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02 - August 13, 2024 Homes Committee of Management Agenda PackageElginCounty Homes Committee of Management Orders of the Day Tuesday, August 13, 2024, 11:00 a.m. Council Chambers 450 Sunset Drive St. Thomas ON Note for Members of the Public: Please click the link below to watch the Committee Meeting: https://www.facebook.com/ElginCountyAdmin/ Accessible formats available upon request. 1. Call to Order 2. Approval of Agenda 3. Adoption of Minutes 4. Disclosure of Pecuniary Interest and the General Nature Thereof 5. Delegations 6. Reports/Briefings 6.1 Director of Homes and Seniors Services - Homes — Committee of Management — Long -Term Care Director's Update April 1, 2024 — June 30, 2024 6.2 Director of Homes and Seniors Services - Homes — Committee of Management — Long -Term Care Operational Report 7. Other Business 8. Correspondence 9. Closed Meeting Items 10. Motion to Rise and Report 11. Date of Next Meeting 12. Adjournment Pages 2 0 16 uoi Homes Committee of Management Minutes June 25, 2024, 10:00 a.m. Council Chambers 450 Sunset Drive St. Thomas ON Members Present: Warden Ed Ketchabaw Deputy Warden Grant Jones Councillor Dominique Giguere Councillor Mark Widner Councillor Jack Couckuyt Councillor Andrew Sloan Councillor Todd Noble Councillor Mike Hentz Councillor Richard Leatham Staff Present: Blaine Parkin, Chief Administrative Officer/Clerk Michele Harris, Director of Homes and Seniors Services Nicholas Loeb, Director of Legal Services Katherine Thompson, Manager of Administrative Services/Deputy Clerk Jenna Fentie, Legislative Services Coordinator Stefanie Heide, Legislative Services Coordinator 1. Call to Order The meeting was called to order at 10.49 a.m. with Warden Ketchabaw in the chair. 2. Approval of Agenda Moved by: Deputy Warden Jones Seconded by: Councillor Sloan RESOLVED THAT the agenda for the June 25, 2024 Homes Committee of Management meeting be approved as presented. Motion Carried. 1 Page 2 of 37 3. Adoption of Minutes None. 4. Disclosure of Pecuniary Interest and the General Nature Thereof None. 5. Delegations None. 6. Reports/Briefings 6.1 Director of Homes and Seniors Services - Homes — Committee of Management — Long -Term Care Director's Update January 1 — March 31, 2024 The Director of Homes and Seniors Services presented the report that provides an overview of recent updates and the Ontario Health and Ministry of Long -Term Care announcements that impact the three (3) Elgin County Long -Term Care Homes. The report also provides an overview of projects and services for the residents and staff of the Homes to support quality services and care. Moved by: Councillor Noble Seconded by: Councillor Couckuyt RESOLVED THAT the report titled "Homes — Committee of Management — Long -Term Care Director's Update January 1 — March 31, 2024" from the Director of Homes and Seniors Services dated June 25, 2024 be received and filed; and THAT the Committee of Management authorize staff to sign and submit Schedule F — Form of Compliance Declaration for the MSAA for the period of April 1, 2023 to March 31, 2024 indicating one exception related to training/work plan requirements. Motion Carried. 6.2 Director of Homes and Seniors Services - Homes — Committee of Management — Policy and Procedure Manuals — Review and Revision The Director of Homes and Seniors Services presented the report that details revisions to the Elgin County Long -Term Care Homes administration, dietary, housekeeping and laundry, infection prevention and control, maintenance, nursing, and program and therapy policy manuals. Moved by: Deputy Warden Jones Seconded by: Councillor Giguere 2 Page 3of37 RESOLVED THAT the report titled "Homes — Committee of Management — Policy and Procedure Manuals — Review and Revision" from the Director of Homes and Seniors Services dated June 25, 2024 be received and filed. Motion Carried. 6.3 Director of Homes and Seniors Services - Homes — Committee of Management — Long Term Care Operational Report The Director of Homes and Seniors Services presented the report that provides an overview of day-to-day operations of the three (3) Elgin County Long -Term Care Homes and details departmental and committee updates and inspections for the period of January 1 - March 31, 2024. Moved by: Councillor Leatham Seconded by: Councillor Widner RESOLVED THAT the report titled "Homes — Committee of Management — Long -Term Care Operational Report" from the Director of Homes and Seniors Services dated June 25, 2024 be received and filed. Motion Carried 7. Other Business None. 8. Correspondence None. 9. Closed Meeting Items None. 10. Motion to Rise and Report None. 11. Date of Next Meeting The next Homes Committee of Management meeting will be held on August 13, 2024 following the County Council meeting. 12. Adjournment Moved by: Deputy Warden Jones Seconded by: Councillor Widner RESOLVED THAT we do now adjourn at 11.49 a.m. to meet again on August 13, 2024 following the County Council meeting. 3 Page 4 of 37 Blaine Parkin, Chief Administrative Officer/Clerk. Warden Ed Ketchabaw, Chair. Page 5of37 ElginCounty Report to Homes Committee of Management From: Michele Harris, Director of Homes and Seniors Services Date: August 13, 2024 Subject: Homes — Committee of Management — Long -Term Care Director's Update April 1, 2024 — June 30, 2024 Recommendation(s): THAT the report titled "Homes — Committee of Management — Long -Term Care Director's Update April 1, 2024 — June 30, 2024" dated August 13, 2024 be received and filed. Introduction: This report provides an overview of recent updates, and, Ontario Health and Ministry of Long -Term Care announcements which impact the three (3) County of Elgin Long -Term Care Homes services and operations. Additionally, an overview of projects and services for the residents and staff of the Homes to support quality services and care is included in the report. Background and Discussion: Ministry Updates On April 19, 2024, the Ministry of Long -Term Care released a memo outlining the COVID-19 vaccine campaign for the spring. Due to waning immunity, the National Advisory Committee on Immunization (NACI) recommended a spring 2024 COVID-19 vaccine, targeting individuals who are at a higher risk for severe illness and hospitalization due to COVID-19, which includes residents living in long-term care homes (LTCHs). The Spring vaccine campaign was put into place at each of our three LTCHs and the infection prevention and control (IPAC) managers worked with Southwestern Public Health to order and prepare to administer vaccines to eligible residents in a timely manner. Page 6 of 37 This memo also provided an update related to the COVID-19 response measures directive and guidance documents which were revoked on April 19, 2024. This change streamlines and integrates the number of IPAC and outbreak management related requirements and guidance documents for LTCHs. A "Fact Sheet (from the Ministry of Long -Term Care) for LTCH Residents Regarding Vaccinations and Therapeutics Spring 2024" was communicated to residents and families to provide additional information to support the campaign. On April 26, 2024, the Ministry of Long -Term Care released a memo and fact sheet regarding the Ontario Regulation 246/22 that came into effect on May 1 and July 1, 2024. Summary of updates effective May 1, 2024 include: • Staffing qualifications were amended for some roles to ensure qualification requirements are proportionate to the responsibilities and accountabilities of the role for the following: o Administrator o Therapy Services Staff o Designated Lead for the Restorative Care Program o Designated Lead for the Volunteer Program