Clove Lakes Health Care And Rehabilitation Center,
Clove Lakes Health Care And Rehabilitation Center, in Staten Island, NY — inspection on November 18, 2025.
Found 1 citation. Severity: Standard violations.
Health inspections identify deficiencies that facilities must correct within required timeframes. Violations range from minor documentation issues to serious safety concerns and are subject to follow-up verification.
Inspection Findings
During a telephone interview on 09/25/2025 at 10:07 AM, Registered Nurse # 1 stated Resident #6 reported allergic reaction to mushrooms and that they observed mushrooms on Resident #6's meal tray that was still in their room.
They immediately reported it to Registered Nurse Supervisor #1.
During an interview on 09/12/2025 at 3:01 PM, Registered Nurse Supervisor #1 stated they entered Resident #6's room at 1:20 PM on 06/05/2025 while Resident #6 was eating.
They stated that Resident #6 picked up the chicken that was on the plate and showed them the mushroom that was under the chicken and pasta.
They stated Resident #6 reported that their tongue was feeling tingly, and both their arms were itching.
They stated Resident #6's arms were observed to be slightly red with raised rash.
During a telephone interview on 09/26/2025 at 12:29 PM, Certified Nursing Assistant #2 stated that Resident #6 reported to them that they were feeling weird after eating from the tray.
They stated they observed mushrooms on the resident's plate.
They checked the meal ticket on the tray, and it states allergies and dislike to mushrooms.
During a telephone interview on 09/29/2025 at 11:30 AM, Director of Nursing stated their investigation concluded that Resident #6's alleged allergy to mushroom was not verified.
They stated on admission; Resident #6 had a dislike for mushroom and the hospital records did not document mushroom as an allergy.
They stated the allergy was updated in March 2025 and they do not know why the system did not update the meal ticket to include the allergy when it was updated.
During a telephone interview on 11/18/2025 at 9:28 AM, Physician #1 stated as per nursing documentation, several attempts were made to contact them about the allergic reaction incident, however, they do not recall that.
They stated the nursing staff contacted another Physician, and orders were put in place.
They stated it was documented in Resident #6's chart that they are allergic to mushroom, however, they do not believe Resident #6 received mushroom from the facility because Resident #6 buys food from outside routinely.
They stated they evaluated Resident #6 on 06/06/2025 or 06/07/2025 and Resident #6 reported that they received mushroom from the facility.
They stated when they evaluated Resident #6, their symptoms had cleared. 10 NYCRR 415.14(d)(4)
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