Eyal LLC 2.

“Based on record review and interview, the manager failed to ensure a caregiver's skills and knowledge were verified and documented before the caregiver provided physical health services, for two of four caregivers sampled. The deficient practice posed a risk if the caregivers were unable to meet a resident's needs. Findings include: 1. Review of E1's and E2's personnel records revealed both were hired as caregivers. 2. Review of E1's personnel record revealed no documentation that E1's skills and knowledge were verified. 3. Review of E2's personnel record revealed a document titled "Caregiver/Assistant Caregiver Skills and Knowledge Checklist" which documented E2's skills and knowledge, however, this document was dated two months after E2 began providing physical health services. 4. In an interview, E1 acknowledged E1's and E2's skills and knowledge were not verified and documented before the caregiver provided physical health services.”

“Based on record review and interview, the manager failed to ensure an employee provided documentation of freedom from infectious tuberculosis (TB) on or before the date the individual began providing services at or on behalf of the assisted living facility, as specified in R9-10-113, for two of four employees reviewed. The deficient practice posed a potential TB exposure risk to residents. Findings include: 1. R9-10-113.A states "If a health care institution is subject to the requirements of this Section, as specified in an Article in this Chapter, the health care institution's chief administrative officer shall ensure that the health care institution establishes, documents, and implements tuberculosis infection control activities that...2. Include: a. For each individual who is employed by the health care institution, provides volunteer services for the health care institution, or is admitted to the health care institution and who is subject to the requirements of this Section, screening, on or before the date specified in the applicable Article of this Chapter, that consists of: i. Assessing risks of prior exposure to infectious tuberculosis, ii. Determining if the individual has signs or symptoms of tuberculosis, and iii. Obtaining documentation of the individual's freedom from infectious tuberculosis according to subsection (B)(1)..." 2. Review of the Centers for Disease Control and Prevention website revealed a web page titled "TB Screening and Testing of Health Care Personnel." The web page stated, "If the Mantoux tuberculin skin test (TST) is used to test health care personnel upon hire (preplacement), two-step testing should be used." 3. Review of E3's personnel record revealed a negative TB skin test, however, it was dated nine months after E3's documented date of hire. No additional documentation of freedom from infectious TB was available for review. 4. Review of E4's personnel record revealed two negative TB skin tests, however, the tests were dated two months after E4's documented date of hire. No additional documentation of freedom from infectious TB was available for review. 5. In an interview, E1 acknowledged E3 and E4 did not provide documentation of freedom from infectious TB as specified in R9-10-113 on or before the date the individual began providing services at or on behalf of the assisted living facility. Technical assistance was provided on this Rule during the compliance inspection conducted June 29, 2023.”

“Based on documentation review, record review, and interview, the manager failed to ensure a personnel record for each employee included documentation of compliance with the requirements in A.R.S. \'a7 36-411(C)(1), for one of four personnel records sampled. The deficient practice posed a risk if E3 was a danger to a vulnerable population. Findings include: A.R.S. \'a7 36-411(C)(1) Owners shall make documented, good faith efforts to: Contact previous employers to obtain information or recommendations that may be relevant to a person's fitness to work in a residential care institution, nursing care institution or home health agency. 1. A review of E3's personnel record revealed a document titled "Employment History" which listed three previous jobs. 2. A review of E3's personnel record revealed a document titled "Verbal Reference Check Verification" which listed the contact information for four references for E3, however, all four references stated that the "relationship to applicant" was "friend". No documentation showing that owners had attempted to contact previous employers was available. 3. In an interview, E1 acknowledged documentation of compliance with the requirements in A.R.S. \'a7 36-411(C)(1) for E3 was not available for review.”

“Based on observation and interview, the manager failed to ensure a calendar of planned activities was prepared at least one week in advance of the date the activity was provided. Findings include: 1. During an environmental inspection of the facility, the Compliance Officer observed the posted activity calendar. The activity calendar was dated August 1, 2023 - August 25, 2024. 2. In an interview, E1 acknowledged a calendar of planned activities was not prepared at least one week in advance.”