Enabling regulated health professionals who are authorized under the Regulated Health Professions Act, 1991, or otherwise acting within their scope of practice, to conduct skin assessments for residents at risk of altered skin integrity. Clarifying amendments related to air conditioning, including: o The limited circumstances in which a licensee would not have to install a portable or window air conditioning unit; o The circumstances when a licensee must implement the heat -related illness prevention and management plan; and, o Consistency in language between the air conditioning and air temperature requirements. Summary of updates effective July 1, 2024 include: • Amendments to enable nursing students working in LTCHs as nursing student externs to carry out certain responsibilities that are restricted to certain roles such as admininstering drugs and conducting skin assessments; • Permitting registered practical nurses (RPN) to complete assessments of applicants for personal care for the purpose of placement coordinators' determinations of eligibility for LTCH admissions; • Clarity to licensees on ensuring access to essential visitors during emergency situations; • Revoking certain pandemic provisions that are no longer relevant and used by system stakeholders; • Technical amendments to provide greater flexibility to support the designation of "imminent home closure" to facilitate resident relocation. On May 1, 2024, the Ministry of Long -Term Care released a follow-up memo regarding the extension of staffing qualifications flexibility provision for Personal Support Workers Page 7 of 37 (PSW) and consultation on Ontario's Regulatory Registry. Effective May 1, 2024, the ministry extended the transitional staffing qualifications for PSWs and staff providing personal supports for an additional 12 months until July 1, 2025. This will continue to allow staff (that is, PSW or staff providing personal support services) without the requisite training to continue providing personal supports to low -risk residents if the licensee is of the reasonable opinion that the individual has the adequate skills, training, and knowledge to perform the job. The ministry posted an approach for consultation on the provincial Regulatory Registry from May 1, 2024 to June 15, 2024. Based on feedback received, the ministry stated it may propose a full suite of amendments to the Regulation in the fall to support the implementation of this approach. The Ministry of Health announced the new regulations under the Health and Supportive Care Providers Oversight Authortiy Act (HSCPOA), 2021 are now final. A press release from the Ministry of Health was released on June 4, 2024, that beginning December 1, 2024, more than 100,000 personal support workers in Ontario will have the option to register with the new HSCPOA. The HSCPOA will ensure consistent education and training for PSWs, regardless of where they work and if they are part-time or full-time, to support their career growth and give patients confidence that they are receiving high - quality care. Those registered with the authority will also be listed on an online public register and be easily identified with the HSCPOA's quality mark on their identification badge or paperwork in order to show proof of registration. Informational webinars are being hosted in July and August for employers to learn about the HSCPOA and an opportunity to ask questions. Information will be shared with front line staff when available. On June 6, 2024, a Government of Ontario press release was received announcing the new Minister of Long -Term Care, Natalia Kusendova-Bashta. Minister Kusendova- Bashta is a registered nurse and worked in the LTC sector during the height of the COVID-19 pandemic. The Canadian Association for Long -Term Care advocated for a national day to be established to recognize long-term care in Canada. National Long -Term Care Day was recognized on June 13, 2024. This day acknowledges the collective contributions and achievements for the LTC sector. Importantly, we also take this time to celebrate the residents and the dedicated and hard-working staff who provide care to Canadians residing in LTCHs. On June 18, 2024, due to the unseasonalby high temperatures in June, the Ministry of Long -Term Care released a memo reminding LTCHs of air conditioning requirements and heat related illness prevention and management plan requirements. The cooling, air conditioning, air temperature and heat -related illness prevention and management plan requirements are set out in LTC legislation and apply to the period of May 15 to September 15 each year; and, on any day on which the outside temperature forecasted by Environment and Climate Change Canada for the area in which the home is located is 26 degrees Celsius or above at any point during the day; and any time the Page 8of37 temperature in an area in the home measured by the licensee reaches 26 degrees Celsius or above. In addition to the installation of air conditioning in resident rooms, operators are to undertake interventions to reduce heat and humidity indoors that may include: • Installing and using window coverings that block the sun and heat. • Keeping windows closed if heat and humidity are higher outside (over 26 degrees Celsius and 50 % humidity). • Readily available cooling supplies and equipment that staff are familiar with using. • Having heating, ventilation and air conditioning systems inspected by certified technicians twice per year and ensuring LTCH maintenance staff are familiar with the manufacturer's required routine maintenance checks. • All portable cooling and air-conditioning equipment are installed, cleaned and maintained in accordance with manufacturer's instructions. • Reschedule the time that heat generating equipment such as dryers and dishwashers are used. On June 24, 2024, as part of the new Your Health: A plan for Connected and Convenient Care launch and the Convenient Care at Home Act, 2023, it was announced by Deputer Minister Melissa Thomson, that the 14 Local Health Integration Networks, operating as Home and Community Care Support Services had amalgamated into a new service organization called Ontario Health atHome as of June 28, 2024. The amalgamation and new designation does not result in changes to the LTCH placement process for applicants, their families/caregivers or LTCHs. Placement services will continue to operate pursuant to the same geographic areas; applicants will continue to access placement coordination services in the same way and through the same contacts through the transition period. Looking forward, the Ministry of Long -Term Care will continue to work with the Ministry of Health, Ontario Health, Ontario Health atHome and the LTC sector to consider how placement services can be managed over the longer -term. This will include considering the role of Ontario Health Teams in providing integrated service delivery for Ontarians. Ministry of Long -Term Care/Ontario Health West Reporting Long -Term Care homes continue to have weekly, quarterly, annual and other time - sensitive reporting and document execution/submission obligations and requirements which are completed within the authority of the delegation bylaw. Reporting and documents submitted for the three County of Elgin Homes during the timeframe of April 1 — June 30, 2024, within the delegation of authority bylaw include the following: • Each home continues to complete the LTCH data submission (L9 Form) weekly to provide details regarding bed vacancies, bed rate changes, etc. Page 9of37 • Each home continues to submit, in consultation with finance and human resource department staff, quarterly staffing reports