K0912 K912: Have power receptacles that are properly grounded.
B

Electrical Receptacle Deficiency in Laundry Room

Warren ManorWarren, Pennsylvania Survey Completed on 04-08-2025

Summary

The facility failed to maintain electrical receptacles in compliance with safety standards in one of over thirty rooms. During an observation on April 8, 2025, at 10:55 a.m., it was noted that the A wing resident laundry room had a washing machine that was not equipped with ground fault circuit interrupter (GFCI) protection. This deficiency was confirmed through an interview with the maintenance supervisor at the same time, who acknowledged the lack of GFCI protection for the electrical outlet in question.

Plan Of Correction

Laundry room receptacle replaced with ground fault circuit interrupter protection. Whole house audit to be completed by Environmental Services Supervisor or designee to ensure all outlets are in compliance by 4/30. Findings to be discussed at Quality Assurance Performance Improvement meeting.

Penalty

No penalty information released
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The penalty, as released by CMS, applies to the entire inspection this citation is part of, covering all citations and f-tags issued, not just this specific f-tag. For the complete original report, please refer to the 'Details' section.
See other K0912 citations
Failure to Maintain GFCI Protection for Electrical Receptacles
B
K0912 K912: Have power receptacles that are properly grounded.
Short Summary

Surveyors identified that three electrical receptacles in the facility were not GFCI protected as required, including those near a sink in the café, a water fountain near the nurse station, and a juice machine in the kitchen. These deficiencies were confirmed by the maintenance supervisor.

No penalty information released
tooltip icon
The penalty, as released by CMS, applies to the entire inspection this citation is part of, covering all citations and f-tags issued, not just this specific f-tag. For the complete original report, please refer to the 'Details' section.
Lack of GFCI Protection on Kitchen Electrical Receptacle
B
K0912 K912: Have power receptacles that are properly grounded.
Short Summary

A kitchen electrical receptacle near the hand sink was found without required GFCI protection during an observation, and this deficiency was confirmed by the administrator and maintenance supervisor.

No penalty information released
tooltip icon
The penalty, as released by CMS, applies to the entire inspection this citation is part of, covering all citations and f-tags issued, not just this specific f-tag. For the complete original report, please refer to the 'Details' section.
Deficiencies in Electrical Outlet Safety and Maintenance
D
K0912 K912: Have power receptacles that are properly grounded.
Short Summary

Surveyors found that an electrical outlet near a waterline was not GFI-protected, a damaged outlet faceplate was present in a resident room, and GFI outlets were not tested according to manufacturer instructions. Staff were unaware of these issues, and the deficiencies affected multiple residents and smoke compartments.

No penalty information released
tooltip icon
The penalty, as released by CMS, applies to the entire inspection this citation is part of, covering all citations and f-tags issued, not just this specific f-tag. For the complete original report, please refer to the 'Details' section.
Non-Compliance with GFI Protection Near Water Sources
E
K0912 K912: Have power receptacles that are properly grounded.
Short Summary

The facility was found non-compliant with GFI protection requirements for power receptacles within six feet of a water source in three smoke zones. Observations revealed non-GFI protected outlets in the D Hall Nurses' Station Nourishment Area, B Hall Beauty Shop, and Main Kitchen Prep Area. This was confirmed by the Assistant DON and Maintenance Director.

No penalty information released
tooltip icon
The penalty, as released by CMS, applies to the entire inspection this citation is part of, covering all citations and f-tags issued, not just this specific f-tag. For the complete original report, please refer to the 'Details' section.
Failure to Maintain GFI Protection Near Water Sources
D
K0912 K912: Have power receptacles that are properly grounded.
Short Summary

The facility did not ensure that power receptacles were GFI protected within six feet of a water source in one of the smoke zones. Observations revealed non-GFI protected outlets behind an ice machine near a resident room and in the Boiler/Generator Room. This was confirmed by the Administrator and Maintenance Director.

No penalty information released
tooltip icon
The penalty, as released by CMS, applies to the entire inspection this citation is part of, covering all citations and f-tags issued, not just this specific f-tag. For the complete original report, please refer to the 'Details' section.
Deficiency in Electrical Receptacle Maintenance
B
K0912 K912: Have power receptacles that are properly grounded.
Short Summary

The facility did not maintain electrical receptacles according to NFPA 101 standards, lacking GFCI protection in the employee lounge water cooler and resident laundry washing machine. This was confirmed by the maintenance director.

No penalty information released
tooltip icon
The penalty, as released by CMS, applies to the entire inspection this citation is part of, covering all citations and f-tags issued, not just this specific f-tag. For the complete original report, please refer to the 'Details' section.

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