Verde Valley Assisted Living.

“Based on observation and interview, the manager failed to ensure poisonous or toxic materials stored by the assisted living facility were inaccessible to residents. Findings include: 1 . During an environmental inspection of the facility, the Compliance Officer observed a cleaning cart sitting outside in a common area. The cleaning cart had a padlocked compartment. However, the padlock was not locked, and the following chemicals were accessible: -A bottle of "Fabuloso" multi-purpose cleaner; -A bottle of "Window Clean"; -A bottle of "Ecolab Lemon Lift" kitchen cleaner; and -A bottle of "Crew" toilet bowl cleaner. 2 . In an exit interview, the findings were discussed with E1 an no additional information was provided.”

“Based on record review and interview, the manager failed to ensure a caregiver provided documentation of completion of a caregiver training program approved by the Department or the Board of Examiners for Nursing Care Institution Administrators and Assisted Living Facility Managers for three of six caregivers sampled. Findings include: 1 . A review of E3's, E4's, and E7's personnel records revealed documentation of completion of a caregiver training program approved by the Department or the Board of Examiners for Nursing Care Institution Administrators and Assisted Living Facility Managers was not available for review at the time of inspection. 2 . In an interview, E1 reported E3, E4, and E7 had documentation of completion of caregiving training program completion verified by the facility. E1 reported a previous employee who handled personnel files was not maintaining the files correctly, but had verified E3's, E4's, and E7's caregiver certifications previously. E1 acknowledged E3's, E4's, and E7's personnel records had not contained documentation of completion of a caregiver training program at the time of inspection.”

“Based on record review and interview, the manager failed to ensure a caregiver's skills and knowledge were verified and documented before the caregiver or assistant caregiver provided physical health services or behavioral health services, for three of six caregivers sampled. Findings include: 1 . A review of E3's, E4's, and E7's personnel records revealed documentation of skills and knowledge verified and documented before providing services was not available for review at the time of inspection. 2 . In an interview, E1 acknowledged E3's, E4's, and E7's personnel records did not include documentation of skills and knowledge verification at the time of inspection.”

“Based on record review and interview, the manager failed to ensure a caregiver received orientation specific to duties to be performed by the caregiver before the caregiver provided assisted living services to a resident, for four of six caregivers sampled. Findings include: 1 . A review of E3's, E4's, E5's, and E7's personnel records revealed documentation of orientation specific to duties to be performed by the caregiver was not available for review at the time of inspection. 2 . In an interview, E1 acknowledged E3's, E4's, E5's, and E7's personnel records did not include documentation of orientation at the time of inspection.”

“Based on documentation review, record review and interview, the manager failed to ensure a personnel record for each employee included documentation of cardiopulmonary resuscitation training (CPR) for four of six caregivers sampled. Findings include: 1 . A review of NationalCPRfoundation.com revealed a FAQ section. The FAQ section revealed a question which stated, "Do you offer hands-on training?" which was answered, "No, we do not offer hands-on training." 2 . A review of E3's, E4's and E7's personnel record revealed documentation of CPR training. However, the documentation was provided from NationalCPRfoundation. 3 . A review of E6's personnel record revealed documentation of CPR training was not available for review at the time of inspection. 4 . In an interview, E1 reported E3, E4, and E7 were attending a CPR class which included a demonstration that same day, but the class was cancelled due to the inspection. E1 acknowledged E3, E4, E6, and E7 did not have valid documentation of CPR certification at the time of inspection.”

“Based on observation and interview, the manager failed to ensure that a current toxicology reference guide was available for use by personnel members. Findings include: 1. No toxicology guide was available for review. 2. During an interview, E1 stated, "I can't find that."”

“Based on documentation review and interview, the manager failed to ensure that the disaster plan was reviewed at least once every 12 months. Findings include: 1. Review of facility disaster plan review documentation indicated that the last review was conducted on March 7, 2023. 2. During an interview, E1 acknowledged that the documentation failed to reflect that a review had been conducted at least once every 12 months.”