to the Ministry. • 2023-2024 Schedule F, Declaration of Compliance for the Multi -Sector Service Accountability Agreement (M-SAA) were signed and submitted to Ontario Health West along with the certificates of insurance on June 26, 2024 for both the Bobier Villa and the Terrace Lodge Adult Day programs. • 2024-25 Level of Care Funding Increases to LTCHs Effective April 1, 2024 signed and submitted to Ontario Health West on May 27, 2024. • 2023-24 and 2024-25 Base Funding for Community Services signed and submitted to Ontario Health West on April 12, 2024. • CCA s. 22 Notice and Amendment of LTCH Service Accountability Agreement Amendment Letter signed and submitted to Ontario Health West on May 8, 2024 (1 for each Bobier Villa, Elgin Manor and Terrace Lodge). • Service Accountability Agreement — French Language Services Survey completed for all three Homes and Adult Day Programs before the due date of June 28, 2024. • Service Accountability Agreement — Advance Indigenous Health Strategies and Outcomes Plan and Health Equity Plan completed for all three Homes and Adult Day Programs before the due date of June 30, 2024. Agreements Executed The following agreements have been developed and executed in consultation with legal services, the procurement team, and, as required, the CAO, and align with the authority of the delegation bylaw. Elgin Manor & Bobier Villa extension and amending agreement with Dawn Peddie for Hair Salon services. o Agreement signed June 14, 2024 for the term of May 1, 2024 to April 30, 2025 with modest price increases. Residents and families continue to express satisfaction with hair care services. o Residents and families pay for individual hair care services. Social Worker Services o Agreement signed June 17, 2024 with Age -wise Solutions Inc. for the term of July 2, 2024 to July 1, 2025. o Social Worker services are funded through ministry Resident Health and Well-being funding and Allied Health Professional Funding. o Social worker services will be available 2 days/week at both Elgin Manor and Terrace Lodge; and, 1 day/week at Bobier Villa. Preventative Maintenance Program for mobility devices o Agreement signed May 10, 2024 with Wellness & Mobility Inc. for the term of June 1, 2024 to May 31, 2027. Eastlink Business - Cable Services for Terrace Lodge and Elgin Manor o Agreement signed May 3, 2024 for 3 year term o No price increase for residents o Additional, new channels provided Project Updates Page 10 of 37 • E-connect o Training, ONEID registration and implementation underway. o Regulated health professionals will be provided access to personal health information via Point Click Care for residents that visit/admitted to hospital. o Regulated health professionals complete training for e-connect, privacy/PHIPA, complete the ONEID registration process and then are approved by one of the LRA's — Admininstrators of the Homes, Director of Homes and Seniors Services. Staff Schedule Care (SSC) o Mass messaging has been implemented across the 3 homes and is supporting future call ins for administrative clerks. o After hours, same day call -ins have been determined to be better managed through the use of the "wizard" by registered staff. o Project sign off by the Director of Homes and Seniors Services and Director of Finance was completed on June 17, 2024. o New and/or returning managers and administrative clerk training will be supported by current team members, resources within SSC and remaining blocks of time with SSC previously purchased. Policv and Procedure Uadates The following policies were reviewed and revised by the Director of Homes and Seniors Services in collaboration with the respective departmental managers to align with the Fixing Long -Term Care Act (FLTCA), 2021 and Ontario Regulation 246/22. Policy Policy Revision Revisions Manual #/Name Date Administrat 3.15.12 Code May 2024 Policy name update to include "Or ion — Silver — Threat". Section 3 Person with Updated with a checklist and a Weapon or directions in regards to a "threat" Threat versus an actual onsite Code Silver Nursing — Medication — April Updated to align with legislation. Section M Self 2024 Incorporated Appendix 1 — Administratio evaluation of self -administration of n by a medications into policy. Resident Pharmacy, physician, manager, front line staff review to support Ministry of Long -Term Care Proactive Compliance Inspection finding. Infection Medical May 2024 Updated to align with current Control Directive — guidance in relation to COVID-19 (IC) COVID- 19 vaccine administration for Section 2 Vaccine residents. Administratio n2.4d) Page 11 of 37 Financial Implications: The Homes are appreciative of the following announcements to support the provision of care and services in our three Homes. On May 6, 2024, LTCHs received the Case Mix Index (CMI) Funding Methodology for 2024 -2025. The ministry also provided the master report which provides an overview for all LTCHs in Ontario and a Case Mix Index Frequently Asked Questions document. The provincial average CMI is 1.0218. The three County of Elgin Homes funded CMI for 2024-2025 is above the provincial average: • Bobier Villa — 1.2064 • Elgin Manor — 1.0832 • Terrace Lodge— 1.1210 Home 2023-2024 Funded CMI 2024-2025 Funded CMI Change Budgetary Impact Bobier Villa 1.1884 1.2064 0.0180 $27,077 Elgin Manor 1.1051 1.0832 (0.0219) ($52,017) Terrace Lodge 1.1250 1.1210 (0.0040) $5,014 Total ($19,925) Note: Unfavourable () - Actual increase received less than budgeted. The Level of Care Funding Summary was also received on May 6, 2024 announcing a 6.6% Funding increase. Staff are working through the details of the funding announcements and will provide a future fulsome report with recommendations. On May 3, 2024, LTCHs received a memo from the Ministry regarding the regulated annual increase to the accommodation rates that came into effect on July 1, 2024. Annual co -payment rate increases are based on the rate of inflation measured by the change in the prior year Canadian Consumer Price Index (CPI) and are capped at 2.5%. Given the change in the prior year CPI was 3.9%, an inflationary increase of 2.5 % has been applied, effective July 1, 2024. Residents electing a Basic room rate are eligible for application for rate reduction and are required to re -apply for a reduction beginning on July 1, 2024. Accommodation Rates as of July 1, 2024 Type of Accommodation Daily Rate Monthly Rate Basic $66.95 $2,036.40 Semi -Private $80.72 $2,455.24 Private $95.65 $2,909.36 Page 12 of 37 LTCHs are required to provide 30 days notice to rate changes, and communications were posted in the Homes, sent to resident council, family council and within the billing notice. On May 14, 2024, the Ministry of Long -Term Care released a memo announcing Preceptor Resource and Education Program for LTC (PREP LTC) Year 4 Enrollment and Registration. This announcement aligns with the January 31, 2024 announcement to extend the program for an additional three years to 2026-2027 to support homes in boosting the quality and quantity of clinical placements in their homes and across the sector. All three of our Homes have enrolled/registered for the 2024/25 PREP LTC initiative. On May 17, 2024, the Ministry of Long -Term Care released a memo to all long-term care homes that the Ministry received information regarding fraudulent police record checks and Tuberculosis (TB) screening documents related to security and resident support staff working in homes through a contracted agency. The ministry contacted all the homes that have used this agency. Our three homes currently does not utilize agency staff; has not utilized agency for security or resident support