“Based on observation and interview, the manager failed to ensure a resident was treated with dignity, respect, and consideration. The deficient practice posed a risk as a resident's rights were violated. Findings include: 1. During the environmental tour of the facility, the Compliance Officer observed a sign on the outside of R4's bedroom door which stated "DO NOT PEE OR POOP ON YOUR BED OR FLOOR. YOUR ROOM SMELLS URINE AND POOP". 2. In an interview, R4 reported that the sign was a message posted by facility staff to the former resident that R4 shared the room with after facility staff had gotten frustrated with the former resident's incontinence. 3. In an interview, E1 reported that the sign was directed at a previous resident, and did not think it was disrespectful.”

“Based on documentation review, record review, and interview, the manager failed to ensure a medical record was maintained for each resident according to A.R.S. Title 12, Chapter 13, Article 7.1, for two of four residents reviewed. The deficient practice posed a risk as required information could not be verified and the Department was unable to determine substantial compliance during the inspection. Findings include: A.R.S. \'a7 12-2297(A)(1) Unless otherwise required by statute or by federal law, a health care provider shall retain the original or copies of a patient's medical records as follows: If the patient is an adult, for at least six years after the last date the adult patient received medical or health care services from that provider. 1. Review of Department documentation revealed a report dated September 9, 2024, which alleged that R2 was not provided with care that followed medical orders. 2. Review of Department documentation revealed a report dated October 6, 2023, which alleged that R3's personal items had been stolen and that services had not been provided per R3's service plan. 3. The Compliance Officer requested to review R2's and R3's medical records; however, no medical records were provided for review. 4. In an interview, E1 reported that R2 had been a resident at the facility, but that E1 had given R2's medical record to R2's hospice agency. E1 reported that R3 had been a resident at the facility, but that E1 did not know where R3's record was. 5. In an interview, E1 acknowledged that a medical record for R2 and R3 were not maintained for at least six years after the last date R2 and R3 received services from the facility.”

“Based on observation and interview, the manager failed to ensure a current drug reference guide was available for use by personnel members. Findings include: 1. The Compliance Officer observed the facility's drug reference guide was the "Mosby's 2022 Nursing Drug Reference 35th edition". 2. Review of the publisher's website revealed the "Mosby's 2025 Nursing Drug Reference 38th edition" was the most recent edition. 3. In an interview, E1 acknowledged that a current drug reference guide was not available for use by personnel members.”

“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. The toxicology guide available for use by personnel members was the "Poisoning & Drug Overdose" Seventh edition, published by McGraw Hill Lange. 2. Review of the publishers website revealed that "Poisoning & Drug Overdose" Eighth edition was the current version. 3. In an interview, E1 acknowledged that a current toxicology reference guide was not available for use by personnel members.”

“Based on observation and interview, the manager failed to ensure a food menu was conspicuously posted at least one calendar day before the first meal on the food menu was served. Findings include: 1. During a tour of the facility, the Compliance Officers observed a food menu dated August 1 - August 3, 2024. 2. In an interview, E1 reported E1 had forgotten to post an updated menu. E1 acknowledged the food menu was not conspicuously posted at least one calendar day before the first meal on the food menu was served.”

“Based on interview, documentation review, and interview, the manager failed to ensure a current therapeutic diet manual was available for use by employees. The deficient practiced posed a risk if the employees did not have access to dietary information required to meet a resident's need. Findings include: 1. In an interview, E1 reported the facility provided therapeutic diets for residents when required by the resident's service plan. E1 reported that R2 received a diabetic diet. 2. Review of the facility's policies and procedures revealed a policy titled "Food Services" which stated "Eyal LLC 2 offers therapeutic diets, a manager shall ensure that: a. A current therapeutic diet manual is available for use by employees." 3. In an interview, E1 reported having no therapeutic diet manual available on site, for use by employees.”

“Based on interview and record review, the manager failed to ensure a therapeutic diet was provided to a resident according to a written order from the resident's primary care provider or a medical practitioner. Findings include: 1. In an interview, E1 reported that R2 received a therapeutic diabetic diet. 2. Review of R2's medical record revealed no written orders for a diabetic diet. 3. In an interview, E1 acknowledged R2 received a diabetic diet and a therapeutic diet order was not available.”

“Based on document review and interview, the manager failed to ensure that smoke detectors were tested at least once a month. The deficient practice posed a health and safety risk if the smoke detectors did not work properly during an emergency. Findings include: 1. A review of facility documentation revealed documentation that the smoke detectors were last tested in July 2024. No documentation was available showing that smoke detectors had been tested in August 2024. 2. In an interview, E1 acknowledged that no documentation was available showing that smoke detectors had been tested at least once a month.”