Kids First Pediatrics Of Georgia Pc

CLIA Laboratory Citation Details

3
Total Citations
11
Total Deficiencyies
9
Unique D-Tags
CMS Certification Number 11D0987757
Address 143 Canal Street, Suite 500, Pooler, GA, 31322
City Pooler
State GA
Zip Code31322
Phone(912) 748-4527

Citation History (3 surveys)

Survey - July 25, 2025

Survey Type: Standard

Survey Event ID: 1XK411

Deficiency Tags: D0000 D3011 D5417 D5429 D6011 D6028

Summary:

Summary Statement of Deficiencies D0000 A Clinical Laboratory Improvement Amendments (CLIA) Recertification Survey was completed on July 25, 2025. The laboratory was not in compliance with applicable CLIA requirements found at 42 CFR 493.1 through 42 CFR 493.1780. The following deficiencies were cited: D3011 FACILITIES CFR(s): 493.1101(d) Safety procedures must be established, accessible, and observed to ensure protection from physical, chemical, biochemical, and electrical hazards, and biohazardous materials. This STANDARD is not met as evidenced by: A review of the laboratory facilities confirmed that was not adequate protection against all potential hazards. THE FINDINGS INCLUDE: 1. A tour of the laboratory testing area confirmed that there was not a designated clean sink to protect against potential cross contamination of specimens and testing personnel. 2. A tour of the facility revealed that an eyewash station was installed on the same sink used for discarding waste products and reagents. 3. An exit interview, with the laboratory staff, on July 25, 2025, at 1:00 pm, confirmed there was not adequate protection against all potential hazards in the testing laboratory. D5417 TEST SYSTEMS, EQUIPMENT, INSTRUMENTS, REAGENT CFR(s): 493.1252(d) (d) Reagents, solutions, culture media, control materials, calibration materials, and other supplies must not be used when they have exceeded their expiration date, have deteriorated, or are of substandard quality. Statement of Deficiencies (X1) Provider/Supplier/CLIA Identification Number (X3) Date Survey Completed Name of Provider or Supplier Street Address, City, State -- 1 of 3 -- This STANDARD is not met as evidenced by: A tour of the laboratory revealed that expired reagents were in use for patient testing and resulting. THE FINDINGS INCLUDE: 1. A tour of the testing laboratory revealed the following expired reagents were in use: a. MCKESSON NORMAL SALINE: Expired 02/13/2025 2. An exit interview, with the Laboratory Director and the Lab Team on July 25, 2025, at 1:00 pm confirmed that expired reagents were in use for patient testing and resulting. D5429 MAINTENANCE AND FUNCTION CHECKS CFR(s): 493.1254(a)(1) (a)(1) Maintenance as defined by the manufacturer and with at least the frequency specified by the manufacturer. This STANDARD is not met as evidenced by: A review of 2023 - 2025 Maintenance Records, confirmed that the annual preventitive maintenance, as required by the manufacturer, was not performed. THE FINDINGS INCLUDE: 1. A review of the Medonics Hematology Analyzer User Manual, Section 8.4 Instrument Maintenance confirmed that preventitive maintenance is required annually or every 20,000 samples. 2. A review of 2023 - 2025 Maintenance Records revealed that the required annual preventive maintenance for the Medonics Hematology Analyzer was not performed. 3. An exit interview, with the laboratory staff, on July 25, 2025, at 1:00 pm confirmed that the annual preventive maintenance for the Medonics Hematology Analyzer was not performed. D6011 LABORATORY DIRECTOR RESPONSIBILITIES CFR(s): 493.1407(e)(2) (e)(2) provide a safe environment in which employees are protected from physical, chemical, and biological hazards; This STANDARD is not met as evidenced by: A review of the laboratory testing facility confirmed that the Laboratory Director failed to provide a safe environment for the laboratory testing personnel. Refer to D3011 D6028 LABORATORY DIRECTOR RESPONSIBILITIES CFR(s): 493.1407(e)(10) (e)(10) Employ a sufficient number of laboratory personnel with the appropriate education and either experience or training to provide appropriate consultation, properly supervise and accurately perform tests and report test results in accordance with the personnel responsibilities described in this subpart; This STANDARD is not met as evidenced by: A review of 2023 - 2025 Personnel Records, confirmed that the Laboratory Director failed to verify that testing personnel met required qualifications. THE FINDINGS INCLUDE: 1. A review of 2023 - 2025 Personnel Records confirmed that Testing Personnel #2 (TP2) ( Form 209: Laboratory Personnel Report) has unverified foreign credentials. 2. An interview with the Laboratory Director confirmed that a United -- 2 of 3 -- States Education Equivalency Evaluation was not performed. 3. An exit interview, with the Laboratory Director and Lab Personnel, on July 25, 2025, at 1:00 pm confirmed that the Laboratory Director failed to certify that all testing personnel met required education qualifications. -- 3 of 3 --

