Parc Joule Assisted Living Home.

“Based on record review and interview, the owner failed to ensure compliance with Arizona Revised Statutes (A.R.S.) § 36-411(C)(1) for two of two personnel reviewed. The deficient practice posed a safety risk as the Department was unable to determine substantial compliance, as the documentation was not in the personnel records during the inspection. Findings include: 1. A.R.S. § 36-411(C) states: "C. Owners shall make documented, good faith efforts to: 1. 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." 2. A review of E1's personnel record did not include documentation of the facility's good-faith effort to contact E1's previous employers to obtain information or recommendations that may be relevant to a person's fitness to work in a residential care institution. 3. A review of E2's personnel record did not include documentation of the facility's good-faith effort to contact E2's previous employers to obtain information or recommendations that may be relevant to a person's fitness to work in a residential care institution. 4. In an exit interview, the findings were reviewed with E2, and no additional information was provided.”

“Based on documentation review, record review, observation, and interview, the manager failed to ensure an individual authorized to administer opioids identified the resident's need for an opioid before administering the opioid and the effect of the opioid administered. The deficient practice posed a risk to the physical health and safety of a resident. Findings include: 1. A review of the facility's policy titled "Opioid Medications" stated, "...1)...record the opioid administration on the facility charting. Narcotic Administration Form or PRN Administration Form...2. Carefully document when and how much opioid medication was administered in order to keep track of how much is left..." Further review revealed that the facility's policy and procedure for administering an opioid did not cover how a patient's need for opioid administration is assessed, how and when a patient receiving an opioid is monitored, and how, when, and by whom the actions taken according to subsections (F)(1)(c) and (d) are documented. 2. A review of R2’s medical record revealed R2 did not have an end-of-life condition or an active malignancy. 3. A review of R2's medical record revealed a signed medication order for Morphine Sulfate 100 mg per 5 mL by mouth under the tongue twice a day as needed. 4. A review of R2's medical record revealed a May 2026 medication administration record (MAR) and an opioid tracking document that included a space for the date, time, dosage, administered by, and number of pills remaining. The form revealed that R2 was administered morphine twice daily from April 30, 2026, to May 13, 2026. However, documentation showing the identification of R2's need for the opioid before the opioid was administered and the effect of the opioid administered was not documented. 5. During an interview, E2 acknowledged that R2's medical record did not include documentation showing that the resident's need for an opioid was identified before administering the opioid and that the effect of the opioid was monitored. 6. In an exit interview, the findings were reviewed with E2, and no additional information was provided.”

“Based on observation, documentation review, and interview, the manager failed to ensure medication was stored according to the instructions on the medication container. The deficient practice posed a risk to the health and safety of the resident if the medication was not stored properly. Findings include: 1. While on-site, the Compliance Officer observed a bottle of R1's medication with a yellow label that stated, "Refrigerate after opening for use" located in the locked cabinet that contained R1's medications. 2. A review of the facility's documentation revealed a policy titled "Medications" that stated, "...F. When medication is stored by an assisted living facility... 2. Medication is stored according to the instructions on the medication container..." 3. In an interview, E2 acknowledged R1's medication was not stored according to the instructions on the medication container. 3. In an exit interview, the findings were reviewed with E2, and no additional information was provided.”

“Based on observation, record review, and interview, the manager failed to designate, in writing, a caregiver who was present on the facility's premises and accountable for the facility when the manager was not present, as the manager's designee. Findings include: 1. When the compliance officer arrived at the facility, the manager was not present. 2. The compliance officer observed E4's manager's certificate conspicuously posted, however, there was no documentation by E4 available for review that indicated that E3, who was the only employee working at the facility, as the manager's designee when the manager was not present at the facility. 3. Review of E3's personnel record indicated that E3 was hired on May 29, 2023 and was a certified caregiver, however, was not designated as a manager's designee. 4. Later when E1 arrived at the facility, E1 acknowledged that E4 had not designated E3 as a manager's designee.”

“Based on observation and interview, the manager failed to ensure the location at which a copy of the most recent Department inspection report and any plan of correction resulting from the Department inspection may be viewed was conspicuously posted. Findings include: 1. During a facility tour, E1 and the compliance officer observed no posted notification of the location of the most recent Department inspection report and any plan of correction resulting from the inspection. The definition of "conspicuously posted" per the definition in A.A.C. R9-10-101(54) as a visible and available area that the public enters the premises of the health care institution. 2. In an interview, E1 acknowledged the required inspection notice was not conspicuously posted as required. Technical assistance was provided during the initial inspection conducted on October 28, 2022.”

“Based on observation, record review, and interview, the manager failed to ensure that a bell, intercom, or other mechanical means to alert employees to a resident's needs or emergencies is available in a bedroom being used by one of four sampled residents receiving directed care services; which posed a health and safety risk. Findings include: 1. During a facility tour, E1 and the surveyor observed R4's bedroom was not equipped with bell, intercom, or other mechanical means to alert employees to a resident's needs or emergencies. 2. Review of R4's medical record indicated that R4 was unable to ambulate even with assistance and was receiving directed care services. 3. In an interview, E1 acknowledged the sampled resident's bedroom was not equipped with a working bell or other mechanical means available to the residents to alert employees of a residents' needs.”

“Based on observation and interview, the manager failed to ensure there was a means of exiting the facility for a resident who does not have a key, special knowledge for egress, or the ability to expend increased physical effort that provides access to an outside area that controls or alerts employees of the egress of a resident from the facility, which posed a safety risk to residents. The facility is licensed to provided directed care services. Findings include: 1. During a facility tour of the residents' proposed secured outdoor area where residents may walk, E3 and the compliance officer observed the exit gate from this proposed secured outdoor area could easily be opened that led to the front of the facility and the City street. There were no activated alarms to alert the employees of the egress of a resident from the facility. 2. In an interview, E1 and E3 acknowledged the unsecured outdoor area.”

“Based on observation and interview, the manager failed to ensure medications stored by the facility were stored in a locked room, closet, cabinet, or self-contained unit; which posed a health and safety risk. Findings include: 1. During a facility tour, E1, E3, and the compliance officer observed in the facility's unlocked garage in an unlocked refrigerator there was stored Robitussin liquid, Ozempic insulin pens, cold and mucus liquid, and allergy relief liquid. 2. In an interview, E1, E2, and E3 acknowledged the unlocked medications the facility was storing.”

“Based on documentation review and interview, the manager failed to ensure an employee disaster drill was conducted at least once every three months on each shift and documented. Findings include: 1. During an interview, E1 reported the facility had two shifts: First shift from 6:30 AM to 6:30 PM, and the second shift from 6:30 PM to 6:30 AM. 2. Review of the employee disaster drill documentation for the past 12 months revealed no employee disaster drills were conducted on the second shift. 3. In an interview, E1 acknowledged there were no employee disaster drills conducted on the second shift during the past 12 months as required.”

“Based on record review and interview, the manager failed to ensure a resident's orientation to the exits from the assisted living facility and the route to be used when evacuating the assisted living facility was completed within 24 hours after the resident's acceptance by the facility and documented; for four of four sampled residents' records reviewed, which posed a safety risk. Findings include: 1. Review of R1's, R2's, R3's, and R4's records, based on their dates of acceptance, revealed there was no documentation indicating the sampled residents received orientation to the exits from the facility and the route to be used when evacuating the facility within 24 hours after the resident was accepted by the facility. 2. During an interview, E1 acknowledged there was no documentation to indicate the sampled residents had received evacuation orientation to the exits from the facility within 24 hours after the residents' acceptance, nor anytime since.”