Truman W Smith Children's Care Center

Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure the appropriate treatment and services to prevent complications was provided for 2 of 6 residents reviewed for feeding tube management. (Resident #1 and Resident #2)The facility failed to follow the physician's orders for Resident #1's feeding tube (medical device to deliver nutrition, hydration, and medication directly to the stomach) rate (how fast it was given) of delivery on 3/16/26 and 3/17/26. The facility failed to follow the physician orders for Resident #2's feeding tube duration of administration and total volume (amount) of feeding on 3/17/26. These failures placed residents at risk for vomiting, aspiration (accidental breathing in food, liquid, or foreign material into airway/lungs which increased the risk of pneumonia (lung infection), malnutrition, and weight gain or loss.

Inspectors wroteBased on observations, interviews, and record reviews, the facility failed to treat each resident with respect and dignity and provide care in a manner that promoted maintenance or enhancement of his or her quality of life for 1 of 24 residents (Resident #63) reviewed for resident rights. The facility failed to ensure RT C acknowledged Resident #63 while providing care on 11/16/25. This failure could place residents at an increased risk of anxiety and a diminished quality of life.

Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure residents who were fed by enteral means received the appropriate treatment and services to prevent complications of enteral feeding for 1 of 11 residents (Resident #18) reviewed for enteral nutrition. The facility failed to ensure Resident #18's head of the bed was elevated while receiving a tube feeding (delivers liquid nutrition through a flexible tube that goes directly into your stomach or small intestine) on 11/16/25. This failure could place residents with gastrostomy tube at risk for complications from feeding tube administration such as aspiration and pneumonia.

Inspectors wroteBased on observations, interviews, and record review, the facility failed to provide a safe, functional, sanitary, and comfortable environment for residents, staff, and the public, for 1 of 1 laundry room reviewed for environment. The facility failed to ensure the air filters in the laundry room were clean, the air filters were dirty with a thick dark gray substance. This failure could place the residents at risk of living and working in an unsafe, unsanitary and uncomfortable environment.

Inspectors wroteBased on observations, interviews, and record review the facility failed to store, prepare, distribute, and serve food in accordance with professional standards for food service safety in 1 of 1 kitchen reviewed for food safety requirements and kitchen sanitation. The facility failed to ensure all foods stored in the freezers, and dry pantry were not kept past their expiration dates and did not contain employee personal items. These failures could place residents at risk of foodborne illness and food contamination.

Inspectors wroteBased on observation, interview, and record review, the facility failed to establish and maintain an infection prevention and control program designed to provide a safe, sanitary, and comfortable environment, and to help prevent the development and transmission of communicable diseases and infections for 1 of 2 residents observed for incontinent care infection control practices (Resident #79), and 3 of 3 residents observed for medication administration control practices. (Resident #'s 27, 91, 71). 1. CNA A did not change her gloves or sanitize her hands after performing incontinent care on the front perineal area for Resident #79 and touched clean areas. 2. The facility failed to ensure RN G performed hand hygiene before and after administering medications to 3 different residents. [...]

Inspectors wroteBased on observation, interview, and record review, the facility failed to provide a safe, functional, sanitary, and comfortable environment for 1 of 23 residents reviewed for environment. (Resident #48) 1. The facility failed to remove a green sputum filled suction canister over ¾ full in the room of Resident #48 a timely manner. This failure placed resident at risk of exposure to growing bacteria from another resident, living in an uncomfortable environment and a decrease in quality of life and self-worth.

Inspectors wroteBased on observations, interviews, and record review, the facility failed to maintain an infection prevention and control program designed to provide a safe, sanitary, and comfortable environment and to help prevent the development and transmission of communicable disease and infection for 1 of 6 residents (Residents #1) reviewed for infection control. 1. While in outbreak status for COVID-19, CNA A, LVN B, and Sitter C failed to wear N-95 masks as identified as a requirement in the facility policy. 2. While removing Resident #1's speaker valve, RT D did not wash, sanitize her hands, or wear gloves during the procedure. These deficient practices could place residents at-risk for infection due to improper care practices.

Inspectors wroteBased on observation, interview, and record review, the facility failed to provide residents with limited range of motion appropriate treatment and services to increase range of motion and to prevent further decrease in range of motion for 4 of 23 residents reviewed for range of motion. (Resident #6, Resident #21, Resident #67, and Resident #68) The facility failed to provide restorative therapy for contractures or contracture prevention for Resident #6, Resident #21, Resident #67, and Resident #68. This failure could place residents who had contractures at risk of not attaining/or maintaining their highest level of physical, mental, and psychosocial well-being.

Inspectors wroteBased on observation, interview, and record review, the facility failed to store, prepare, and serve food in accordance with professional standards for food service safety in the facility's only kitchen, reviewed for kitchen sanitation. 1. The facility failed to ensure refrigerated foods were properly labeled and dated. 2. The facility failed to ensure the fryer was clean and free of food debris. These failures could place residents at risk for food-borne illness.

Inspectors wroteBased on observations, record review and interviews, the facility failed to ensure an environment that was free of accident hazards and that each resident received adequate supervision to prevent accidents for 1 of 24 residents (Resident # 25) reviewed for accidents. The facility failed to protect Resident #25 when CNA A shook off the metal hook from the mechanical lift with her hands causing the metal hook to fall and hit Resident #25 in the chest and fall to her lap. This failure could place residents at risk for injury or harm.

Inspectors wroteBased on observation, interview, and record review, the facility failed to maintain and ensure safe and sanitary storage of residents' food items for 1 of 3 resident personal refrigerators reviewed for food safety (Resident # 51). The facility failed to ensure the refrigerator for Resident # 51 did not contain expired foods. This failure could place resident at risk for food borne illnesses.

Inspectors wroteBased on observation, interview, and record review the facility failed to maintain an infection prevention and control program designed to provide a safe, sanitary, and comfortable environment and to help prevent the development and transmission of communicable diseases and infections for 1 of 22 residents (Residents # 5) reviewed for infection control practices. The facility failed to ensure that a urine sample was removed from Resident # 5's dresser. These failures placed residents at risk for cross contamination and infection.