Arcadia Assisted Care Villa.

“Based on observations, documentation review, and interview, the manager failed to ensure the 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, controlled or alerted employees of the egress of a resident from the facility.   Findings include:   1. A review of Department documentation revealed the facility was authorized to provide directed care services. 2. During the environmental inspection, when the patio door was opened, no alarm sounded to alert employees that a person was exiting the facility. In order to confirm the lack of alarm, the Compliance Officers exited and entered through the patio door.   2. During the environmental inspection the Compliance Officers observed E2 turning on the alarm from a control panel. 3. During the environmental inspection, the Compliance Officers opened the patio door a second time, and the alarm alerted.   4. In an interview, E1 acknowledged the patio door alarm was turned off and could pose a risk to the residents if they exited the facility without the personnel being alerted.”

“Based on observation, record review, and interviews, the manager failed to ensure that a medication administered to a resident was documented in the resident's medical record. The deficient practice posed a risk if the resident experienced a change in condition due to improper administration of medication.   Findings include:   1. A review of R1's medical record revealed a medication order for Atorvastatin 10 mg - 1 tab by mouth every night at bedtime.   2. An observation of R1's medication bottle for Atorvastatin, that was last filled on February 7, 2025, showed that the bottle matched the written order.   3. A review of R1's Medication Administration Record (MARS) revealed no written documentation for Atorvastatin being administered as written and prescribed.   4. In an interview, E1 acknowledged a medication administered to a resident was not documented in the resident's medical record.”

“Based on observation and interview the manager failed to ensure a refrigerator used by an assisted living facility to store food or medication contained a thermometer, accurate to plus or minus 3° F, placed at the warmest part of the refrigerator. The deficient practice posed a risk for potential food borne illnesses.   Findings include:   1. During n environmental inspection, the Compliance Officers (CO) observed that a kitchen refrigerator did not contain a thermometer.   2. In an interview, E1 acknowledged that there was no thermometer as required.”

“Based on observation and interview, the manager failed to ensure that the premises and equipment used at the assisted living facility were free from a condition or situation that may cause a resident or other individual to suffer physical injury. The deficient practice posed potential egress dangers to residents.   Findings include:   1. During the environmental inspection, the Compliance Officers (CO) observed the wheelchair ramp that was on the outside of the patio door, slid when R1 used the ramp.   2. In an interview, E1 acknowledged that the ramp was in violation of the rule and reported that it would be fixed the same day.”