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Based upon observation, interview and record review, the facility failed to properly maintain the physical plant to prevent pest infestations. This deficient practice could effect the well-being of all patients, staff, and visitors.

Findings Include:
On 5/23/11 at approximately 10:40 AM, based upon observation and interview, it was discovered that a toilet room attached to the 1 East patient dining area is not properly maintained. This toilet room was padlocked shut. A graham cracker was observed in the undercut of the door. Upon having the lock removed, it was further discovered that there was a significant accumulation of dust and debris, mouse droppings, and an additional graham cracker in this room. The toilet in this room was also observed to be completely dry. Staff C stated in interview at approximately 10:45 AM that this room is kept locked to prevent psychiatric patients from having unsupervised access to this room.

On 5/23/11 at approximately 10:50 AM, based upon observation it was discovered that the 1 East patient dining room is not properly maintained. This room was observed to have mouse droppings located behind the patient refrigerator and adjacent cabinets. An open hole approximately 3 inches in diameter in one of these cabinets was observed to have a sweetener packet and paper towel in it. A glue board used for trapping pests was observed stuck to the underside of the window sill used as a means to seal an open hole. Cove base was observed loose and missing throughout the room, particularly near the windows and entrance areas. The under-counter sink cabinet in this room was observed to have open penetrations that connect to the under-counter sink cabinet in the laundry room. Dirt and debris accumulation were observed along the floor/wall juncture throughout the room.

On 5/23/11 at approximately 11:00 AM, based upon observation it was discovered that the staff Report Room on the 1 East unit is not properly maintained. This room was observed to have mouse droppings located inside of the heating unit on the exterior wall, underneath the window. Snacks used for patient nourishments between meals are stored in open baskets within this room.

On 5/23/11 at approximately 11:05 AM, based upon observation it was discovered that the staff office/computer room located on 1 East is not properly maintained. Mouse droppings were observed in this room behind the file cabinets and behind the cardboard box used to collect pop bottles for recycling.

On 5/23/11 at approximately 11:10 AM, based upon observation it was discovered that the laundry room on 1 East is not properly maintained. The under-sink cabinet in this room is kept locked at all times. Upon opening this cabinet, a large accumulation of debris was observed and the interior of the cabinet surface has been damaged and is no longer easily cleanable.

On 5/23/11 at approximately 11:30 AM, based upon observation it was discovered that the hospital's kitchen is not properly maintained. Mouse droppings were observed behind a 1 door upright cooler and bulk storage bin containing oatmeal. Debris accumulation observed underneath the sinks at the pot-pan washing area.

On 5/23/11 at approximately 11:20 AM based upon record review and interview it was discovered that the contracted pest control technician had been in the 1 east unit prior to the findings listed above. Several employees at the nurse station on the 1 East unit indicated that they had seen the contracted pest control technician earlier in the morning, but could not confirm at time that he had been there. At approximately 12:15 PM, upon return to the office of Staff B, a completed work order for the 1 East unit was observed underneath the office door. This document contained the date, contractor's initials and the word "Done". This document did not contain any information regarding the pest management activities performed or the products used on the 1 East unit. In interview with Staff B at approximately 12:15 PM confirmed that this is the typical response from the technician when responding to work orders and when performing routine pest control activities.