February 11, 2014 Imran Khan Pioneer Rehabilitation Specialists, Inc.

State of Michigan
DEPARTMENT OF HUMAN SERVICES
BUREAU OF CHILDREN AND ADULT LICENSING
RICK SNYDER
MAURA D. CORRIGAN
GOVERNOR
DIRECTOR
February 11, 2014
Imran Khan
Pioneer Rehabilitation Specialists, Inc.
6372 Tutbury Ln.
Troy, MI 48098
RE: License #: AS630311899
Troy Hills
6372 Tutbury Ln.
Troy, MI 48098
Dear Mr. Khan:
Attached is the Licensing Study Report for the facility referenced above. The violations
cited in the report require the submission of a written corrective action plan. The
corrective action plan is due 15 days from the date of this letter and must include the
following:
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•
•
•
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How compliance with each rule will be achieved.
Who is directly responsible for implementing the corrective action for each
violation.
Specific dates for each violation as to when the correction will be completed or
implemented.
How continuing compliance will be maintained once compliance is achieved.
The signature of the licensee or licensee designee or home for the aged
authorized representative and a date.
Upon receipt of an acceptable corrective plan, a regular license will be issued. If you
fail to submit an acceptable corrective action plan, disciplinary action will result.
Feel free to contact me with any questions. In the event that I am not available and you
need to speak to someone immediately, you may contact the local office at (248) 9755053.
Sincerely,
Stephanie A. Williams, Licensing Consultant
Bureau of Children and Adult Licensing
4th Floor, Suite 4B
51111 Woodward Avenue
Pontiac, MI 48342
(586) 256-2097
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MICHIGAN DEPARTMENT OF HUMAN SERVICES
BUREAU OF CHILDREN AND ADULT LICENSING
RENEWAL INSPECTION REPORT
I.
IDENTIFYING INFORMATION
License #:
AS630311899
Licensee Name:
Pioneer Rehabilitation Specialists, Inc.
Licensee Address:
6372 Tutbury Ln.
Troy, MI 48098
Licensee Telephone #:
(248) 854-8527
Licensee/Licensee
Designee/Authorized
Representative:
Imran Khan
Administrator:
Zubair Ahmed
Name of Facility:
Troy Hills
Facility Address:
6372 Tutbury Ln.
Troy, MI 48098
Facility Telephone #:
(248) 854-8527
Original Issuance Date:
08/09/2011
Capacity:
6
Program Type:
ALZHEIMERS
PHYSICALLY HANDICAPPED
TRAUMATICALLY BRAIN INJURED
AGED
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II. METHODS OF INSPECTION
Date of On-site Inspection(s):
02/10/2014
Date of Fire Inspection:
02/10/2014
Date of Environmental/Health Inspection:
02/10/2014
Date of Exit Conference: 02/10/2014
III. DESCRIPTION OF FINDINGS & CONCLUSIONS
This facility was found to be in non-compliance with the following rules::
R 400.14204
Direct care staff; qualifications and training.
(3) A licensee or administrator shall provide in-service training
or make training available through other sources to direct care
staff. Direct care staff shall be competent before performing
assigned tasks, which shall include being competent in all of the
following areas:
(g) Prevention and containment of communicable diseases.
During the onsite inspection and observation of the medication pass, I observed
Heather, staff not taking universal precautions when passing residents’ medications.
R 400.14312
Resident medications.
(1) Prescription medication, including dietary supplements, or
individual special medical procedures shall be given, taken, or
applied only as prescribed by a licensed physician or dentist.
Prescription medication shall be kept in the original pharmacysupplied container, which shall be labeled for the specified
resident in accordance with the requirements of Act No. 368 of
the Public Acts of 1978, as amended, being {333.1101 et seq. of
the Michigan Compiled Laws, kept with the equipment to
administer it in a locked cabinet or drawer, and refrigerated if
required.
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During the onsite inspection and review of the records on 02/10/2014, I observed
that Resident A did not have prescriptions for any of the over the counter
medications being given and all of the residents’ medications were not being
secured. The key for the cabinet was kept in the lock and cabinet door was
unlocked.
R 400.14312
Resident medications.
(2) Medication shall be given, taken, or applied pursuant to label
instructions.
During the onsite inspection and review of the records, I observed Resident A’s
prescription for stool softener stated medication is to be given as follow; one tab two
times daily but medication record documented that two tab two times daily was being
given.
R 400.14401
Environmental health.
(6) Poisons, caustics, and other dangerous materials shall be
stored and safeguarded in nonresident areas and in non-food
preparation storage areas.
During the onsite inspection of the facility on 02/10/2014, I observed that bleach and
other caustic cleaning supplies were being stored under the kitchen sink and was
not secured or safeguarded from the residents.
R 400.14402
Food service.
(4) All food service equipment and utensils shall be constructed
of material and that is nontoxic, easily cleaned and maintained
in good repair. All food services equipment and eating and
drinking utensils shall be thoroughly cleaned after each use.
During the onsite inspection of the facility on 02/10/2014, I observed that the handle
on the freezer door of the refrigerator was broken.
R 400.14403
Maintenance of premises.
(1) A home shall be constructed, arranged, and maintained to
provide adequately for the health, safety, and well-being of
occupants.
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During the onsite inspection of the facility on 02/10/2014, I observed the following:
• Ceiling fan blades in bedroom #1, ventilation in bathroom#1, air vent on
ceiling in hallway between bedrooms were dirty and dust covered.
• Blown light bulb in bathroom#2.
• Bedroom#3’s bedroom door did not close properly and was not flushed
against the frame.
• Remove clothing items found behind washing machine and dryer.
R 400.14403
Maintenance of premises.
(2) Home furnishings and housekeeping standards shall present
a comfortable, clean, and orderly appearance.
During the onsite inspection of the facility on 02/10/2014, I observed the recliner
chair was torn in bedroom #1 and there were missing window blinds in bedroom#4.
R 400.14408
Bedrooms generally.
(4) Interior doorways of bedrooms that are occupied by
residents shall be equipped with a side-hinged, permanently
mounted door that is equipped with positive-latching, nonlocking-against-egress hardware.
During the onsite inspection of the facility residents’ bedrooms were not equipped
with positive-latching non-locking-against-egress hardware.
R 400.14408
Bedrooms generally.
(8) Residents of the opposite sex shall not occupy the same
bedroom for sleeping purposes, unless they are husband and
wife.
During the onsite inspection of the facility and review of the records on 02/10/2014, I
observed that Resident B and Resident C had been identified as brother and sister
were sharing a room at the facility.
R 400.14512
Electrical service.
(1) The electrical service of a home shall be maintained in a
safe condition.
During the onsite inspection of the facility on 02/10/2014, I observed that the door to
the electrical fuse box was broken off.
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Licensee was informed that, pursuant to MCL 400.713(3)(e), they are responsible for
assessing the good moral character of any person who provides care for residents of
this facility under the direction, or in the place of, the licensee. Licensee provided a
description of their process to determine good moral character.
The licensee, at the time of this renewal inspection, was found to be in compliance
with those rules related to the handling and accounting of resident funds and
valuables. This determination is based on the financial information provided by the
licensee for those resident files reviewed.
IV. RECOMMENDATION
Contingent upon receipt of an acceptable corrective action plan, renewal of the license
is recommended.
02/11/2014
_______________________________________
Stephanie A. Williams
Date
Licensing Consultant
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