Bethesda North Kelowna Home
Confidential · Residential Care - Licensing
Inspection summary
Bethesda North Kelowna Home has been inspected 8 times by Interior Health Authority since September 3, 2015. The most recent inspection, on May 19, 2026, recorded 2 infractions.
1 of 8 inspections on record found no infractions at all. In the past 12 months there was 1 inspection with 2 infractions recorded. All recorded findings relate to upkeep, equipment or paperwork rather than direct health risks.
Recent inspections have recorded fewer infractions than earlier ones, so the record is improving.
What these findings mean
Health authorities word their findings differently, so we group them by what they mean for the people in care. Higher-risk findings are the ones that could directly make someone sick, and they matter more here because young children, older adults and people who are unwell are more vulnerable to infection.
Permits, records and postingLower risk
Operating permits, required signage, written procedures and logs. These findings are administrative: the documentation was missing or out of date at the time of inspection.
Recorded 6 times across 4 separate inspections, most recently on April 7, 2022. For example:
1 - Are person in care records current, complete and kept confidential?
Equipment and utensilsLower risk
Equipment has to be made of cleanable materials, kept in good repair and stored properly. These findings are mostly about upkeep, like a cracked surface or worn part. They are generally lower risk but show how well the place is maintained.
Recorded 3 times across 3 separate inspections, most recently on May 19, 2026. For example:
1 - Are the physical facility, equipment and furnishings maintained, sanitary, accessible and appropriate for persons in care?
Other findingsLower risk
Findings that do not fit the categories above, such as follow-ups that confirm an earlier violation was corrected, or requirements specific to this type of facility.
Recorded 7 times across 3 separate inspections, most recently on May 19, 2026. For example:
1 - Are medications stored, handled, and administered appropriately?
About this data
These results come from Interior Health Authority, which inspects food premises and other public facilities in this area. We republish the authority's public disclosure data and refresh it regularly; the official record is the final word.
8 inspections
- Routine Inspection
2 infractions
- R7.1 - Are the physical facility, equipment and furnishings maintained, sanitary, accessible and appropriate for persons in care?
- Observation(s): It is observed that some cleaning products are not securely stored. When cleaning products are not safely and securely stored, there is a risk that persons in care may ingest or use these products in a manner not intended, which could result in illness or harm. This was also identified as a contravention in the previous inspection report. While the closet referenced in the previous inspection is now locked, cleaning products were observed to be stored in an unsecured manner in a different area of the facility. Submit to Licensing by June 03, 2026, a plan outlining how all cleaning agents, chemical products, and other hazardous materials will be safely stored and secured in accordance with legislative requirements. The plan must identify the steps that will be taken to achieve compliance, as well as the measures that will be implemented to ensure ongoing compliance.
- R7.1AK- Provide appropriately furnished and equipped areas for secure, safe and adequate storage of cleaning agents, chemical products and other hazardous materials; 35( 1 )(c)
- R9.1 - Are medications stored, handled, and administered appropriately?
- Observation(s): It is observed that some medication provided by family does not have a pharmacy label. This was also noted in the most recent medication safety and advisory committee (MSAC) meeting in December 2025. When medications are not correctly labelled, there is an increased risk of inaccurate or incorrect administration. Submit to Licensing by June 03, 2026, a plan outlining how all medications will have a pharmacy label prior to administration. The plan must identify the steps that will be taken to achieve compliance, as well as the measures that will be implemented to ensure ongoing compliance with legislative requirements.
- R9.1C - Ensure a pharmacist packages all medications and records all medications on the person in care's medication administration record; 69( 1 )(a)(b)
- R7.1 - Are the physical facility, equipment and furnishings maintained, sanitary, accessible and appropriate for persons in care?
- Routine Inspection
1 infraction
- R7.1 - Are the physical facility, equipment and furnishings maintained, sanitary, accessible and appropriate for persons in care?
- Observation(s): During the inspection it was observed that some cleaning agents and chemical products are stored in a closet which is not kept locked.
- R7.1AK- Provide appropriately furnished and equipped areas for secure, safe and adequate storage of cleaning agents, chemical products and other hazardous materials; 35( 1 )(c)
- R7.1 - Are the physical facility, equipment and furnishings maintained, sanitary, accessible and appropriate for persons in care?
- Routine Inspection
0 infractions
- Routine Inspection
1 infraction
- R4.1 - Are person in care records current, complete and kept confidential?
- Observation(s): Person in care weights are not consistently being documented at least once each month as required by section 83(4)(a) of the Residential Care Regulation (RCR). Please ensure a system is in place for maintaining compliance.
- R4.1R - Weigh each person in care monthly and record their weight in their nutritional plan (Does not apply to Hospice); 83( 4 )(a)(c)
- R4.1 - Are person in care records current, complete and kept confidential?
- Routine Inspection
1 infraction
- R7.1 - Are the physical facility, equipment and furnishings maintained, sanitary, accessible and appropriate for persons in care?
- Observation(s): The manager informed Licensing Officer (LO) during the inspection that an electronic surveillance device had been installed in a person in care's room with consent from family. The video camera was installed to monitor the person's medical condition when they are alone in their room. LO reviewed the legislation for video surveillance and inquired how the employees are ensuring the persons's privacy and dignity while providing care. LO and manager reviewed different options and the manager stated the person care's care plan would be updated to reflect the changes and the employees will be educated on these changes.
