street. The alarm notifies the facility if the water is shut off. This affected all patients at the Manteca Campus and could result in a delay in detecting a suspension of water supplied to their automatic sprinkler system.

Findings:

During a facility tour with staff, on 5/7/10 at 8:24 a.m., the post indicator valve at the Manteca Campus was closed. There was no audible alarm or visual indicator, that notified staff or the monitoring company, that the post indicator valve was closed or was being closed. The valve was returned to the open position.

The valve was closed a second time at 8:32 a.m. There was no audible or visual indicator that indicated the post indicator valve was closed or was being closed. The facility initiated a fire watch at 10:30 a.m. and conducted hourly checks of the post indicator valve until their sprinkler system vendor was able to address the issue at approximately 5:30 p.m.

Based on observation and interview, the facility failed to maintain their automatic sprinkler system in accordance with NFPA 13 and NFPA 25. This was evidenced by four sprinkler heads that had an accumulation of dust on them and by no spare sprinkler heads for one type of sprinkler in use. This affected 1 of 2 buildings and could result in a delay in sprinkler activation or a delay to replace a malfunctioning sprinkler head.

NFPA 13, 1999 edition
3-2.9.1 A supply of spare sprinklers (never fewer than six) shall be maintained on the premises so that any sprinklers that have operated or been damaged in any way can be promptly replaced. These sprinklers shall correspond to the types and temperature rating of the sprinklers in the property. The sprinklers shall be kept in a cabinet located where the temperature to which they are subjected will at no time exceed 100 F (38 C).
3-2.9.3 The stock of spare sprinklers shall include all types and ratings installed and shall be as follows:
(1) For systems having less than 300 sprinklers, not fewer than six sprinklers
(2) For systems with 300 to 1000 sprinklers, not fewer than 12 sprinklers
(3) For systems with over 1000 sprinklers, not fewer than 24 sprinklers

NFPA 25, 1998 edition
2-2.1.1 Sprinklers shall be inspected from the floor level annually. Sprinklers shall be free of corrosion, foreign materials, paint, and physical damage and shall be installed in the proper orientation (e.g., upright, pendant, or sidewall). Any sprinkler shall be replaced that is painted, corroded, damaged, loaded, or in the improper orientation.

Findings:

During a facility tour with staff on 5/6/10, the automatic sprinkler system and corresponding components for the Manteca Campus were observed.

1. At 8:55 a.m., 1 of 2 sprinklers on the 3rd floor in Room 3001 had an accumulation of dust and debris on it.

2. At 9:54 a.m., 2 of 3 sprinklers on the 2nd floor in Room 2009 had an accumulation of dust and debris on them.

3. At 9:59 a.m., 1 of 3 sprinklers on the 2nd floor in Room 2003 had an accumulation of dust and debris on it.

4. At 1:38 p.m., the facility was observed to have multiple types of sprinklers in use throughout the facility. One of the sprinkler types used in the facility was a glass bulb type. The facility supply of spare sprinklers was observed. There were no spare glass bulb type sprinklers in the facility spare sprinkler cabinets.

During an interview, a staff member was asked if there were any glass bulb type spare sprinkler heads on site in another location. The staff member confirmed that their were no spare glass bulb type sprinkler heads on site.

Based on document review and interview, the facility failed to maintain their smoke and fire dampers. This was evidenced by 7 dampers which were listed as failing in April 2009, that were not repaired or replaced until February 2010. This affected 1 of 2 buildings and could result in the spread of smoke or fire to other locations in the facility.

Findings:

During document review, on 5/5/10 at 4:30 p.m., the Manteca Campus smoke and fire damper inspection report was reviewed. The last smoke and fire damper inspection was completed on 4/19/09. The report indicated that 7 dampers failed the inspection. The facility was asked to show records that the failed dampers had been repaired or replaced.

