Ark of Angel Assisted Living.

“Based on documentation review, record review, and interview, the manager of an assisted living center who contacted emergency responders on behalf of a resident failed to provide to the emergency responders a written document that included all information required in A.R.S. § 36-420.04, for one of one applicable residents sampled. The deficient practice posed a risk if the emergency responder was not aware of critical health information for the resident.   Findings include: 1. A review of facility documentation revealed a progress note dated April 30, 2024. The progress note revealed R1 had been transported to the hospital. 2. A review of R1's medical record revealed a standardized form which failed to include all information required in A.R.S. § 36-420.04, including basic information about the resident's physical and mental conditions, as well as dates of recent episodes. 3. In an exit interview, the findings were reviewed with E1 and no additional information was provided.”

“Based on documentation review and interview, the manager of an assisted living home failed to maintain a copy of the document provided to the emergency responder which included the items listed in Arizona Revised Statutes (A.R.S.) § 36-420.04(A)(1) through (9), for one of one applicable residents reviewed. Findings include: 1. A review of Department documentation revealed an intake that reported R1 had been transported from the facility to the hospital by Emergency Medical Services (EMS) on April 30, 2025. 2. A review of R1's medical record revealed a progress report dated April 30, 2025, that stated "...911 came and brought R1 to the hospital..." 3. In an interview, E1 reported E1 did not have a copy of the documents provided to the emergency responders, which included the items listed in Arizona Revised Statutes (A.R.S.) § 36-420.04(A)(1). 4. In an exit interview, the findings were reviewed with E1 and no additional information was provided.”

“Based on documentation review, record review, and interview, the manager failed to ensure when a resident had an incident resulting in the resident needing medical services, a caregiver documented the date and time of the incident; a description of the incident; the names of individuals who observed the incident; the action taken by the caregiver; the individuals notified by the caregiver; and any action taken to prevent the incident from occurring in the future, for one of three residents reviewed. The deficient practice posed a health and safety risk. Findings include: 1. A review of Department documentation revealed 911 was called for R1 following an accident, emergency, or injury to R1 on April 30, 2025. 2. A review of R1's medical record revealed a document titled "Care Giver Notes". The document included the following: -date and time of the accident, emergency, or injury; -the names of individuals who observed the accident, emergency, or injury; -a description of the accident, emergency; -the actions taken by the caregiver; -the individuals notifed by the caregiver; However, documentation did not include a description of any action taken to prevent the accident, emergency, or injury from occurring in the future. 3. In an exit interview, the findings were reviewed with E1 and no additional information was provided.”