Fellowship Square Historic Mesa Oasis.

“Based on documentation review and interview, after the manager had a reasonable basis, according to Arizona Revised Statutes (A.R.S.) \'a7 46-454, to believe abuse, neglect, or exploitation had occurred on the premises, the manager failed to report the suspected abuse, neglect, or exploitation, initiate an ivestigation of the suspected abuse, neglect, or exploitation, and maintain documentation including all requirements of this rule for at least 12 months after the date the investigation was initiated. The deficient practice posed a risk if a resident was not protected from abuse, neglect, or exploitation. Findings include: 1. A review of facility documentation revealed no incident report for R1. 2. In an interview, E1 acknowledged hospital staff where R1 was receiving medical attention had informed E1 that R1 was alleging a sexual assault. E1 was informed on September 24, 2024. E1 acknowledged the incident had not been reported by the facility in compliance with A.R.S. \'a7 46-454.”

“Based on documentation review, record review, and interview, the governing authority failed to ensure compliance with Arizona Revised Statutes (A.R.S.) \'a7 36-411, for one of two sampled employees. The deficient practice posed a risk if the employee was a danger to a vulnerable population. Findings include: 1. A.R.S. \'a7 36-411(A) states, "A. Except as provided in subsection F of this section, as a condition of licensure or continued licensure of a residential care institution, a nursing care institution or a home health agency and as a condition of employment in a residential care institution, a nursing care institution or a home health agency, employees and owners of residential care institutions, nursing care institutions or home health agencies or contracted persons or volunteers who provide medical services, nursing services, behavioral health services, health-related services, home health services or supportive services and who have not been subject to the fingerprinting requirements of a health professional's regulatory board pursuant to title 32 shall have valid fingerprint clearance cards that are issued pursuant to title 41, chapter 12, article 3.1 or shall apply for a fingerprint clearance card within twenty working days of employment or beginning volunteer work or contracted work." 2. A review of E2's personnel record revealed a fingerprint clearance card with an expiration date of February 12, 2024. No other documentation to reflect E2's compliance with A.R.S. \'a7 36-411(A) was provided at the time of the inspection. 3. A review of the Arizona Department of Public Safety (DPS) website revealed E2's fingerprint clearance card expired on February 12, 2024. The website also revealed E2 had no application for renewal. 4. In an interview, E1 acknowledged E2's fingerprint clearance card was expired. E1 acknowledged E2 had not yet submitted an application for renewal to DPS.”

“Based on observation and interview, the manager failed to ensure poisonous or toxic materials stored by the facility were stored in a locked area and inaccessible to residents. The deficient practice posed a health and safety risk to residents with access to the poisonous or toxic materials. Findings include: 1. During the environmental inspection of the facility, the Compliance Officer observed "Micro-kill foaming Disinfectant Cleaner" stored in an unlocked kitchen cabinet which was accessible to residents. 2. In an interview, E2 acknowledged the aforementioned toxic material was not stored in a locked location and inaccessible to residents.”