A facility generated work order, issued on 2/18/10, was reviewed. The work order indicated that facility staff was to "repair fire dampers as per 4 yr inspection." The work order was completed by 2 facility staff members on 5/6/10. A facility staff member indicated that he had completed the repair of the dampers in February 2010 but did not document it. According to the 2/18/2010 damper work order, 2 of the 7 failed dampers have yet to be addressed due to accessibility of one damper and one damper that needs a new motor.

Based on observation, the facility failed to maintain their storage of medical gas. This was evidenced by the failure to separate full and empty oxygen E cylinders stored within the same enclosure. This affected 1 floor in 1 of 2 buildings and could result in a delay to obtain a full oxygen E cylinder in an emergency.

NFPA 99, 1999 edition
4-3.5.2.2(b)2 If stored within the same enclosure, empty cylinders shall be segregated from full cylinders. Empty cylinders shall be marked to avoid confusion and delay if a full cylinder is needed hurriedly.

Findings:

Manteca Campus

During a facility tour with staff, on 5/6/10 at 9:35 a.m., the oxygen storage room located on the 2nd floor near room 2546 was observed. 1 full oxygen E cylinder was stored in a rack with 1 empty oxygen E cylinder. The crate had a sign on it indicating that the rack was for "empty oxygen tanks only."

Based on observation, the facility failed to maintain their piped in medical gas system. This was evidenced by a nitrous oxide manifold that had non-functioning indicator light bulbs. This affected 1 of 2 buildings and could result in confusion in determining which bank of nitrous oxide tanks were in use and which bank was on standby.

Findings:

During a facility tour with staff, on 5/6/10 at 1:21 p.m., the nitrous oxide manifold at the Manteca Campus was observed. The light bulbs indicating which bank was in use and which bank was standby were not illuminated. Staff could not determine which bank of nitrous oxide was in use.

Based on observation, the facility failed to maintain their electrical equipment and utilities. This was evidenced by high powered appliances that were plugged into surge protected multi-outlet extension cords, the use of non-surge protected extension cords, and surge protected multi-outlet extension cords that were plugged into other surge protected multi-outlet extension cords. This affected 5 floors in 2 of 2 buildings and could increase the risk of an electrical fire to occur.

NFPA 70, 1999 edition
240-4 Flexible cord, including tinsel cord and extension cords, and fixture wires shall be protected against overcurrent by either (a) or (b).
(a) Ampacities. Flexible cord shall be protected by an overcurrent device in accordance with its ampacity as specified in Tables 400-5(A) and (B). Fixture wire shall be protected against overcurrent in accordance with its ampacity as specified in Table 402-5. Supplementary overcurrent protection, as in Section 240-10, shall be permitted to be an acceptable means for providing this protection.
400-8 Unless specifically permitted in Section 400-7, flexible cord and cables shall not be used for the following:
(1) As a substitute for the fixed wiring of a structure
(2) Where run through holes in walls, structural ceilings, suspended ceilings, dropped ceilings, or floors
(3) Where run through doorways, windows, or similar openings
(4) Where attached to building surfaces
(5) Where concealed behind building walls, structural ceilings, suspended ceilings, dropped ceilings, or floors
(6) Where installed in raceways, except as otherwise permitted in this Code

Findings:

During a facility tour with staff, the electrical equipment and wiring were observed.

Modesto Campus:

1. On 5/5/10 at 10:02 a.m., a small refrigerator was plugged into a surge protected multi-outlet extension cord on the 1st floor in the Radiology office (H1222).

2. On 5/5/10 at 10:18 a.m., a microwave oven and a small refrigerator were plugged into 1 surge protected multi-outlet extension cord on the basement level in Clinical Technology (HB211).

Manteca Campus:

1. On 5/6/10 at 9:19 a.m., a refrigerator temperature monitor was plugged into a black non-surge protected extension cord, on the 3rd floor near the nurses' station.

2. On 5/6/10 at 9:50 a.m., a microwave oven and a small refrigerator were plugged into 1 surge protected multi-outlet extension cord, on the 2nd floor in room 2013.

