HospitalInspections.org

Based upon observation and interview it was determined that the facility failed to maintain smoke barriers in one instance on one of four floors.

Findings Include:

1. Observation on December 3, 2014, revealed the following smoke barrier deficiency:

a) At 10:18 a.m., the first floor smoke barrier had a large penetration around conduits in the purchasing department storage area.

Interview with facility personnel on December 4, 2014, at 1:30 p.m., confirmed the smoke barrier issue.

Based upon observation and interview it was determined that the facility failed to maintain smoke barrier doors in two instances on two of four floors.

Findings Include:

1. Observation on December 3, 2014, and December 4, 2014, revealed the following smoke barrier door deficiencies:

a) On December 3, 2014, at 10:13 a.m., the first floor smoke barrier door outside of clinical engineering room 185 did not close in its frame.
b) On December 4, 2014, at 9:56 a.m., the fourth floor Director of Nursing office door is in the smoke barrier and lacked an automatic closing device.

Interview with facility personnel on December 4, 2014, at 1:30 p.m., confirmed the smoke barrier door issues.

Based upon observation and interview it was determined that the facility failed to maintain hazardous areas in four instances on two of four floors.

Findings Include:

1. Observation on December 3, 2014, revealed the following hazardous area deficiencies:

a) At 8:29 a.m., the first floor boiler room had several penetrations that were not sealed around large pipes going through the wall on the infection control side of the room by the exit steps.
b) At 8:33 a.m., the first floor boiler room had a penetration where a large pipe was removed beside the elevator shaft.
c) At 10:01 a.m., the first floor laundry area entry door does not close and latch in its frame.
d) At 11:41 a.m., the second floor Endoscopy soiled utility room door 2253 was being held open using a trash receptacle and a floor mat.

Interview with facility personnel on December 4, 2014, at 1:30 p.m., confirmed the hazardous area issues.

Based upon observation and interview it was determined that the facility failed to maintain electrical wiring requirements in one instance on one of four floors.

Findings Include:

1. Observation on December 3, 2014, revealed the following electrical wiring deficiency:

a) At 8:26 a.m., in the first floor boiler room there was a fan plugged into an extension cord.

Interview with facility personnel on December 4, 2014, at 1:30 p.m., confirmed the electrical wiring issue.

Based upon observation and interview it was determined that the facility failed to maintain smoke barriers in one instance on one of four floors.

Findings Include:

1. Observation on December 3, 2014, revealed the following smoke barrier deficiency:

a) At 10:18 a.m., the first floor smoke barrier had a large penetration around conduits in the purchasing department storage area.

Interview with facility personnel on December 4, 2014, at 1:30 p.m., confirmed the smoke barrier issue.

Based upon observation and interview it was determined that the facility failed to maintain smoke barrier doors in two instances on two of four floors.

Findings Include:

1. Observation on December 3, 2014, and December 4, 2014, revealed the following smoke barrier door deficiencies:

a) On December 3, 2014, at 10:13 a.m., the first floor smoke barrier door outside of clinical engineering room 185 did not close in its frame.
b) On December 4, 2014, at 9:56 a.m., the fourth floor Director of Nursing office door is in the smoke barrier and lacked an automatic closing device.

Interview with facility personnel on December 4, 2014, at 1:30 p.m., confirmed the smoke barrier door issues.

Based upon observation and interview it was determined that the facility failed to maintain hazardous areas in four instances on two of four floors.

Findings Include:

1. Observation on December 3, 2014, revealed the following hazardous area deficiencies:

a) At 8:29 a.m., the first floor boiler room had several penetrations that were not sealed around large pipes going through the wall on the infection control side of the room by the exit steps.
b) At 8:33 a.m., the first floor boiler room had a penetration where a large pipe was removed beside the elevator shaft.
c) At 10:01 a.m., the first floor laundry area entry door does not close and latch in its frame.
d) At 11:41 a.m., the second floor Endoscopy soiled utility room door 2253 was being held open using a trash receptacle and a floor mat.

Interview with facility personnel on December 4, 2014, at 1:30 p.m., confirmed the hazardous area issues.

Based upon observation and interview it was determined that the facility failed to maintain electrical wiring requirements in one instance on one of four floors.

Findings Include:

1. Observation on December 3, 2014, revealed the following electrical wiring deficiency:

a) At 8:26 a.m., in the first floor boiler room there was a fan plugged into an extension cord.

Interview with facility personnel on December 4, 2014, at 1:30 p.m., confirmed the electrical wiring issue.