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414 W JEFFERSON PO BOX 396

MAHNOMEN, MN 56557

No Description Available

Tag No.: K0056

Observations indicated that the automatic sprinkler system has not been maintained in accordance with NFPA 13 Standard for the Installation of Sprinkler System 1999 edition. This deficient practice may allow a fire to grow uncontrolled which will negatively impact all the residents, visitors and staff.

Findings include:
During the facility tour on August 5, 2010 , between 9:30 am and 11:30 am, observations revealed that the storage in the P{T/OT closet is obstructing the sprinkler head.

The Facility Director verified this finding during the facility tour and with the Administrator after the exit conference.

No Description Available

Tag No.: K0064

Observations revealed that the portable fire extinguishers are not in accordance with NFPA 10 Standard for the installation of Portable Fire Extinguishers 1998 edition. This deficient practice could allow a fire to grow out of control, which could negatively impact the staff and visitors in the kitchen.

Findings include:
During the facility tour on August 5, 2010 , between 9:30 am and 11:30 am, observations revealed that the potable fire extinguisher in the boiler room was not hung properly so that is at least 4 inches above the floor..

The Facility Director verified this finding during the facility tour and with the Administrator after the exit conference.

No Description Available

Tag No.: K0076

Observations revealed that the compressed gases are not stored in accordance with NFPA 99 Health Care Facilities 1999 edition section 4-3.5.2.1. Not properly securing compressed gas cylinders can allow them to tip, damaging the cylinder or valve, which could cause the cylinder to release the compressed gas into the room it is in and for the cylinder to become a projectile, which can injure the residents, staff and visitors within the area of the oxygen storage room.

Findings include:
During the facility tour on August 5, 2010 , between 9:30 am and 11:30 am, observations revealed that the K-size compressed gas cylinders (oxygen) were not properly secured within the oxygen storage room.

The Facility Director verified this finding during the facility tour and with the Administrator after the exit conference.

No Description Available

Tag No.: K0130

Observations indicate that the new computers in the patient rooms may not meet NFPA 99 Health Care Facilities 1999 edition Section 7-5.1.2.2 for use in a patient care vicinity. This deficient practice could negatively impact the residents, staff and guests of individual rooms by exposing occupants for electrical shock.

Findings include:
During the facility tour on August 5, 2010 , between 9:30 am and 11:30 am, observations revealed that the new computers and monitors installed between the beds in the patent rooms are with in 6 feet of the beds and could not be documented as meeting the requirements of electrical appliances used in a patient care vicinity. The appliances must be grounded or double insulated.

The Facility Director verified this finding during the facility tour and with the Administrator after the exit conference.

LIFE SAFETY CODE STANDARD

Tag No.: K0056

Observations indicated that the automatic sprinkler system has not been maintained in accordance with NFPA 13 Standard for the Installation of Sprinkler System 1999 edition. This deficient practice may allow a fire to grow uncontrolled which will negatively impact all the residents, visitors and staff.

Findings include:
During the facility tour on August 5, 2010 , between 9:30 am and 11:30 am, observations revealed that the storage in the P{T/OT closet is obstructing the sprinkler head.

The Facility Director verified this finding during the facility tour and with the Administrator after the exit conference.

LIFE SAFETY CODE STANDARD

Tag No.: K0064

Observations revealed that the portable fire extinguishers are not in accordance with NFPA 10 Standard for the installation of Portable Fire Extinguishers 1998 edition. This deficient practice could allow a fire to grow out of control, which could negatively impact the staff and visitors in the kitchen.

Findings include:
During the facility tour on August 5, 2010 , between 9:30 am and 11:30 am, observations revealed that the potable fire extinguisher in the boiler room was not hung properly so that is at least 4 inches above the floor..

The Facility Director verified this finding during the facility tour and with the Administrator after the exit conference.

LIFE SAFETY CODE STANDARD

Tag No.: K0076

Observations revealed that the compressed gases are not stored in accordance with NFPA 99 Health Care Facilities 1999 edition section 4-3.5.2.1. Not properly securing compressed gas cylinders can allow them to tip, damaging the cylinder or valve, which could cause the cylinder to release the compressed gas into the room it is in and for the cylinder to become a projectile, which can injure the residents, staff and visitors within the area of the oxygen storage room.

Findings include:
During the facility tour on August 5, 2010 , between 9:30 am and 11:30 am, observations revealed that the K-size compressed gas cylinders (oxygen) were not properly secured within the oxygen storage room.

The Facility Director verified this finding during the facility tour and with the Administrator after the exit conference.

LIFE SAFETY CODE STANDARD

Tag No.: K0130

Observations indicate that the new computers in the patient rooms may not meet NFPA 99 Health Care Facilities 1999 edition Section 7-5.1.2.2 for use in a patient care vicinity. This deficient practice could negatively impact the residents, staff and guests of individual rooms by exposing occupants for electrical shock.

Findings include:
During the facility tour on August 5, 2010 , between 9:30 am and 11:30 am, observations revealed that the new computers and monitors installed between the beds in the patent rooms are with in 6 feet of the beds and could not be documented as meeting the requirements of electrical appliances used in a patient care vicinity. The appliances must be grounded or double insulated.

The Facility Director verified this finding during the facility tour and with the Administrator after the exit conference.