Fieldstone at Chester Springs.

“Prescription medication (Calmoseptine ointment) ordered for twice-daily application was administered by direct-care staff who had not completed Department-approved medication administration training and competency testing within the past two years.”

“An over-the-counter medication (Calmoseptine ointment) on a resident's night table was not labeled with the resident's name as required.”

“Medication administrations were not logged on the resident's Medication Administration Record with the correct staff person's initials. Direct care staff applied the ointment but medication technicians logged the administrations with their own initials, falsifying the record.”

“Medication administration records (MAR) did not include the initials of the staff person who administered medications at the times specified. Two residents' May 2025 MARs were missing documentation of staff initials for capsule administration at 2:00 PM and tablet administration at 5:00 PM.”

“Staff members laughed at a resident being hit during incontinence care, failing to treat the resident with dignity and respect. The resident became upset and requested all three staff members leave the room.”

“The home failed to implement positive interventions for a resident who is resistive to care. Staff yelled at the resident, physically restrained the resident's hands, and laughed at the resident being hit, contrary to the resident's care plan which required only one staff member using soft calm voices and invitations to participate in care.”

“Staff physically restrained a resident's hands by grabbing and holding them during incontinence care, which constitutes a prohibited procedure. The resident would break away and hit staff, and the staff member had to repeatedly restrain the resident's hands.”

“A resident's initial support plan was not completed within 30 days of admission as required.”

“The facility's current Licensing Inspection Summary was not posted in a conspicuous and public place in the home.”

“Food was stored in opened and unsealed bags in a stand-out freezer, including French fries, chicken wings, carrots, chicken nuggets, bread, and crispy chicken pieces.”

“Unlabeled and undated trays of chicken were found in the main kitchen walk-in refrigerator, and unlabeled, undated bags of food items were in a stand-out freezer.”

“A resident's prescribed medication was not available in the home on the date of inspection.”

“A medication prescribed for anxiety or agitation was administered to a resident to control behaviors without proper documentation of a specific diagnosis, potentially constituting use as a chemical restraint.”

“A resident's initial assessment was not completed within 15 days of admission as required.”

“Emergency telephone numbers for the nearest hospital and fire department were not posted on or by telephones in bedrooms 3031, 3023, and 3001.”

“The food warmer was missing from the Memory Care Unit on the 1st floor small kitchen, no refrigerator was in the Memory Care Unit on the 2nd floor small kitchen, and the handrail in the bathroom of bedroom 3001 had a loose cover ring.”

“There was no toilet paper for the toilet in bathroom 3013.”

“Soap dispensers within reach of bathroom sinks were not provided in any of the Memory Care bathrooms, including bedrooms 157A and B.”

“Fire extinguisher in the basement has not been inspected by a fire safety expert since June 2023, and the fire extinguisher on the Memory Care Unit small kitchen on the first floor has not been inspected by a fire safety expert since July 2023.”