πŸ”’ Unlock Deficiency Summary

Get full access to the detailed deficiency summary for this facility

One-time payment β€’ Lifetime access

Survey - July 20, 2023

Survey Type: Standard

Survey Event ID: 4FIX11

Deficiency Tags: D0000 D3031 D6010

Summary:

Summary Statement of Deficiencies D0000 A recertification survey was performed on July 20, 2023. The facility was found to be NOT in compliance with all applicable CLIA requirements for specialties /subspecialties for 42 CFR. D3031 RETENTION REQUIREMENTS CFR(s): 493.1105(a)(3) Analytic systems records. Retain quality control and patient test records (including instrument printouts, if applicable) and records documenting all analytic systems activities specified in 493.1252 through 493.1289 for at least 2 years. This STANDARD is not met as evidenced by: Based on review of the monthly Temperature logs, and staff interview, for the years 2021, 2022, and 2023, the laboratory failed to retain copies of temperature logs for 7 out of 12 months for 2022. Documents should be kept for at least 2 years. Findings: 1. Based on the review of the Monthly Temperature logs for 2022, the laboratory could not provide copies of the temperature charts for the following months: April, May, June, July, August, September, and November. 2. Interview with the Laboratory Director on July 20, 2023, at approximately 3 pm in the upstairs hallway, confirmed the aforementioned statement. D6010 LABORATORY DIRECTOR RESPONSIBILITIES CFR(s): 493.1407(e)(2) The laboratory director is responsible for the overall operation and administration of the laboratory, including the employment of personnel who are competent to perform test procedures, and record and report test results promptly, accurate, and proficiently and for assuring compliance with the applicable regulations. (e) The laboratory director must-- (e)(2) Ensure that the physical plant and environmental conditions of the laboratory are appropriate for the testing performed. Statement of Deficiencies (X1) Provider/Supplier/CLIA Identification Number (X3) Date Survey Completed Name of Provider or Supplier Street Address, City, State -- 1 of 2 -- This STANDARD is not met as evidenced by: Based on review of the Temperature documents and staff interview, the Laboratory Director (LD) failed to make sure the temperature charts for 7 out of 12 months were retained for the year 2022. Per CMS regulations, documents are kept for at least 2 years. Findings: 1. Based on the review of the Monthly Temperature logs for 2022, the laboratory could not provide copies of the temperature charts for the following months: April, May, June, July, August, September, and November. 2. Interview with the Laboratory Director on July 20, 2023, at approximately 3 pm in the upstairs hallway, confirmed the aforementioned statement -- 2 of 2 --

πŸ”’ Unlock Deficiency Summary

Get full access to the detailed deficiency summary for this facility

One-time payment β€’ Lifetime access

Survey - July 27, 2021

Survey Type: Standard

Survey Event ID: SCVJ11

Deficiency Tags: D0000 D2007

Summary:

Summary Statement of Deficiencies D0000 On September 27, 2021 an off site followup review was completed. The report revealed that

πŸ”’ Unlock Deficiency Summary

Get full access to the detailed deficiency summary for this facility

One-time payment β€’ Lifetime access