staff, and, as such were not contacted by the Ministry. The management of the Homes work closely with Human Resources to ensure that all staff onboarding to the Homes meet the legislative requirements for screening. On May 23, 2024, the Ministry of Long -Term Care released a memo advising LTCHs of a mandatory survey to obtain information from homes on how minor capital funds have been used in previous fiscal years and planned minor capital projects in future years. The survey was completed by senior LTCH management and the Director of Homes and Seniors Services in collaboration with the finance and facilities department within the required timelines. On June 3, 2024, the Ministry of Long -Term Care released a memo announcing a top - up in addition to the maximum eligible costs outlined in the Laboratory Services Funding Guidelines. Reimbursements are retroactive to April 1, 2024 and shall be based on the actual cost for services received from April 1, 2024 through March 31, 2025, to a maximum of the amounts specified. On June 18, 2024, the Ministry of Long -Term Care released a memo related to the 2024-25 and 2025-26 one-time funding for the Integrated Technology Solution (ITS) Program to support homes in continuing to enhance medication safety and meeting the unique technological and digital solutions needs. This program replaces and combines the Medication Safety Technology (MST) and the Clinical Support Tools (CST) programs and funding. The Ministry will provide funding based on a calculation of $1.13 in per diem funding or $30,000 whichever is greater. The funding for our three Homes is demonstrated in the table below outlining the funding change. Page 13 of 37 Integrated Tech noLoLPv Fuuundiun Greater of Home Sleds FerlDierrn Amount Fuuundiun EM 90 $37,120.50 $30,000 $37,121 TL 100 $41,245.00 $30,000 $41,245 BV 57 $23,509.65 $30,000 $30,000 P�rio�r F�uundiun MSTP" GMT T rtal Funding Change 29,014 $10,000 $39,014 Decrease 32„226 $10,000 $42,228 ; Decrease 16,373 $10,000 $28,373 $1,6271Increase On June 24, 2024, the Ministry of Long -Term Care released a memo announcing updates to funding for LTC Infection Prevention and Control (IPAC) Personnel including an IPAC Lead, training and education. An analysis of the funding announcement was conducted and the funding change is demonstrated in the table below. 2024 IPAC F'unndinn Home 2024--25 Funndinn� Budgeted Funding Change EM $01,430 $102,560 t l 9 21 Decrease TIL $81,439 $105,023 'c ,,,`, 4 IDecreese BV $54,273 $67,616 .;y 9 r^i,:h Decrease Flexibility within the Allied Health Professional funding will be utilized to adjust for any IPAC funding decreases. Alignment with Strategic Priorities: Serving Elgin Growing Elgin Investing in Elgin ® Ensuring alignment of ❑ Planning for and ® Ensuring we have the current programs and facilitating commercial, necessary tools, services with community industrial, residential, and resources, and need. agricultural growth. infrastructure to deliver programs and services ® Exploring different ways ® Fostering a healthy now and in the future. of addressing community environment. need. ® Delivering mandated ® Enhancing quality of programs and services ® Engaging with our place. efficiently and effectively. community and other stakeholders. Local Municipal Partner Impact: The announcements from the Ministry of Long -Term Care and Ontario Health support the quality of care and support positive outcomes for the three County of Elgin LTCHs Page 14 of 37 as we continue to provide care and services to the residents of our homes and community clients. Communication Requirements: Information has been communicated to the appropriate departments, resident council, family council, residents, staff and visitors as required. Conclusion: The long-term care homes management team continues to be thankful for the support from Council, the Chief Administrative Officer, the Senior Management Team, and the staff in all departments as we work collaboratively to maintain and improve the quality of services and care for our residents, families, staff and communities. All of which is Respectfully Submitted Michele Harris Director of Homes and Seniors Services Approved for Submission Blaine Parkin Chief Administrative Officer/Clerk Page 15 of 37 ElginCounty Report to Homes Committee of Management From: Michele Harris, Director of Homes and Seniors Services Date: August 13, 2024 Subject: Homes — Committee of Management — Long -Term Care Operational Report Recommendation(s): THAT, the report titled "Homes — Committee of Management — Long -Term Care Operational Report" dated August 13, 2024 be received and filed. Introduction: This report provides an overview of day-to-day operations of the three (3) County of Elgin Long -Term Care Homes (LTCH) along with pertinent departmental and committee updates and inspections for the period of April 1, 2024 to June 30, 2024. Background and Discussion: Ministry of Long -Term Care (MLTC) Compliance Inspection Visit Reports Summary Ministry of Long -Term Care Inspections are unannounced and last from 1 day to 2 weeks depending on the purpose of the inspection. There are several types of inspections of long-term care homes as follows: • Reactive Inspections which are done in response to complaints or critical incident submissions and generally focus on the substance of the complaint or incident ; and, follow-up inspections conducted to ensure that any compliance orders have been addressed. • Proactive Inspections are broad -based inspections carried out on a regular basis to ensure a home is in ongoing compliance with the Act and Regulation. • Other types of inspections include pre -occupancy and post -occupancy inspections visits to a home undergoing the development/redevelopment of beds. Bobier Villa MLTC inspectors visited the Home on April 3, 4, 8, 9,and 10, 2024 to conduct a critical inicident inspection related to an allegation of resident abuse. During the course of this inspection the inspector made relevant observations, reviewed records and conducted Page 16 of 37 interviews. Inspection protocols utilised during the inspection included skin and wound prevention and management, infection prevention and control, responsive behaviours, reporting and complaints, and falls prevention and management. There were no findings related to resident abuse. There was one written notification issued related to falls prevention and management and skin and wound care in relation to resident assessment. 0 �uIus . .,Iu .I ...............V..............................,...V........J...1...............6...........°...a ...................................