3. On 5/6/10 at 10:38 a.m., a refrigerator was plugged into a surge protected multi-outlet extension cord, on the 1st floor in the Operator Services room.

4. On 5/6/10 at 10:39 a.m., computer equipment on the 1st floor in the Operator Services room was plugged into a surge protected multi-outlet extension cord that was plugged into another surge protected multi-outlet extension cord.

5. On 5/6/10 at 10:55 a.m., 2 of 2 refrigerators on the 1st floor in the Laboratory were plugged into 2 separate orange non-surge protected extension cords.

6. On 5/6/10 at 1:43 p.m., a small refrigerator was plugged into a surge protected multi-outlet extension cord, on the 1st floor in the Intensive Care Unit.

7. On 5/6/10 at 3:41 p.m., a small refrigerator was plugged into a 3 outlet surge protected wall adapter on the 1st floor in the Anesthesia Work Room.

8. On 5/6/10 at 3:51 p.m., warm air producing medical equipment was plugged into a surge protected multi-outlet extension cord, on the 1st floor in the Surgery Office area. Staff indicated that some staff members use the machine to warm the office rooms when they get cold.

Based on observation, the facility failed to maintain their installation of alcohol based hand rub dispensers (ABHR). This was evidenced by 12 alcohol based hand rub dispensers that were mounted over or adjacent to ignition sources. This affected 4 floors in 2 of 2 buildings and could result in an alcohol based hand rub ignited fire.

Findings:

During a facility tour with staff, the alcohol based hand rub dispensers were observed.

Modesto Campus:

1. On 5/4/10 at 12:40 p.m., an ABHR dispenser on the 3rd floor in the Labor and Delivery room 4 (H3478), was mounted approximately 2.5 feet above an electrical receptacle. The hand rub was 62.5% ethyl alcohol by volume.

2. On 5/4/10 at 12:53 p.m., an ABHR dispenser on the 3rd floor in the Neonatal Intensive Care Unit waiting room (H3211), was mounted approximately 4 inches to the upper left of a light switch. The hand rub was 62.5% ethyl alcohol by volume.

3. On 5/4/10 at 12:55 p.m., an alcohol based hand rub dispenser on the 3rd floor in the meeting room (H3281-1), was mounted approximately 4 inches to the upper left of a light switch. The hand rub was 62.5% ethyl alcohol by volume.

4. On 5/4/10 at 3:22 p.m., an alcohol based hand rub dispenser on the 2nd floor in room 219 (H2131), was mounted approximately 2.5 feet above an electrical receptacle. The hand rub was 62.5% ethyl alcohol by volume.

5. On 5/4/10 at 3:33 p.m., an alcohol based hand rub dispenser on the 2nd floor in room 207 (H2114), was mounted approximately 2.5 feet above an electrical receptacle. The hand rub was 62.5% ethyl alcohol by volume.

6. On 5/4/10 at 3:35 p.m., an alcohol based hand rub dispenser on the 2nd floor in room 206 (H2113), was mounted approximately 3.5 inches to the upper left of a light switch. The hand rub was 62.5% ethyl alcohol by volume.

7. On 5/5/10 at 8:46 a.m., an alcohol based hand rub dispenser on the 1st floor in the Laboratory break room, was mounted approximately 3 feet above an electrical receptacle. The hand rub was 62.5% ethyl alcohol by volume.

8. On 5/5/10 at 9:18 a.m., an alcohol based hand rub dispenser on the 1st floor in the Emergency Department registration room (H1613), was mounted approximately 5 inches to the upper left of a light switch. The hand rub was 62.5% ethyl alcohol by volume.

9. On 5/5/10 at 9:31 a.m., an alcohol based hand rub dispenser on the 1st floor in the C-Pod Emergency Department Nutrition Room (H1469), was mounted approximately 5 inches to the upper left of a light switch. The hand rub was 62.5% ethyl alcohol by volume.

