Based on observation and interview, the facility failed to ensure storage and maintenance closets containing insulin syringes and hazardous chemicals remained locked in order to protect residents. The administrator reported 37 residents resided in the facility. Findings: A Storage Areas, Maintenance policy, dated December 2009, read in part, Maintenance storage areas shall be maintained in a clean and safe manner. A Hazardous Areas, Devices and Equipment policy, dated July 2017, read in parts, A hazard is defined as anything in the environment that has the potential to cause injury or illness .Sharp objects that are accessible to vulnerable residents .Open areas or items that should be locked when not in use .Access to toxic chemicals .Disabled locks. On 01/22/25 at 10:41 a.m., during initial tour a medical supply closet was observed to be unlocked. Insulin syringes were observed to be stored inside the unlocked closet. On 01/22/25 at 10:53 a.m., a maintenance closet was observed to be unlocked. The closet was observed to contain liquid hand soap, disinfectant spray, and a bottle of granite/stone cleaner without a spray pump or any type of lid on the container. Two cans of AX-IT spray baseboard stripper were observed. A rusted container, without a clear label, was observed with a liquid substance which was noted to have a chemical like smell. On 01/22/25 at 1:00 p.m., the storage/maintenance closets were observed to remain unlocked. On 01/22/25 at 10:45 a.m. to 2:00 p.m., observations of residents were made throughout the facility. No residents were observed to wander into rooms, open doors, or show interest in the supply closets. During this time period several staff members including CNAs, CMAs, and housekeeping staff were interviewed regarding residents with wandering behaviors. Staff reported no knowledge of any resident who would open closed doors or get into the storage and/or maintenance closets. On 01/22/25 at 2:14 p.m., the administrator reported the storage and maintenance closets should have been locked. The administrator reported sometime over the weekend a staff member had combined all of the keys to the storage closets on one key holder. The administrator reported maintenance staff was going to change and install all new locks on each of the supply closets immediately.

**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, record review, and interview, the facility failed to ensure oxygen tubing was labeled and dated, per the facility policy and professional standards of care, for two (#9 and #19) of three residents reviewed for respiratory services. Findings: The facility's Oxygen Administration policy, dated 10/2020, read in part, .After completing the oxygen setup or adjustment, the following information should be recorded in the resident's medical record .The date and time that the procedure was performed .The name and title of the individual who performed the procedure .The rate of oxygen flow, route and rationale .The frequency and duration of the treatment . 1. Resident #9 was admitted to the facility on [DATE] with a diagnosis of chronic obstructive pulmonary disease. A physician order, with start date of 12/03/21, documented, Change and date O2 tubing every week on Sunday, and prn in the evening every Sun. On 12/21/23, the resident's oxygen tubing was observed to be dated 12/11/23. The resident's December TAR documented the oxygen tubing had been changed on 12/17/23. 2. Resident #19 was admitted on [DATE] with a diagnosis of heart failure. A physician's order, dated 12/03/21, documented, Change O2 tubing every week on Sunday and PRN every night shift every Sun for Infection control protocol. On 12/21/23, the resident's oxygen tubing was observed to be dated 12/11/23. The resident's December TAR documented the oxygen tubing had been changed on 12/17/23. On 12/21/23 at 2:45 p.m., LPN #1 observed the O2 tubing for resident #9 and #19, and noted the date of 12/11/23. The LPN reported the tubing should have been changed the previous Sunday night on 12/17/23. On 12/21/23 at 3:00 p.m., the administrator was informed of the above findings and reported the O2 tubing should have been changed as ordered.