[,:,.!,...,,,il,........... Elgin Manor MLTC inspectors visited the Home on June 3, 4, 7, 10, 11, 12, and 13, 2024 to conduct a critical incident inspection regarding 6 critical incidents submitted by the Home related to allegations of resident abuse and the fall of a resident with injury. Inspection protocols utilized during the inspection included Infection Prevention and Control, Prevention of Abuse and Neglect, Responsive Behaviours, and Falls prevention and Management. There was one compliance order in regards to duty to protect with a timeframe of July 26, 2024 to provide retraining to all staff in post falls procedures; keeping a documented record of the training and contents of the training; providing retraining to all staff regarding the documentation and process to follow when a resident's status changes and keeping a documented record of the training, who attended, who provided the training and the contents of the training. The management team immediately met to develop a plan of correction to meet all compliance order requirements within the required timeframe to ensure compliance. ¢ i'ii in II\lll a ir: g Il n spl gQ � n` a o in II � ep g� ,-t j «, a n e 2024 Terrace Lodge Terrace Lodge moved into Phase 2 of the Redevelopment Project in May 2024. The Ministry of Long -Term Care Pre -occupancy inspection was conducted on April 16, 2024. There were seven deficiencies identified, all minor in nature, with some required to be completed on move day. All deficiencies were corrected as required to support the Terrace Lodge Phase 2 move day on May 15, 2024. See Attachment #1 — Terrace Lodge Pre -Occupancy Inspection Report April 2024 MLTC inspectors visited the Home on May 28 and 29, 2024 to conduct a critical incident inspection regarding 2 critical incidents submitted by the Home in regards to an outbreak and a resident fall. Inspection protocols utilized during the inspection included Infection Prevention and Control and Falls Prevention and Management. During the course of the inspection the inspector made relevant observations, reviewed records and conducted interviews. There were no findings of non-compliance. apa e ::::o g "....Ili��u°� pl M'J` n II''���li �u:�5` II\llla:�'....�'�6��'�a:� up. Page 17 of 37 MLTC inspectors visited the Home on May 28 and 29, 2024 to conduct a post - occupancy inspection following Phase 2 move in day at Terrace Lodge. Inspection protocols utilized during the inspection included Infection Prevention and Control; Food, Nutrition and Hydration; and Safe and Secure Home. During the course of the inspection the inspector made relevant observations, reviewed records and conducted interviews. There were no findings of non-compliance a Critical Incident Systems Report Summary for all Three Homes Types of Critical Incidents —April 1 — June 30, 2024 Total Number — Three Homes Abuse & Neglect — Any alleged, suspected or witnessed abuse of a 28 resident by anyone or neglect of a resident by the licensee or staff that resulted in harm or risk of harm to the resident, misue or misappropriation of residents' money, misuse or misappropriation of funds provided to licensee. Unlawful or Improper or Incompetent Treatment or Care — Includes care of 1 a resident that resulted in harm or risk of harm to resident. Unexpected Death — Including a death resulting from an accident or 0 suicide. Medication Incident — Includes a medication incident or adverse drug 0 reaction in respect of which a resident is taken to hospital. Environmental Hazard — Includes breakdown or failure of the security 1 system or major equipment or a system in the Home that affects the provision of care or the safety, security, or well-being of residents for a period greater than six hours Disease Outbreak 5 Contamination of Drinking Water Supply 0 Incident that Causes Injury and Transfer to Hospital — Includes injury in 3 respect of which a person is taken to hospital resulting in a significant change in status Controlled Substance Missing/Unaccounted — Includes missing or 0 unaccounted for controlled substance Written complaint 3 The above noted critical incidents have been reviewed and internally investigated. It is important to note that the abuse and neglect critical incident reporting includes "harm or risk of harm". Each of the three Homes have a memory care resident home area supporting mild to severe cognitively impaired residents that may, at times, and despite interventions, exhibit responsive behaviours resulting in "risk of harm". The Homes are diligent in reporting responsive behaviours in the "risk of harm" category with 25 of the 28 reports falling into this category. Follow up to each incident is conducted by the Page 18 of 37 management team in collaboration with both the internal and external Behavioural Support Ontario (BSO) teams and is ongoing to develop interventions and update plans of care to support all residents on the memory care resident home areas and throughout the Homes. Three written complaints were received in this quarter in relation to entry to the home, temperature control, and communications related to dietary intake; and, appropriate follow up was completed. The management team and continuous quality improvement team have developed and implemented a plan of action to address all of the critical incident related and written complaint areas, including, but not limited to, providing additional training and education as required. Outbreaks Home Number of Timeframe of # of Residents Outbreaks and Outbreak Impacted Agent Bobier Villa 0 N/A N/A Elgin Manor 4outbreaks #1 —April 26 — May #1 — 2 #1 — enteric & 10, 2024 #2 — 3 COVID-19 #2 — May 10 — May #3 — 4 #2 — Human 17, 2024 #4 — 22 Metapneumovirus #3 — May 30 — June #3 — Parainfluenza 10, 2024 #4 — COVID-19 #4 - June 29 — July 18, 2024 Terrace Lodge 1 outbreak May 2 — May 27, 24 COVID-19 2024 The Infection Prevention and Control (IPAC) managers continue to participate in the IPAC Hub and community of practice meetings. Ongoing collaboration with Southwestern Public Health continues to support accuracy in decision -making and planning regarding updated circulating pathogens, guidance documents and policy and procedures. The IPAC teams across the Homes have been providing education to residents and families and promoting the Spring COVID vaccine campaign. Some residents were ineligible for the Spring COVID vaccine based on recent COVID infections which impacted vaccination rates for residents across the Homes. The updated guidance documents provided for changes to support impacted staff members earlier return to work provided that the staff member has an improvement in symptoms and is fever -free. Staff returning to work must follow masking and distancing protocols. Occupancy Data Page 19 of 37 A 97 % occupancy rate is required to support full ministry funding. All 3 Homes continue to work diligently to support >97% occupancy rates. ,TelOT VIIIR Occupancy Data excluding respite bed April 1 — June 30, 2024 Occupancy 99 % Admissions (Move -Ins) 2 Discharges 3 Elgin Manor Occupancy Data excluding respite bed April 1 — June 30, 2024 Occupancy 98 % Admissions (Move -Ins) 13 Discharges 15 Terrace Lodge Occupancy Data excluding respite bed April 1 — June 30, 2024 Occupancy 99 % Admissions (Move -Ins) 11 Discharges 9 Health System Partners (i.e. Fire, Public Health, Ministry of Labour) • Monthly fire drills are conducted each month on all shifts at all three Homes. • Monthy health and safety inspections are completed at all three Homes. • Terrace Lodge had a public health pre -occupancy inspection of the Phase 2 Home Kitchens, Serveries and Dining Areas on April 9, 2024. There were no findings of non-compliance. • Elgin Manor received a field/site visit from the Ministry of Labour, Immigration, Training and Skills Development on April 25, 2024. The inspector was onsite in relation to a complaint regarding a verbal threat of violence. During the course of the field visit, the inspector reviewed policy and procedures, training records and conducted interviews. Two orders were issued in relation to a minor policy update, failure to complete a risk assessment immediately following the verbal threat, and training in relation to the policy update. The requirements related to the orders were complied with within the agreed to timelines. See Attachment #2 — Elgin Manor Ministry of Labour Notice of Compliance April 2024. Page 20 of 37 Dietary and Housekeeping/Laundry Departmental Updates Department Bobier Villa Elgin Manor Terrace Lodge Dietary A huge shout out to The residents are Terrace Lodge dietary staff and enjoying barbeque main kitchen their dedication to season and local remains "under the home — there harvest produce renovation". has been 0 unfilled including