Family Matters II.

“Based on record review and interview, the manager failed to ensure that before or at the time of acceptance of an individual, the individual submitted documentation that was dated within 90 calendar days before the individual was accepted by the assisted living facility and included whether the individual required continuous medical services, continuous or intermittent nursing services, or restraints, and was dated and signed by a physician, registered nurse practitioner, registered nurse, or physician assistant for one of two residents sampled.  Findings include: 1. A review of R2's medical records revealed no documentation to indicate whether R2 required continuous medical services, continuous or intermittent nursing services, or restraints, dated and signed by a physician, registered nurse practitioner, registered nurse, or physician assistant. Based on the resident's date of acceptance, this documentation was required. 2. In an interview, E1 acknowledged that the medical record for R2 did not include the required documentation dated within 90 calendar days before R2 was accepted by the assisted living facility.”

“Based record review, and interview, the manager failed to ensure that within five working days after a resident's acceptance by the assisted living facility, the documented agreement required in subsection (D), was signed by the resident's representative, the resident's legal guardian, or another individual who has been designated by the individual under A.R.S. § 36-3221 to make health care decisions on the individual's behalf, for one of two residents sampled.   Findings include:    1. A review of R2's medical record revealed R2 received directed care services. Further review revealed a residency agreement with all required elements. However, the resident agreement was not signed by the resident's representative, the resident's legal guardian, or another individual designated by the resident. 2. In an interview, E1 acknowledged R2's medical records did not include a residency agreement signed by the resident's representative, the resident's legal guardian, or another individual who has been designated by the resident, within five days of R2's acceptance into the facility.”

“Based on record review, observation, and interview, the manager failed to ensure that there was a means of exiting the facility that controlled or alerted employees of the egress of a resident from the facility.   Findings include:      1. During an environmental tour of the facility, the Compliance Officers observed three sliding back doors leading to the back yard. However, none of the doors had a control or alerted employees of the egress of residents from the facility. The facility is licensed for directed care services. 2. In an interview, E1 acknowledged there was no means of exiting the facility that controlled or alerted employees of the egress of a resident from the facility.”

“Based on documentation review, observation, and interview, the manager failed to ensure a pest control program that complied with A.A.C. R3-8-201(C)(4) was implemented and effective. The deficient practice posed a potential risk to residents. Findings include: 1. R3-8-201.C.4. stated "C. Applicator licensure. 4. An individual may not provide pest management services at a school, child care facility, health care institution, or food-handling establishment unless the individual is a certified applicator in the certification category for which services are being provided." 2. Review of the facility Maintenance log revealed pest control was not documented in the years of 2024 to current day. 3. The Compliance Officers observed a spray bottle of Hot Shot Bed Bug Killer that E1 brought to them. 4. In an interview, E1 acknowledged E1 does the facility’s pest control and E1 reported that he uses the spray bottle mentioned above along the baseboards. E1 reported E1 was not a licensed applicator 5. In an interview, E1 acknowledged the facility did not utilize a pest control program compliant with A.A.C. R3-8-201(C)(4).”