| Statement of Deficiencies | (X1) Provider/Supplier/CLIA Identification Number 01G011 | (X3) Date Survey Completed 10/08/2025 |
| Name of Provider or Supplier Rainbow Omega, Inc, | Street Address, City, State 202 Hope Drive, Eastaboga, AL | |
| For information on the provider's plan to correct this deficiency, please contact the provider or the state survey agency. | ||
| (X4) ID Prefix Tag | Summary Statement of Deficiencies
(Each deficiency should be preceded by full regulatory or LSC identifying information) |
| KS100 | General Requirements - Other CFR(s): NFPA 101 General Requirements - Other 2012 EXISTING List in the REMARKS section any LSC Section 33.1 or 33.2 General Requirements that are not addressed by the provided K-tags, but are deficient. This information, along with the applicable Life Safety Code or NFPA standard citation, should be included on Form CMS-2567. This STANDARD is not met as evidenced by: Based on observation, the facility failed to maintain the oxygen cylinders per the requirements of: 2012 NFPA 99, 11.6.2.3 (11), 11.3.4.1, and 11.6.5.2 This deficiency affects 1 of 1 oxygen storage areas. Findings include: During a tour of the facility, the surveyor observed the following in the Med Gas Storage Closet at the Nurses' Station: 1. One 24 cu.ft. and two 6 cu.ft. unsecured oxygen cylinders 2. The door to the closet did not have a precautionary sign that reads: "Caution: Oxidizing Gas(es) Stored Within No Smoking" 3. The empty cylinders were not segregated from the full cylinders A member of the maintenance staff was present when this deficiency was identified. |