Manteca Campus:

1. On 5/6/10 at 10:36 a.m., an alcohol based hand rub dispenser on the 1st floor in the Operator Services room, was mounted approximately 4 inches to the left of a light switch. The hand rub was 62% ethyl alcohol by volume.

2. On 5/6/10 at 11:10 a.m., an alcohol based hand rub dispenser on the 1st floor in the file room in Radiology, was mounted approximately 8 inches above a printer server and uninterrupted power supply unit. The dispenser was also 6 inches to the right of a light switch in that room. The hand rub was 62.5% ethyl alcohol by volume.

3. On 5/6/10 at 11:17 a.m., an alcohol based hand rub dispenser on the 1st floor in the CT Scan room, was mounted approximately 3.5 feet above an electrical receptacle. The hand rub was 62.5% ethyl alcohol by volume.

Based on observation, the facility failed to maintain corridor doors. This was evidenced by 2 doors that were obstructed from latching and 1 door that was obstructed from closing. This affected 3 floors in 2 of 2 buildings and could result in the spread of smoke or fire to other locations of the facility.

Findings:

During a facility tour with staff, from 5/4/10 - 5/6/10, the doors in the facility were observed.

Modesto Campus:

1. On 5/4/10 at 12:11 p.m., the door to the sterile elevator was equipped with a self closing device, on the 3rd floor, in the Labor and Delivery department. The door was released from its magnetic holder and allowed to close. The door failed to latch. The door was obstructed from latching by the door frame.

2. On 5/5/10 at 10:06 a.m., the doors to the elevators in the basement labeled HB001-E were equipped with self closing devices. The doors were released from their magnetic holders and allowed to close. The doors failed to latch. The doors were obstructed from latching by the door frame.

Manteca Campus:

1. On 5/6/10 at 8:56 a.m., the door to Room 3001, 3rd floor, was obstructed from closing. The door was held in the open position by tape that was stuck to the door and the adjacent wall.

Based on document review and interview, the facility failed to conduct their fire drills under varying times and conditions. This was evidenced by 4 of 4 NOC shift fire drills for 1 of 2 buildings that were conducted at the end of each quarter, each beginning at 5:30 a.m. This could result in a delayed response to a fire emergency if staff were unfamiliar with fire drill procedures at varied times.

Findings:

During document review, on 5/5/10 at 3:00 p.m., the Manteca Campus fire drill records were observed. 4 of the past 4 NOC shift fire drills, for the Manteca Campus, were conducted during the last month of each quarter. All four fire drills were conducted at 5:30 a.m.

During an interview Staff indicated that they were aware of this pattern and had implemented a new fire drill schedule to create more variance in times and conditions. The new fire drill schedule was implemented in April 2010.

Based on observation, the facility failed to maintain their supervised alarms for the automatic sprinkler system. This was evidenced by the post indicator valve (PIV) for 1 of 2 buildings that failed to initiate an alarm or visual signal when the valve was closed. The PIV controls the water flow for the sprinkler system from the street. The alarm notifies the facility if the water is shut off. This affected all patients at the Manteca Campus and could result in a delay in detecting a suspension of water supplied to their automatic sprinkler system.

Findings:

During a facility tour with staff, on 5/7/10 at 8:24 a.m., the post indicator valve at the Manteca Campus was closed. There was no audible alarm or visual indicator, that notified staff or the monitoring company, that the post indicator valve was closed or was being closed. The valve was returned to the open position.

The valve was closed a second time at 8:32 a.m. There was no audible or visual indicator that indicated the post indicator valve was closed or was being closed. The facility initiated a fire watch at 10:30 a.m. and conducted hourly checks of the post indicator valve until their sprinkler system vendor was able to address the issue at approximately 5:30 p.m.

Based on observation and interview, the facility failed to maintain their automatic sprinkler system in accordance with NFPA 13 and NFPA 25. This was evidenced by four sprinkler heads that had an accumulation of dust on them and by no spare sprinkler heads for one type of sprinkler in use. This affected 1 of 2 buildings and could result in a delay in sprinkler activation or a delay to replace a malfunctioning sprinkler head.