“Based on documentation review and interview, the manager failed to ensure that documentation of each evacuation drill included the following: The amount of time taken for employees and residents to evacuate the assisted living facility and identification of residents needing assistance for evacuation. Findings include: 1. Review of 12 months of facility evacuation drill documentation revealed that the documentation failed to identify the amount of time taken to evacuate the facility and identification of residents needing assistance for evacuation. 2. During an interview, E1 stated, "We do have directed care residents here who would need assistance." 3. During an interview, E1 acknowledged the required documentation was not available for review”

“Based on documentation review and interview, the manager failed to ensure that the health care institution establishes, documents, and implements tuberculosis infection control policy and procedure. Findings include: 1. Review of facility policies and procedures failed to reveal documentation indicating that the health care institution had established and documented tuberculosis infection control policies and procedures that include subsections a. through f. of this rule. 2. During an interview, E1 acknowledged that the required documentation was not available for review.”

“Based on record review and interview, the chief administrative officer failed to ensure that the health care institution established, documented, and implemented tuberculosis infection control activities that included annually providing training and education related to recognizing the signs and symptoms of tuberculosis (TB) to individuals employed by the health care institution. Findings include: 1. Review of the record for E1 failed to reveal documentation indicating that annual training related to recognizing the signs and symptoms of TB had been completed. No TB training documentation was available for review. 2. Review of the record for E2 failed to reveal documentation indicating that annual training related to recognizing the signs and symptoms of TB had been completed. No TB training documentation was available for review. 3. Review of the record for E3 failed to reveal documentation indicating that annual training related to recognizing the signs and symptoms of TB had been completed. No TB training documentation was available for review. 4. Review of the record for E4 failed to reveal documentation indicating that annual training related to recognizing the signs and symptoms of TB had been completed. No TB training documentation was available for review. 5. During an interview, E1 acknowledge that the required documentation was not available.”

“Based on documentation review and interview, the manager failed to ensure that the health care institution establishes, documents, and implements tuberculosis infection control activities that included annually assessing the health care institution's risk of exposure to infectious tuberculosis. Findings include: 1. Review of facility documentation failed to reveal an annual assessment of the health care institution's risk of exposure to infectious tuberculosis. 2. During an interview, E1 acknowledged that the required documentation was not available for review.”

“Based on interview and record review, the manager failed to ensure that a resident had a written service plan that included the amount, type, and frequency of assisted living services being provided to the resident. Findings include: 1. During an interview, E1 stated "I asked (E3) and she said that at the end of January (2024) caregivers started putting the resident [R4] into briefs at night because the resident was having accidents." 2. During an interview, E1 indicated the resident had begun receiving services from Northern Arizona Home Health. 3. The record for R4 contained a service plan dated February 9, 2024 that indicated R4 was at the personal care level was in "stable health, skin was clean and intact and the resident was not incontinent". 4. During an interview, E1 acknowledged that the resident's service plan did not contain the required documentation.”

“Based on record review, documentation review and interview, the manager failed to ensure that when a resident has an accident or injury that results in the resident needing medical services, a caregiver documents a. The date and time of the accident, emergency, or injury; b. A description of the accident, emergency, or injury; c. The names of individuals who observed the accident, emergency, or injury; d. The actions taken by the caregiver or assistant caregiver; e. The individuals notified by the caregiver or assistant caregiver; and f. Any action taken to prevent the accident, emergency, or injury from occurring in the future. Findings include: 1. During an interview, E1 indicated that on January 28, 2024 R4 was observed by a caregiver to have an injury to their knee that required medical services. 2. Review of the record for R4 revealed "Patient Discharge Instructions" from Northern Arizona Healthcare indicating the resident had received medical services on January 28, 2024. No incident report documentation as required by subsections a. through e. of this rule was available for review. 3. During an interview, E1 stated "I don't have an incident report for that."”