A Parent's Paradise and Care LLC.

“Based on record review and interview, for three of three employees reviewed, the health care institution failed to implement tuberculosis (TB) infection control activities, including annually providing training and education related to recognizing the signs and symptoms of TB to individuals employed by the health care institution. The deficient practice posed a risk as the caregiver received no organized instruction or information related to TB surveillance. Findings include:  1. In record review, the personnel records for E1, E2, and E3, included a document "Annual Training for Tuberculosis Infection Prevention;" however, the document was a TB screening document for the employee and did not indicate the employee was trained on recognizing the signs and symptoms of TB. 2. During an interview, E1 reported the documentation was a TB screening document, and the employees did not receive the required training on recognizing the signs and symptoms of TB.”

“Based on documentation review, record review, and interview, for three of three employees reviewed, the governing authority failed to ensure compliance with A.R.S. § 36-411. The deficient practice posed a risk if a personnel member was a danger to a vulnerable population.   Findings Include: 1. A.R.S. § 36-411 states: C. Each residential care institution, nursing care institution and home health agency shall make documented, good faith efforts to: 3. Beginning January 1, 2025, verify that a potential employee is not on the adult protective services registry pursuant to section 46-459. If a potential employee is found to be on the adult protective services registry, the residential care institution, nursing care institution or home health agency may not hire the potential employee. 4. On or before March 31, 2025, verify that each employee is not on the adult protective services registry pursuant to section 46-459. If an employee is found to be on the adult protective services registry, the residential care institution, nursing care institution or home health agency shall take action to terminate the employment of that employee. 5. Beginning March 31, 2025, annually reverify that each employee is not on the adult protective services registry pursuant to section 46-459. 2. In observation, E1 and E3 were observed on site during the inspection. 3. In record review, the personnel records for E1 (hired as a caregiver on February 2, 2018), E2 (hired as the manager on February 1, 2018), and E3 (hired as a caregiver on March 15, 2023), did not include documentation of the verification that E1, E2 and E3 were not on the adult protective services registry pursuant to section 46-459. 4. During an interview, E1 reported the facility did not verify E1, E2, and E3 were not on the adult protective services registry, and acknowledged the verification was required by March 31, 2025.”

“Based on documentation review, observation, record review, and interview, the manager failed to ensure a resident was not subjected to restraint. The deficient practice posed a risk of injury and violated a resident's rights.  Findings include: 1. R9-10-101.201 defines "Restraint" as any physical or chemical method of restricting a patient's freedom of movement, physical activity, or access to the patient's own body. 2. During an environmental inspection with E3, the Compliance Officer entered R1's bedroom and observed a mattress (upright and lengthwise) propped against the resident's bed. A dresser and a wheelchair were pushed against the mattress. R1 was observed in the bed with a bed rail in place. R1 was asking for help and trying to get out of bed. 3. During an interview, E3 reported "R1 always jumps in the bed, falls, always climbing..." 4. In record review, R1's medical record included documentation on acceptance that indicated R1 did not need restraints. 5. During an interview, the findings were reviewed with E1, who reported the resident was a fall risk, and the family was in agreement with the method the facility used to keep the resident from falling out of bed. E1 acknowledged the use of the mattress and dresser against R1's bed restricted R1's movement and restrained R1.”

“Based on observation, documentation review, and interview, for a facility that provided directed care services, the manager failed to ensure there was a means of exiting the facility that provided access to an outside area, which controlled or alerted employees of the egress of a resident from the facility. The deficient practice posed a risk if the facility was unaware of the general or specific whereabouts of a resident.   Findings include:   1. A review of the license issued by the Department revealed the facility was licensed at the directed care level.   2. The Compliance Officer observed R3's bedroom had a patio door to the backyard, which did not control or alert employees of the egress of a resident. The door appeared to have a non-working alarm. 3. During an interview, E1 and E3 acknowledged the patio door was not controlled and did not alert the employees of the egress of a resident from the facility.”