Arc of Care LLC.

“Based on record review and interview, the manager failed to ensure that the assisted living home maintained a standardized form for each resident that included the information prescribed in subsection A of this section, except for the information prescribed in subsection A, paragraph 1 of this section, to be provided at the time the emergency responder is contacted. Findings include: 1. A review of R1’s and R2’s medical records revealed no face sheet of information to be given to an emergency responder on behalf of the residents.   2. In an interview, E3 acknowledged that the facility did not have face sheets to provide to emergency responders.”

“Based on observation, documentation review, and interviews, the manager failed to ensure that at least the manager or a caregiver was present at an assisted living home when a resident was present in the assisted living home. The deficient practice posed a risk as no qualified employee was present to meet a resident's needs.   Findings include:   1. Upon arriving at the facility, the Compliance Officers were greeted by E2. E2 was observed to be the only staff member in the facility with five residents. E2 called E3, who arrived at the facility approximately 30 minutes after the Compliance Officers arrived.   2. A review of E2's personnel record revealed that E2 did not have a caregiver certificate.   3. In an interview, E3 revealed that E2 was an assistant caregiver. E3 revealed that E2 was supposed to be working supervised under a caregiver, but E3 had a doctor's appointment. E3 acknowledged that there was no certified caregiver on-site while a resident was present.”

“Based on documentation review, observation, record review, and interview, the governing authority failed to ensure compliance with A.R.S. § 36-411 for two of three personnel sampled. The deficient practice posed a risk if E3 was a danger to a vulnerable population.   Findings include:    1. A.R.S. § 36-411(C)(4) states, “On or before March 31, 2025, verify that each employee is not on the adult protective services registry (APS) pursuant to section 46-459…”   2. While on-site for the compliance inspection, the Compliance Officers observed E2 and E3 at the facility, providing services to residents.   3. A review of E2’s and E3's personnel records revealed no documentation of a check of the adult protective services registry.   4. In an interview, E3 acknowledged that E2 and E3 had no APS registry checks. This is a repeat deficiency from the compliance inspection conducted July 7, 2022, and the complaint investigation conducted on October 28, 2022.”

“Based on observation and interview, the manager failed to ensure there was a caregiver present on the assisted living facility's premises and accountable for the assisted living facility when the manager is not present on the assisted living facility's premises.   Findings include:   1. During the environmental inspection of the facility, the Compliance Officers observed a posting titled, “Delegation of Authority." However, the delegation had not included E2 or E3.   2. In an interview, E3 acknowledged that the Delegation of Authority was not updated for the facility.”

“Based on record review, documentation review and interview, the manager failed to ensure a caregiver’s or assistant caregiver’s skills and knowledge were verified and documented before the caregiver or assistant caregiver provided physical health services or behavioral health services an according to policies and procedures. The deficient practice posed a risk if the employee were unable to meet a resident’s needs. Findings include: 1. A review of E2’s personnel file revealed no documentation verifying a caregiver’s or assistant caregiver’s skills and knowledge.  2. A review of facility policy and procedures revealed a policy titled, “Verifying Caregiver’s Skills and Knowledge”.  Number 1 states, “All staff need to be trained and their skills and knowledge verified prior to staff providing assistance with new equipment or procedures. The manager will interview and assess the staff and test on caregiver skills.” 3. In an interview E3 acknowledged that E2 did not have a verified skills and knowledge document.”

“Based on documentation review and interview, the manager failed to ensure that documentation was maintained for at least 12 months after the last date on the documentation of the caregivers and assistant caregivers working each day, including the hours worked by each. The deficient practice posed a risk as there was no documentation to identify if qualified staff were present each day to ensure the health and safety of residents. Findings include: 1. A review of facility documentation revealed an employee work schedule for June 2025.  However, E2 was not listed on the work schedule. 2. In an interview, E3 acknowledged that E2 was not on the work schedule.”

“Based on documentation review and interview, the manager failed to ensure that a calendar of planned activities was maintained for at least 12 months after the last scheduled activity.   Findings include:     1. A review of facility documentation revealed a posted activity calendar for February 2025. However, documentation of activity calendars for prior months was not available.     2. In an interview, E2 acknowledged that a calendar of planned activities was not maintained for at least 12 months after the last scheduled activity.”

“Based on documentation review, record review, and interview, the manager failed to ensure that a resident's medical record contained documentation of the resident's notification of the availability of vaccination for influenza (flu) and pneumonia, according to A.R.S. § 36-406(1)(d) for two of two residents sampled. The deficient practice posed a potential illness risk to residents.   Findings include:  1. A.R.S. § 36-406(1)(d) states "The department shall: Require as a condition of licensure that nursing care institutions and assisted living facilities make vaccinations for influenza and pneumonia available to residents on site on a yearly basis. The department shall prescribe the manner by which the institutions and facilities shall document compliance with this subdivision, including documenting residents who refuse to be immunized. The department shall not impose a violation on a license for not making a vaccination available if there is a shortage of that vaccination in this state as determined by the director." 2. A review of R1's medical record revealed notification of the availability of flu and pneumonia vaccinations dated November 2022. However, R1's medical record did not include documentation of R1's notification of the availability of flu and pneumonia vaccinations annually. Based on R1's acceptance date, this documentation was required.   3. A review of R2’s medical record revealed no notification of the availability of the flu and pneumonia vaccinations available. Based on R2’s acceptance date, this documentation was required. 4. In an interview, E3 acknowledged R1's and R2’s medical record did not contain documentation of notification of the availability of vaccinations according to A.R.S. § 36-406(1)(d).”

“Based on record review, observation, and interview, the manager failed to ensure that a medication administered to a resident was documented in the resident's medical record for one of two residents reviewed. The deficient practice posed a health and safety risk to the resident if a caregiver did not know whether a medication was administered, and the Department was provided false and misleading information. Findings include: 1. Review of R1's medical record revealed signed medication orders dated May 1, 2025. These medication orders stated the following: ·        Advair Diskus 250 MCG (microgram) 50 MCG/dose Poser Inhalation. ·        Lisinopril 10mg (milligram) tablet oral. Give 1 tab (tablet) daily for HTN (Hypertension). ·        Vitamin D3 (2,000 units) tablet oral. Give 1 tab daily. (Supplement). However, there was no documentation that the medications were given. 2. Review of R1’s medical record revealed signed medication orders dated May 1, 2025.  These medication orders stated the following:  ·        Clopidogrel 75 MG. Give 1 tab PO (orally) daily for DVT/Prophylaxis. However, the documentation revealed the medication was signed off as given for 7 am on June 10, 2025, the day after the compliance inspection. 3. During an interview, E3 acknowledged R1's medical record did not include documentation that the medications were administered per medication orders. This is a repeat deficiency from the compliance inspection conducted on July 7, 2022.”

“Based on observation and interview, the manager failed to ensure that poisonous or toxic materials stored by the assisted living facility were maintained in labeled containers in a locked area separate from food preparation and storage, dining areas, and medications, and were inaccessible to residents. The deficient practice posed a risk to the physical health and safety of a resident.   Findings include: 1. During the environmental inspection, the Compliance Officers observed the following toxic chemicals located under the kitchen sink with a lock.  However, the cabinet was open and accessible to residents: ·        Cascade liquid dish detergent ·        Clorox bleach ·        Easy-Off oven cleaner 2. In an interview, E3 acknowledged that there were poisonous or toxic materials stored by the assisted living facility that were not in a locked or secure area and inaccessible to residents.”