HospitalInspections.org

K018

Based on observation the facility failed to provide corridor doors that would close and resist the passage of smoke in accordance with the LSC section 19.3.6.3. This deficient practice could potentially affect 40 occupants of the facility by contributing to the spread of fire and smoke into the corridor exposing occupants to fire and the products of combustion rendering the corridor unusable for evacuation of the facility.

Findings Include:

On 10-5-16 observation revealed the following:
1. At about 9:45 AM, observed the corridor door to patient room 249 would not positive latch when closed.
2. At about 10:00 AM, observed the corridor door to patient room 269 would not positive latch when closed.
3. At about 11:10 AM, observed the corridor door to patient room 275 would not positive latch when closed.

This was also observed by the Senior Director of Plant Operations.

K051

Based on observation the facility failed to provide an approved fire alarm system in accordance with the LSC sections 19.3.4, 9.6. This deficient practice could potentially affect 25 occupants of the facility by contributing to a delay in notification of occupants and emergency services in the event of a fire.

Findings include:

Observation revealed that on 10-4-16, at about 10:50 AM, a corridor smoke detector located near the central nurse station was located within 3 feet of a air vent.

This was also observed by the facility Senior Director of Plant Operations.

K056

Based on observation the facility failed to provide a sprinkler system in accordance with the LSC section 19.3.5. This deficient practice could potentially affect 50 occupants of the facility by contributing to the spread of fire throughout the facility due an improperly installed sprinkler system which may fail to suppress a fire.

Findings include:

1. On 10-4-16, at about 9:00 AM, during an inspection of the sprinkler system with the maintenance supervisor, the following observation were made:

Observed there is no fire sprinkler in the vestibule located at the main entrance.

This deficiency was confirmed with the Senior Director of Plant Operations.

K147
Based on observation the facility failed to provide the electrical system in accordance with the LSC section 9.1.2. This deficient practice could potentially affect 25 occupants of the facility by contributing to the overload of electrical circuits which increases the chance for the development of fire, exposing occupants to fire and the products of combustion.
Findings include:

On 10-5-16 at approximately 10:40 AM the following observation was made:
Observed in the 2nd floor staff lounge a multi outlet extension cord was being used to power a coffee maker, toaster and microwave oven.

This deficiency was confirmed with the Senior Director of Plant Operations.