Staff should be shifts for the past strawberries, commended for few months. asparagus and having adjusted to Ongoing blueberries. reduced work interdisciplinary spaces and meal service Residents were revised job meetings (nursing provided the routines in the and dietary) to opportunity to main kitchen to support meal enjoy the social accommodate service delivery in program of hulling renovations. follow up to the quarts and quarts proactive of strawberries Air conditioning compliance this season. has been installed inspection continue in the home with table side Theme days have kitchens in Phase beverage service kept the kitchen 2 of the project. being the focus this busy with quarter. traditional Resident choice "Stamppot" meals meals are being from the offered twice Netherlands; monthly. creation of 1970s "TV dinners" and Local fresh fruit Pork Goulash and vegetables inspired by have been added Croatia. to the menu during the summer months — residents are enjoying many options including strawberries and corn on the cob. Food Committee Resident Council Food Monthly and Food Committee met to encouragement Committee voted to review and for residents to donate $400 to approve the recommend meal support the Spring Summer items for purchase of a new 2024 Menu and "Resident choice barbeque for the agreed to continue meal day" twice Home. Residents with Elgin Manor per month and Page 21 of 37 are now enjoying meal times hamburger & weekly barbequed at 830, 1200 noon hotdog days have meals. and 5pm. been implemented as per food A "Build your own committee request Burger" event with every Thursday all the toppings during the BBQ was hosted and season. thoroughly enjoyed by all. Theme meal planning continues with April focusing on Italian culinary adventure featuring an omelette style pasta bar where residents could select their own toppings and sauces to create a unique pasta dish. This event created such a "positive buzz" and aromas throughout the home that it was offered again in June. Housekeeping/laundry Acknowledgement The housekeeping Housekeeping to the team has been staff continue to housekeeping kept busy with work through the team —their outbreak changes in job exceptional, management. routines as the diligent cleaning Their diligent Home works and IPAC practices efforts were through the has supported 0 effective in redevelopment outbreaks this preventing project and should quarter. extensive spread be commended for during 3 their ability to outbreaks. adjust and accommodate the operational needs and needs of the residents. Joint Health & Safety Code Drills - Code Drills —Code Monthly Code Silver policy Drills with team Page 22 of 37 Code Silver policy reviewed, revised members creating reviewed and and approved. poster boards to approved increase staff Code Silver policy awareness. education and Regular awareness Code Silver policy inspections and fire training reviewed and drills conducted. approved Workplace Regular Violence Risk inspections and Assessment fire drills. conducted and the team is working on potential updates based on results. Regular inspections and fire drills Resident & Family Council Updates Resident Council Bobier Villa Elgin Manor Terrace Lodge April April 18 April 18 April 5 Discussion topics: Discussions Low attendance due Treasurers Report included: to outbreak Review of Silent Auction Residents Bill of planning Sharing and Rights Use of fob for discussing updates — Review of Quality residents redevelopment Improvement Plan Review of project updates and (QIP) Residents Bill of memo distribution Donation of $400 Rights and Homes QIP review to support the Mission Statement Action plan for purchase of a new Eulogy Memories resident survey BBQ Admission and improvements Discharges Financial Program Calendar statement/information Review and regarding funding suggestions for Preparation for total future programs solar eclipse Treasurers Report April 25 Review of Resident rights #10, 11, 12 Page 23 of 37 Religious and Spiritual Care discussion Environmental Services update Volunteer services update Library outreach program Craft program and pianist Recreation and social program updates Solar eclipse recap Nutrition and hydration care IPAC update Health Quality Ontario website, features and relationship to the UP May May 23 May 16 May 2 Discussion topics: Discussion topics: Terrace Lodge Treasurer Report Silent Auction Redevelopment — Resident Bill of planning May 15 move plan Rights Residents Bill of discussion and Review of Home Rights review with Accommodation Eulogy Memories Administrator Charges Admission and Discharges Wellness & Mobility Program Calendar Inc. information Review and circulated suggestions for future programs Regular May meeting Treasurers Report cancelled due to Administrator outbreak Report June June 15 June 20 June 27 Discussion topics: Discussion topics: Discussion topics Resident Bill of Resident Bill of Resident Bill of Rights Rights Rights Treasurers Report Eulogy memories Spritival and religious care Page 24 of 37 Updated Admissions and Recreation and hairdressing Discharges Social Programs services fees Program Calendar Menu cycle review Suggestions: Review Meal and snack time Bingo 2x/week Treasurer Report review Reduction of Suggested future Inspection report movies to programs from May 30 once/month Administrator CQI team overview Request for more report and review of summer bbqs monthly meeting June 28 Review of documents: Social worker services memo Tub room renovations memo Hair services pricing update memo Visitor/guest meal pricing update memo Regulation changes update from MLTC LTCH Accommodation Rate changes from MLTC Family Council Bobier Villa Elgin Manor Terrace Lodge April April 17 April 12 April 4 No members able Discussion topics: Meeting information to attend; Ministry inspection communciated but information report review (Feb. members unable to circulated 2024) attend April meeting electronically as Monthly Billing virtually/inperson required Monthly CQI report QIP review Recruitment efforts Care conferences ongoing (posted in Location of the Home, sent via meeting minutes email/newsletter) Family council related to decreased letter to families membership; options Development of a to communicate via resource guide meetings available in Front Door access person/phone/zoom after hours to support Cable services attendance. Page 25 of 37 Snack cart service Calendars and newsletter review Side tables front lobby Terrace Lodge Redevelopment Update and Core Area Renovations sent to members electronically and posted in the Home May May 22 May 22 May 2 and May 9 Meeting information No members able Discussion topics: communciated but to attend; Home updates members unable to information Responses to prior attend circulated month concerns electronically as Cable notice and required channel updates Information sent Regulation electronically to changes members Introduction of Resident Care Resident and Family Coordinator Move Day letter returning from Phase 2 leave Accommodation Charges Wellness and Mobility Inc. introduction letter CQI report Info re: new government dental plan June June 18 June 14 June 13 & 28 No members able Discussion topics: Meeting information to attend; communciated but information New menu members unable to circulated Visitor meals and attend electronically as location for same required IPAC updates Wellness & Mobility Hairdressing fee Inc. memo update Copayment CQI reports Accommodation New Community Bulletin sent Legal Education electronically Ontario (CLEO) booklet distribution Program and Therapy Department Updates Page 26 of 37 Item Bobier Villa Elgin Manor Terrace Lodge Special Programs & Pet Therapy Pet Therapy Solar Eclipse was Event Highlights enjoyed April 2024 Country of Discover Country of Discover (Italy— Italian pasta (Netherlands —red, Elegant Mother's luncheon and blue and white Day Tea cooking colours dress - demonstration) up -and Chemed McDonalds Take meal) Out enjoyed by 40 Country of Discover residents (Mexico — Mexican Country of Discover Chemed lunch) (Croatia — themed Terrace Lodge meal and Move Day- May 15 Strawberry Social travelogue) Chinese food Take Solar Eclipse event History Talk with out enjoyed by 40 Guest Speaker residents History Talk with (Pete Sheridan) Guest Speaker Father's Day (Pete Sheridan — Bus outings Celebration with solar eclipse, Crime Suzie Q Talk, Joh Kenneth Weekly tuck shop Galbraith) with the Auxiiliary Canada Day Celebration June Mother's Day 70's Theme Day — 30 with Traci Treats and groovy photo shot, Kennedy Programming reminiscing throughout the program week Mother's Day Sunday Tea with Social the Auxiliary Auxiliary Bake Sale and Tea Room Father's Day celebration and sundae bar New Fun & Fitness Inukshuk craft Summer Reading Initiatives/Enhanced partnering with a Club Programming physical trainer - Evening Piano with intergenerational Fitness with Larry Volunteer Program Partnership with Animal Farm Aylmer Library Therapy by Little Hobby Hill Farm Page 27 of 37 Bus Outings to Tai Chi New Community enjoy the seasonal Outreach — Aylmer weather Breakfast Club Imperial Market Coffee Out Trip Animal Farm "Anna Mae's" Therapy by Full Art Therapy Project Circle Ranch — awaiting a plaque — "Home is Where the Heart is" (see link below) Education Therapeutic Therapeutic Neurologic Music Recreation Ontario Recreation Ontario Therapy BIARK Conference Conference — 1 Aqua Infused Yoga attended Specialty and Certification Program — 2 staff near completion Therapeutic Recreation Ontario Conference (3 attended) Student Placements None this quarter None this quarter Terrace Lodge participated in the East Elgin Secondary School Community Volunteer Fair Volunteer Services 14 registered active 16 registered active Several tours of volunteers; 2 new volunteers; 2 new redeveloped home since last quarter since last quarter areas provided to volunteers Volunteer Volunteer 19 new volunteers appreciation Appreciation in process of formal luncheon Brunch registration; 50 active volunteers; 5 new inquiries; New volunteer positions — horticulture, genealogy, gift shop (coming soon), recreation program, portering support See Attachment #3 — Terrace Lodge Art Therapy Project 2024 Page 28 of 37 Nursing Department and Quality Improvement Updates Department Bobier Villa Elgin Manor Terrace Lodge Mandatory All mandatory teams Implementation of Implementation of Programs & and programs in place; updated program updated program Committees continue to build evaluation evaluation membership with staff template to template to changes. support support Behavioural Supports compliance and compliance and Ontario (BSO) team legislative legislative onboarding 2 new interpretation interpretation members. Home specific The Bobier Villa team is Ongoing Ongoing nursing/quality pleased that the implementation of increased updates Manager of Resident initial coaching frequency of team Care vacancy has been concepts to huddles for day filled with Bev support and afternoon Drouillard (former onboarding of new shifts to enhance Quality employees. communication, Improvement/Education decision making Coordinator for all 3 and teamwork; Homes and former BSO team huddle Registered Nurse for frequency Bobier Villa). increased to Bev will be a significant support asset to the team knowledge supporting the overall sharing and success of Bobier Villa. embedded processes; implementation of trial bath shifts to support continuity and quality of care. Student Summer Students have Summer students Summer students placements onboarded. have onboarded. have onboarded. 8 PSW students and 1 RPN student Additional Three letters of Diagnostic Diagnostic educational understanding in place equipment training equipment training opportunities to support education ongoing ongoing opportunity Diagnostic equipment training ongoing Page 29 of 37 Management team Management Management members across all team members team members departments engaged across all across all in Indigenous Cultural departments departments Awareness Safety engaged in engaged in Training and Equity, Indigenous Indigenous Diverstity, Inclusion and Cultural Cultural Anti -Racism training Awareness Safety Awareness Safety Training and Training and Equity, Diverstity, Equity, Diverstity, Inclusion and Anti- Inclusion and Anti - Racism training Racism training Quality Indicators Key Performance Bobier Villa Elgin Manor Terrace Lodge Indicator Falls Jan — March 15% 12.6% 18% April — June 7% 9.6% 24.4% Daily Physical Restraints Jan — March 2.1 % 0% 1.1 % April — June 0% 0% 1.1 % Worsening Pressure Ulcer (Stage 2-4) Jan — March 3.4% 2.06% 8.7% April — June 1 % 3.0% 8.6% Antipsychotics without a supporting Diagnosis Jan — March 20% 26% 15% April — June 3% 23.8% 3.8% Administrative Department Updates Item Bobier Villa Elgin Manor Terrace Lodge Staff Schedule Wizard and Mass Wizard and Mass Wizard and Mass Care (SSC) — messaging messaging messaging autofill, wizard, implemented. implemented. implemented. project sign off for Final project sign Final project sign Final project sign these requirements off off off Clinical Training and Training and Training and Connect/econnect onboarding with onboarding with onboarding with Page 30 of 37 ONEID across all 3 Homes continues ONEID across all 3 Homes continues ONEID across all 3 Homes continues Staffing Updates Letter of No changes One vacancy; Understanding with actively recruiting SEIU to support administrative clerk temporary part time position for coverage Education April 17 — 19 April 17 — 19 April 17 — 19 2 managers 2 managers 3 managers attended attended attended AdvantAge Ontario AdvantAge Ontario AdvantAge Ontario convention convention convention participating in participating in participating in several Long-term several Long-term several Long-term care sector relevant care sector relevant care sector relevant sessions sessions sessions All Homes All Homes All Homes managers managers managers completed completed completed Psychological Psychological Psychological Health and Safety Health and Safety Health and Safety Webinar Series Webinar Series Webinar Series with CMHA —front with CMHA— front with CMHA— front line staff scheduled line staff scheduled line staff scheduled for July and for July and for July and September September September Several Managers Several Managers Several Managers completed completed completed "Manager as a "Manager as a "Manager as a Coach Learning Coach Learning Coach Learning Sessions April 1 — Sessions April 1 — Sessions April 1 — June 26 across the June 26 across the June 26 across the Homes and are Homes and are Homes and are implementing small implementing small implementing small work groups to work groups to work groups to support ongoing support ongoing support ongoing implementation of implementation of implementation of concepts at the concepts at the concepts at the Home level Home level Home level June 27 — Severe June 27 — Severe June 27 — Severe Weather: Reducing Weather: Reducing Weather: Reducing Risks and Risks and Risks and Safeguarding Safeguarding Safeguarding Page 31 of 37 Communities — Communities — Communities — Administrator and Administrator and Administrator and Director Director Director Terrace Lodge Phase 2 of the Redevelopment Terrace Lodge Redevelopment Project completed; Phase 3 underway Financial Implications: None Alignment with Strategic Priorities: Serving Elgin Growing Elgin Investing in Elgin ® Ensuring alignment of ❑ Planning for and ® Ensuring we have the current programs and facilitating commercial, necessary tools, services with community industrial, residential, and resources, and need. agricultural growth. infrastructure to deliver programs and services ® Exploring different ways ® Fostering a healthy now and in the future. of addressing community environment. need. ® Delivering mandated ® Enhancing quality of programs and services ® Engaging with our place. efficiently and effectively. community and other stakeholders. Local Municipal Partner Impact: None Communication Requirements: Information has been communicated to the appropriate departments, resident council, family council, residents, staff and visitors as required. Conclusion: The long-term care homes management team continues to be thankful for the support from Council, the Chief Administrative Officer, the Senior Management Team, and the Page 32 of 37 staff in all departments as we work collaboratively to maintain and improve the quality of services and care for our residents, families, staff and communities. All of which is Respectfully Submitted Michele Harris Director of Homes and Seniors Services Approved for Submission Blaine Parkin Chief Administrative Officer/Clerk Page 33 of 37 Ministry of Long -Term Care Ministere de longue duree Long -Term Care Capital Development Division 8th Floor, 438 University Ave Toronto, ON M5G 2K8 Tel.: (416) 327-7461 Fax: (416) 327-7603 Division du developpement du capital de soins de longue duree 438, rue University, 8e etage Toronto, ON M5G 2K8 Telephone: (416) 327-7461 Telecopieur: (416) 327-7603 • Q Pre -Occupancy Review Summary Report Inspection prealable a 1 `occupation des lieux Project Name of Long -Term Care Home/Etablissement de soins de longues duree Date/Date ID/ N°de ro'et Terrace Lodge — Phase 2 April 16, 2024 PROJ-078 Address/Adresse City/Ville Prov Postal Code/Code Phone #/ NO de Postal telephone Michele Harris 475 Talbot St. E. Aylmer ON N5H 3A5 519-631-1460 ext. 191 Name and title of Ministry representative/Nom et titre du (de la) representante) Scott Meikleham — Technical Specialist — Capital Development Division Peter Hannaberg — Inspector - Long -Term Care Inspections Branch Project Summary/Resume du projet The project involves improvements to the existing Terrace Lodge building. Terrace Lodge is currently comprised of 4 Resident Home Areas (RHAs), each housing 25 residents in a combination of Private, Semi -Private and 4 bed ward type rooms, for a total of 100 beds. The existing home will be renovated, and an addition will be constructed in order to increase the number of private bedrooms, remove the 4 bed ward type rooms, and improve the quality of resident spaces, resulting in a new building that maintains four 25- bed RHAs, for a total of 100 residents. Phase 2 includes: Renovations to existing 15t and 2"d floor North RHA's, completion of Tub Room renovations located between the completed Phase 1 addition portion of the work and the renovated North RHA's (Floor 1 and 2) associated with Phase 2 # Code/Code # The following is a list of deficiencies that must be corrected 1. Operational Issue/Question Ce qui suit est une liste d'infractions qui doivent etre rectifiees operationnelle 2. Construction/ Construction E Inspection Results/Resultats de ('inspection d Date for Corrective Action/Date de a; o la mesure corrective — U Door to Therapy Room (N227) on second floor North RHA Operator to confirm work has 1 requires a locking mechanism to be installed on the 2 been completed prior to admittance of first resident, work entrance door, to prevent unauthorized access by to be verified at the post- residents., when not in use occu ncy inspection. Operator to confirm work has Doors to Point of Care areas (N134 and N234) adjacent to been completed prior to 2 the Dining Rooms on both levels 1 and 2 require automatic 2 admittance of first resident, work closers to be installed. to be verified at the post - occupancy inspection. The temporary partitions that are currently in place between Operator to confirm work has the renovated portion of Phase 2 and the currently occupied been completed prior to 3 expansion associated the Phase 1 of the project, on both 2 admittance of first resident, work levels 1 and 2, are to be removed, patched and made good. to be verified at the post - occupancy inspection. Individual towel bars, one for each resident, are to be Operator to confirm work has 4 installed in the shared washroom associated with the semi- 2 been completed prior to private Resident bedrooms on both floors 1 and 2 admittance of first resident, work Page 34 of 37 to be verified at the post - occupancy inspection. The outdoor terrace area located off Dining Room (N133A) on the 11 floor of the renovation associated with Phase 2 is to be completed prior to providing access to any resident. 5 This includes the completion of the perimeter security 2 Work to be verified at the post - fencing, and all landscaping. The door leading from the occupancy inspection. Dining Area to the outdoor terrace area is to remain locked and secure, preventing unauthorized access, until all work has been completed. Operator to confirm work has been completed (door in place The secure access door on the first floor memory care RHA and functioning) on the day of 6 to be relocated and installed in good working order to 1 resident move (via email) and maintain the memory care residents within their temporary Pine/Birch RHA during Phase 2. work to be verified at the post - occupancy inspection. Resident beds and furnishings to be relocated to their Work to be verified at the post- 7 rooms on the newly renovated first and second floors 1 occupancy inspection. associated with Phase 2. Page 35 of 37 Minlstry of Labour, Immigration, Training and Skills Development Safe At;Work Operations Occupational Division Health and Safety OHS Case ID! 02821THTT014 Field Visit No: 02821 THVL015 Return To; EMII,Y MRRPIRLD INDUSTRIAL HEALTH AND SAFETY INSPECTOR PROVINCIAL OFFENCES OFFICER 217 York Street, 51h Floor, London, ON N6A 5P9 Tel; (519) 671-9318 Faxl519-672.0260 Visit Data: 2024-APR•25 Notice of Compliolnoo Workplace Idenflflcatlon, ELGIN MANOR Notice ID; 39262 FINGAL ROAD, ST THOMAS, ON, CANADA N5P 3S5 FINGAL RDRR1 Page 1 of 1 Take Notice orders were Issued under the auihorlly of the occupational Health and Safety Act or Regulations made there under. A notice of compliance shall be submitted to the Ministry of LabourwIIhln three days after the constructor or Employer believes that compliance with the orders) / Regulremenl(s) have been achieved, Orders) /Requirement(s) Issued; To: Role CORPORATION OF THP COUNTY OF ELGIN Primary Pmployor Malilno Address; 450 SUNSET DR, ST, THOMAS, ON, CA N5R 5V1 Orders) / Requirement(s) Descrlptlon, You are required to comply with the Order(s) / Requirement(s) by the Comply by Dates listed below, No, Type ActReg Year Sec, Sub Clause Code Sec, 1 Time OHSA 1990 32,0,3 4 ozsziTHVQo10 2 Time OHSA 1990 25 2 020217HVR019 compliance Detalls / JHSC Worker Member/comply by Data Worker Representative bate! NAgree j 024-MAY-24 Isagrea• -- - `"(signature) -- - -- ' t d� Agree 2024-MAY-24 El Dlidgre.o (Signature) Form completed by: _ (� (� h � Joint Health and Safety Committee Member representing workers (l or Worker Represenlallve agrees ordlsogrees Thal compliance a2r (�y fry Qo,([ : rut !"e- S has been achieved with ail the orders) as Indicated above, Title; a ( f) J (Tor>nbehalf of j' e Name! 3 ;i a t 1)t_� i ,, f; Signature:�ij Signature:. z r l 0757 Page 36 of 37 Page 37 of 37