- R7.1G - Display a notice in a prominent place if electronic surveillance is being used to transmit or record images of persons in care or members of the public; 19 ( 13 )
- R7.1 - Are the physical facility, equipment and furnishings maintained, sanitary, accessible and appropriate for persons in care?
- Monitoring
1 infraction
- R2.1 - Are written policies and procedures in place to guide employees in all matters relating to the care and supervision of persons in care?
- Observation(s): The reportable incident policy continues to not include aggression between residents. The manager stated that it is upper management who reviews and revises policies and they are aware, however the policy has not been updated to reflect all reportable incidents in schedule D of the Residential Care Regulation. There is no policy and procedure in place to guide employees in the event of a disease outbreak, or for disease outbreak prevention.
- R2.1P - Provide written policies and procedures for the purposes of guiding employees in all matters related to care and supervision of persons in care; 85( 1 )(a)
- R2.1 - Are written policies and procedures in place to guide employees in all matters relating to the care and supervision of persons in care?
- Monitoring
4 infractions
- R4.3 - Is documentation concerning restraints adequate?
- Observation(s): January 18, 2017 - The facility's system to ensure compliance with keeping a record of the duration of the restraint, and the monitoring of the person in care during the use of the restraint is ineffective. LO reviewed a restraint care plan and found the duration and monitoring of persons in care during the use of the restraint to be missing. The facility does not have a system in place to ensure compliance with keeping a record of the result of the reassessment for restraints. LO observed outdated documentation for the reassessment of the restraint however there was no documented outcome of the reassessment.
- R4.3D - Keep a record of the duration of the restraint and the monitoring of the person in care during the restraint in the persons care plan; 84(d)
- R4.3E - Keep a record of the result of any reassessment for the use of the restraint in the persons care plan; 84(e)
- R3.1 - Do the manager and employees meet the employment requirements and are they assessed regularly for performance?
- Observation(s): January 18, 2017 - The facility's system for ensuring compliance with employees having required training for the safe prepping and handling of food is ineffective. LO reviewed employee files and found one file to not contain food safe training. The manager has a list at the facility that shows the documents obtained for each employee at the time of hire. This list indicates the food safe certificate is missing for this employee.
- R3.1Q - Ensure employees responsible for the preparation and delivery of food have the necessary experience, competence and training to ensure that food is safely prepared and handled, and meets the nutrition needs of persons in care; 44 ( 1 )(a)
- R4.6 - Are facility records current and complete?
- Observation(s): January 18, 2017 - The facility does not have a system in place to ensure compliance with retaining a record of complaints brought forward. The facility has a complaint policy in place, however they are not maintaining a record of the complaints and concerns brought forward, and their responses to them. The facility does not have a system in place to ensure compliance with keeping a record of family/resident council meetings. The facility holds a council meeting once a year, however there is no documentation of the meeting and the outcome.
- R4.6F - Retain a record of complaints made and concerns expressed under section 60 (dispute resolution) and the responses to them; 89 ( 1 )
- R4.6H - Retain records of compliance with family and resident council required in section 59; 89( 2 )(b)
- R6.3 - Does the facility demonstrate appropriate outbreak prevention and control measures?
- Observation(s): January 18, 2017 - The facility does not have a system in place to ensure compliance with the safe storage of food. LO observed the recorded fridge temperatures to be consistently above 0-4 degrees Celsius (the safe temperature for food storage). There was no documentation of any actions taken to bring the temperature into the safe range.
- R6.3B - Ensure that food is safely prepared, stored, served and handled; 63 ( 1 )
- R4.3 - Is documentation concerning restraints adequate?
- Monitoring
6 infractions
- 4.2 Are Medication Administration Records accurate, kept on site and are adverse events documented and reported?
- Observation(s): Unable to locate reason for, and effectiveness of, as needed (PRN) medications on multiple person in care medication records.
- Keep a medication administration record showing all medications administered to the person in care; 78( 2 )(a)
- 6.2 Have all persons admitted to the facility complied with the Province’s immunization and tuberculosis control programs?
- Observation(s): Unable to locate record of Tuberculosis screening for person in care.
- Ensure that all persons admitted comply with the Province’s immunization and tuberculosis control programs; 49 ( 1 )
- 1.1 Does the Licensee operate in accordance with their license and inform Licensing of any significant changes?
- Observation(s): Manager has been away on leave since June. Unable to locate report of same to licensing.
- Notify licensing if the manager resigns or expects to be absent for at least 30 consecutive days; 8( 3 )(a)
- 2.1 Are written policies and procedures in place to guide employees in all matters relating to the care and supervision of persons in care?
- Observation(s): Handout regarding complaint process does not include contact information for licensing or other regulating bodies.
- Prior to admission, advise how the person, their parent or representative may express concerns or make complaints to licensing; 48( 1 )(c)(i)
- 5.1 Does the facility provide food services which meet nutritional needs and preferences for persons in care?
- Observation(s): Snacks do not consistently contain items from 2 food groups.
- Provide for each day, at least 2 nutritious snacks with at least 2 food groups described in Canada's Food Guide; 62( 2 )(b)
- 6.3 Does the facility demonstrate appropriate outbreak prevention and control measures?
- Observation(s): Inadequate monitoring of food fridge temperatures. Actual temperatures not recorded, but "in range" check done monthly. One zipper bag of produce in freezer dated 2013.
- Ensure that food is safely prepared, stored, served and handled; 63 ( 1 )
- 4.2 Are Medication Administration Records accurate, kept on site and are adverse events documented and reported?