NFPA 13, 1999 edition
3-2.9.1 A supply of spare sprinklers (never fewer than six) shall be maintained on the premises so that any sprinklers that have operated or been damaged in any way can be promptly replaced. These sprinklers shall correspond to the types and temperature rating of the sprinklers in the property. The sprinklers shall be kept in a cabinet located where the temperature to which they are subjected will at no time exceed 100 F (38 C).
3-2.9.3 The stock of spare sprinklers shall include all types and ratings installed and shall be as follows:
(1) For systems having less than 300 sprinklers, not fewer than six sprinklers
(2) For systems with 300 to 1000 sprinklers, not fewer than 12 sprinklers
(3) For systems with over 1000 sprinklers, not fewer than 24 sprinklers

NFPA 25, 1998 edition
2-2.1.1 Sprinklers shall be inspected from the floor level annually. Sprinklers shall be free of corrosion, foreign materials, paint, and physical damage and shall be installed in the proper orientation (e.g., upright, pendant, or sidewall). Any sprinkler shall be replaced that is painted, corroded, damaged, loaded, or in the improper orientation.

Findings:

During a facility tour with staff on 5/6/10, the automatic sprinkler system and corresponding components for the Manteca Campus were observed.

1. At 8:55 a.m., 1 of 2 sprinklers on the 3rd floor in Room 3001 had an accumulation of dust and debris on it.

2. At 9:54 a.m., 2 of 3 sprinklers on the 2nd floor in Room 2009 had an accumulation of dust and debris on them.

3. At 9:59 a.m., 1 of 3 sprinklers on the 2nd floor in Room 2003 had an accumulation of dust and debris on it.

4. At 1:38 p.m., the facility was observed to have multiple types of sprinklers in use throughout the facility. One of the sprinkler types used in the facility was a glass bulb type. The facility supply of spare sprinklers was observed. There were no spare glass bulb type sprinklers in the facility spare sprinkler cabinets.

During an interview, a staff member was asked if there were any glass bulb type spare sprinkler heads on site in another location. The staff member confirmed that their were no spare glass bulb type sprinkler heads on site.

Based on document review and interview, the facility failed to maintain their smoke and fire dampers. This was evidenced by 7 dampers which were listed as failing in April 2009, that were not repaired or replaced until February 2010. This affected 1 of 2 buildings and could result in the spread of smoke or fire to other locations in the facility.

Findings:

During document review, on 5/5/10 at 4:30 p.m., the Manteca Campus smoke and fire damper inspection report was reviewed. The last smoke and fire damper inspection was completed on 4/19/09. The report indicated that 7 dampers failed the inspection. The facility was asked to show records that the failed dampers had been repaired or replaced.

A facility generated work order, issued on 2/18/10, was reviewed. The work order indicated that facility staff was to "repair fire dampers as per 4 yr inspection." The work order was completed by 2 facility staff members on 5/6/10. A facility staff member indicated that he had completed the repair of the dampers in February 2010 but did not document it. According to the 2/18/2010 damper work order, 2 of the 7 failed dampers have yet to be addressed due to accessibility of one damper and one damper that needs a new motor.

Based on observation, the facility failed to maintain their storage of medical gas. This was evidenced by the failure to separate full and empty oxygen E cylinders stored within the same enclosure. This affected 1 floor in 1 of 2 buildings and could result in a delay to obtain a full oxygen E cylinder in an emergency.

NFPA 99, 1999 edition
4-3.5.2.2(b)2 If stored within the same enclosure, empty cylinders shall be segregated from full cylinders. Empty cylinders shall be marked to avoid confusion and delay if a full cylinder is needed hurriedly.

Findings:

Manteca Campus

During a facility tour with staff, on 5/6/10 at 9:35 a.m., the oxygen storage room located on the 2nd floor near room 2546 was observed. 1 full oxygen E cylinder was stored in a rack with 1 empty oxygen E cylinder. The crate had a sign on it indicating that the rack was for "empty oxygen tanks only."

