The Springs of El Dorado

In the surveyor’s words

From the most serious findings on record at The Springs of El Dorado, in the surveyor’s own words.

• Immediate jeopardy, isolatedF689Dec 30, 2022

  Based on record review and interview, the facility failed to provide adequate supervision and assistive devices to prevent accidents for 1 (Resident #52) of 1 sampled resident who fell during transport in the facility van. This failed practice resulted in Immediate Jeopardy, which caused or could have caused serious harm, injury, or death to Resident #52 who fell out of the wheelchair in the facility van during transport on 11/22/22. The failed practice had the potential to affect all 63 residents who resided in the facility as documented on the Daily Census Report provided by the Administrator on 12/27/22 at 10:27 a.m. The Administrator was notified of the Immediate Jeopardy on 12/27/22 at 3:50 PM. The findings are: 1. […]

• No harm, potential for more than minimal, widespreadF812Mar 1, 2024

  Based on observation, record review and interview, the facility failed to ensure dented cans were discarded to prevent bacteria growth; food items had opened and/or received dates; shelves were clean of debris; and contaminated pan covers were not placed on food to be served. These practices had the potential to affect 80 (total census 81) residents who resided in the facility. The findings are: 1. On 2/26/2024 at 11:30 AM, one 50 ounce can of Tomato Soup did not have received date and had a dent near the seal. The Surveyor asked the Dietary Manager, why should dented cans not be used? The Dietary Manager confirmed dented cans bent at rim may not be safe, may be contaminated. 2. […]

• No harm, potential for more than minimal, widespreadF880Mar 1, 2024

  Based on record review and interview, the facility failed to ensure that resident laundry was transported in a way to prevent the spread of infection. This failed practice had the potential to affect 81 residents residing in the facility. The findings are: 1. On 02/26/24 at 3:43 PM, Laundry Worker #1 was putting clothes away in room [ROOM NUMBER]. The laundry cart was sitting outside in the hall, uncovered, with clean clothing laying on it. 2. On 02/29/24 at 2:35 PM, the Housekeeping Supervisor [HS] was asked, How is clean laundry supposed to be transported back to a resident's room? The HS stated, The laundry is supposed to be on a cart and covered with a sheet. 3. […]

• No harm, potential for more than minimal, widespreadF812Dec 30, 2022

  Based on observation and interview, the facility failed to ensure dietary staff washed their hands between clean and dirty tasks, foods were utilized prior to their use by dates, containers were sealed to prevent the potential for food borne illness for residents who received meals from 1 of 1 kitchen and the kitchen and equipment was cleaned to prevent cross contamination. These failed practices had the potential to affect 62 residents (Total Census: 63) who obtained their meals from 1 of 1 kitchen according to a list provided by the Administrator on 12/29/22 at 1:18 PM. The findings are: 1. On 12/27/22 at 10:32 AM, the following observations were made in the Dry Storage Area: a. On a shelf was a 25 pound box of graham cracker crumbs was on a shelf. […]

• No harm, potential for more than minimal, widespreadF885Dec 30, 2022

  Based on record review and interview, the facility failed to notify residents, their representatives, and families of those residing in facilities by 5:00 p.m. the next calendar day following the occurrence of a single confirmed infection of COVID-19 for 4 (Residents #1, #3, #36 and #52) sampled residents whose records were reviewed. The findings are: 1. The Center for Clinical Standards and Quality/Quality, Safety & Oversight Group Interim Final Rule Updating Requirements for Notification of Confirmed and Suspected COVID-19 Cases Among Residents and Staff in Nursing Homes dated 05/06/2020 documented, .COVID-19 Reporting. The facility must . (3) Inform residents, their representatives, and families of those residing in facilities by 5 p.m. […]