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Based on observation and interview, it was determined that the facility was not maintained to assure the safety of staff and patients.

Findings were:

" OSHA/Bloodborne Pathogen Regulations Policy #138-030-060 " stated in part " The facility provides sufficient housekeeping and maintenance personnel to maintain the interior and exterior of the facility in a safe, clean, orderly, and attractive manner. "

Tour of the facility on 7/31/12 revealed the following:

? Three chairs in the ER waiting room with torn vinyl seats. These tears make cleaning impossible and cross contamination likely.
? 2 patient beds in the ER also had torn vinyl covers which again made cleaning impossible and cross contamination likely.
? The walls behind the beds in the ER had gouges and chips in the sheetrock, making thorough cleaning of the area impossible.
? In OR # 1, there was chipped paint on the walls and OR light. There was a large gouge on the floor and it was noted that a hair had been waxed to the floor. A small beetle was observed walking across the floor of the Operating Room.
? In OR # 2, the walls were also gouged and chipped. An open trash can was noted and another beetle was spotted on the floor
? The IV room in the Pharmacy had notable chipped and gouged walls
? The kitchen had various areas where chipped and gouged walls were found. Grease splatters were noted on the wall above the stove.
? The lab area had torn vinyl seats in the patient waiting room and the phlebotomy chair had a torn arm that had been covered in tape. Numerous torn chairs where observed throughout the lab area.
? The tile floor in the Respiratory Care area was stained and appeared dirty.
? In the hallway leading to the storage area, many dead beetles and crickets were observed. The doorway leading outside from the storage area lacked adequate weather stripping which allowed for entry of vectors into the facility. There were also large cobwebs hanging from the ceiling which indicated inadequate cleaning of the area.

In an interview with the RN Project Coordinator on 7/31/12, the above deficits were acknowledged.

Based on observation, it was determined that the facility failed to provide a sanitary environment in all areas of the hospital.

The Centers for Disease Control and Prevention (CDC) article, GUIDELINE FOR DISINFECTION AND STERILIZATION IN HEALTHCARE FACILITIES, 2008, by William A. Rutala, Ph.D., M.P.H., David J. Weber, M.D., M.P.H., and the Healthcare Infection Control Practices Advisory Committee (HICPAC), found at: , states on page 74 that hinged instruments and instruments that are closed should be opened during the process of sterilization.

Tour of the facility on 7/31/12 revealed the following:

? 12 pair of " sterile " scissors were found in the sterile supply area. The hinged scissors were noted to be in the " closed " position, making complete sterilization impossible.

? 2 patient beds in the ER also had torn vinyl covers which again made cleaning impossible and cross contamination likely.
? The walls behind the beds in the ER had gouges and chips in the sheetrock, making thorough cleaning of the area impossible.
? In OR # 1, there was chipped paint on the walls and OR light. There was a large gouge on the floor and it was noted that a hair had been waxed to the floor. A small beetle was observed walking across the floor of the Operating Room.
? In OR # 2, the walls were also gouged and chipped. An open trash can was noted and another beetle was spotted on the floor. The anesthesia cart had 3 open " sterile " endotrachael tubes.
? The IV room in the Pharmacy had notable chipped and gouged walls
? The lab area had torn vinyl seats in the patient waiting room and the phlebotomy chair had a torn arm that had been covered in tape. Numerous torn chairs where observed throughout the lab area.
? The tile floor in the Respiratory Care area was stained and appeared dirty.
? In the hallway leading to the storage area, many dead beetles and crickets were observed. The doorway leading outside from the storage area lacked adequate weather stripping which allowed for entry of vectors into the facility. There were also large cobwebs hanging from the ceiling which indicated inadequate cleaning of the area.

In an interview with the RN Project Coordinator on 7/31/12, the above infection control issues were confirmed.

Based on observation and interview, it was determined that the facility was not maintained to assure the safety of staff and patients.

Findings were:

" OSHA/Bloodborne Pathogen Regulations Policy #138-030-060 " stated in part " The facility provides sufficient housekeeping and maintenance personnel to maintain the interior and exterior of the facility in a safe, clean, orderly, and attractive manner. "

Tour of the facility on 7/31/12 revealed the following:

? Three chairs in the ER waiting room with torn vinyl seats. These tears make cleaning impossible and cross contamination likely.
? 2 patient beds in the ER also had torn vinyl covers which again made cleaning impossible and cross contamination likely.
? The walls behind the beds in the ER had gouges and chips in the sheetrock, making thorough cleaning of the area impossible.
? In OR # 1, there was chipped paint on the walls and OR light. There was a large gouge on the floor and it was noted that a hair had been waxed to the floor. A small beetle was observed walking across the floor of the Operating Room.
? In OR # 2, the walls were also gouged and chipped. An open trash can was noted and another beetle was spotted on the floor
? The IV room in the Pharmacy had notable chipped and gouged walls
? The kitchen had various areas where chipped and gouged walls were found. Grease splatters were noted on the wall above the stove.
? The lab area had torn vinyl seats in the patient waiting room and the phlebotomy chair had a torn arm that had been covered in tape. Numerous torn chairs where observed throughout the lab area.
? The tile floor in the Respiratory Care area was stained and appeared dirty.
? In the hallway leading to the storage area, many dead beetles and crickets were observed. The doorway leading outside from the storage area lacked adequate weather stripping which allowed for entry of vectors into the facility. There were also large cobwebs hanging from the ceiling which indicated inadequate cleaning of the area.

In an interview with the RN Project Coordinator on 7/31/12, the above deficits were acknowledged.

Based on observation, it was determined that the facility failed to provide a sanitary environment in all areas of the hospital.

The Centers for Disease Control and Prevention (CDC) article, GUIDELINE FOR DISINFECTION AND STERILIZATION IN HEALTHCARE FACILITIES, 2008, by William A. Rutala, Ph.D., M.P.H., David J. Weber, M.D., M.P.H., and the Healthcare Infection Control Practices Advisory Committee (HICPAC), found at: , states on page 74 that hinged instruments and instruments that are closed should be opened during the process of sterilization.

Tour of the facility on 7/31/12 revealed the following:

? 12 pair of " sterile " scissors were found in the sterile supply area. The hinged scissors were noted to be in the " closed " position, making complete sterilization impossible.

? 2 patient beds in the ER also had torn vinyl covers which again made cleaning impossible and cross contamination likely.
? The walls behind the beds in the ER had gouges and chips in the sheetrock, making thorough cleaning of the area impossible.
? In OR # 1, there was chipped paint on the walls and OR light. There was a large gouge on the floor and it was noted that a hair had been waxed to the floor. A small beetle was observed walking across the floor of the Operating Room.
? In OR # 2, the walls were also gouged and chipped. An open trash can was noted and another beetle was spotted on the floor. The anesthesia cart had 3 open " sterile " endotrachael tubes.
? The IV room in the Pharmacy had notable chipped and gouged walls
? The lab area had torn vinyl seats in the patient waiting room and the phlebotomy chair had a torn arm that had been covered in tape. Numerous torn chairs where observed throughout the lab area.
? The tile floor in the Respiratory Care area was stained and appeared dirty.
? In the hallway leading to the storage area, many dead beetles and crickets were observed. The doorway leading outside from the storage area lacked adequate weather stripping which allowed for entry of vectors into the facility. There were also large cobwebs hanging from the ceiling which indicated inadequate cleaning of the area.

In an interview with the RN Project Coordinator on 7/31/12, the above infection control issues were confirmed.