Based on observation, the facility failed to maintain their piped in medical gas system. This was evidenced by a nitrous oxide manifold that had non-functioning indicator light bulbs. This affected 1 of 2 buildings and could result in confusion in determining which bank of nitrous oxide tanks were in use and which bank was on standby.

Findings:

During a facility tour with staff, on 5/6/10 at 1:21 p.m., the nitrous oxide manifold at the Manteca Campus was observed. The light bulbs indicating which bank was in use and which bank was standby were not illuminated. Staff could not determine which bank of nitrous oxide was in use.

Based on observation, the facility failed to maintain their electrical equipment and utilities. This was evidenced by high powered appliances that were plugged into surge protected multi-outlet extension cords, the use of non-surge protected extension cords, and surge protected multi-outlet extension cords that were plugged into other surge protected multi-outlet extension cords. This affected 5 floors in 2 of 2 buildings and could increase the risk of an electrical fire to occur.

NFPA 70, 1999 edition
240-4 Flexible cord, including tinsel cord and extension cords, and fixture wires shall be protected against overcurrent by either (a) or (b).
(a) Ampacities. Flexible cord shall be protected by an overcurrent device in accordance with its ampacity as specified in Tables 400-5(A) and (B). Fixture wire shall be protected against overcurrent in accordance with its ampacity as specified in Table 402-5. Supplementary overcurrent protection, as in Section 240-10, shall be permitted to be an acceptable means for providing this protection.
400-8 Unless specifically permitted in Section 400-7, flexible cord and cables shall not be used for the following:
(1) As a substitute for the fixed wiring of a structure
(2) Where run through holes in walls, structural ceilings, suspended ceilings, dropped ceilings, or floors
(3) Where run through doorways, windows, or similar openings
(4) Where attached to building surfaces
(5) Where concealed behind building walls, structural ceilings, suspended ceilings, dropped ceilings, or floors
(6) Where installed in raceways, except as otherwise permitted in this Code

Findings:

During a facility tour with staff, the electrical equipment and wiring were observed.

Modesto Campus:

1. On 5/5/10 at 10:02 a.m., a small refrigerator was plugged into a surge protected multi-outlet extension cord on the 1st floor in the Radiology office (H1222).

2. On 5/5/10 at 10:18 a.m., a microwave oven and a small refrigerator were plugged into 1 surge protected multi-outlet extension cord on the basement level in Clinical Technology (HB211).

Manteca Campus:

1. On 5/6/10 at 9:19 a.m., a refrigerator temperature monitor was plugged into a black non-surge protected extension cord, on the 3rd floor near the nurses' station.

2. On 5/6/10 at 9:50 a.m., a microwave oven and a small refrigerator were plugged into 1 surge protected multi-outlet extension cord, on the 2nd floor in room 2013.

3. On 5/6/10 at 10:38 a.m., a refrigerator was plugged into a surge protected multi-outlet extension cord, on the 1st floor in the Operator Services room.

4. On 5/6/10 at 10:39 a.m., computer equipment on the 1st floor in the Operator Services room was plugged into a surge protected multi-outlet extension cord that was plugged into another surge protected multi-outlet extension cord.

5. On 5/6/10 at 10:55 a.m., 2 of 2 refrigerators on the 1st floor in the Laboratory were plugged into 2 separate orange non-surge protected extension cords.

6. On 5/6/10 at 1:43 p.m., a small refrigerator was plugged into a surge protected multi-outlet extension cord, on the 1st floor in the Intensive Care Unit.

7. On 5/6/10 at 3:41 p.m., a small refrigerator was plugged into a 3 outlet surge protected wall adapter on the 1st floor in the Anesthesia Work Room.

8. On 5/6/10 at 3:51 p.m., warm air producing medical equipment was plugged into a surge protected multi-outlet extension cord, on the 1st floor in the Surgery Office area. Staff indicated that some staff members use the machine to warm the office rooms when they get cold.