Advantage Adult Health Care II.

“Based on observation, documentation review, record review, and interview, the manager failed to ensure a caregiver's skills and knowledge were verified and documented according to policies and procedures, for one of two caregivers sampled. The deficient practice posed a risk if the employees were unable to meet a resident's needs. Findings include: 1 . The Compliance Officers observed E3 working and providing services to resident when they arrived at the facility. 2 . A review of facility documentation revealed a policy titled "Employees and Volunteers Qualification." The policy stated, "The hiring individual will check and document qualification, skills and knowledge for each employee and volunteer to ensure the meet criteria....Documentation of such check is going to be kept in the employees' record upon hiring ("Employee Orientation" and "Employee Qualification and Skills.")" 3 . A review of E3's personnel record revealed documentation of "Employee Qualification and Skills". However, the documentation was not completed at the time of inspection. 4 . In an exit interview, the findings were discussed with E2, and no additional information was provided.”

“Based on record review and interview, the manager failed to ensure a service plan was reviewed and updated at least once every three months for a resident receiving directed care services, for one of two residents sampled. Findings include: 1 . A review of R4's medical record revealed the latest completed service plan dated December 1, 2025. However, documentation of a completed service plan after December 1, 2025 was not available for review at the time of inspection. 2 . In an exit interview, the findings were discussed with E2 and no additional information was provided.”

“Based on record review and interview, the manager failed to ensure a caregiver documented the services provided in the resident's medical record, for four of seven residents sampled. 1 . A review of R1's, R2's, R3's and R4's medical records revealed documentation of service plans which reported the residents needed assistance with hygiene daily, dressing daily, and comb hair daily. However, documentation of activities of daily living (ADL) sheets for April 2026 for R1, R2, R3, and R4 were not documented as provided from April 14, 2026 to April 16, 2026. 2 . In an exit interview, the findings were discussed with E3 and no additional information was provided.”

“Based on record review and interview, the manager failed to ensure medication administered to a resident was documented in the resident's medical record, for four of four residents sampled. The deficient practice posed a risk as medication could not be verified as administered against a medication order. Findings include: 1 . In an interview, E3 reported the residents received medication administration. 2 . A review of R1's medical record revealed a signed medication order list for the following: -Citalopram 20 MG 1 tablet daily; -Losartan 100 MG 1 tablet daily; -Aspirin 81 MG 1 tablet daily; -Potassium Chloride 10 MEQ 1 tablet daily; -Carvedilol 6.25 MG 1 tablet twice daily; -Bumetanide 0.5 MG 1 tablet daily; and -Levothyroxine 50 MCG 1 tablet daily. However, a review of R1's medication administration record (MAR) sheet for April 2026 revealed the above medications were not documented as administered from April 15, 2026 and April 16, 2026. 3 . A review of R2's medical record revealed a signed medication order list for the following: -Synthroid 50 MG 1 tablet daily; -Memantine 10 MG 1 tablet daily; -Rosuvastatin 5 MG 1 tablet daily; -Rivastigmine 9.5 MG 1 patch daily; and -Melatonin 10 MG 1 tablet daily. However, a review of R2's medication administration record (MAR) sheet for April 2026 revealed the above medications were not documented as administered from April 15, 2026 and April 16, 2026. 4 . A review of R3's medical record revealed a signed medication order list for the following: -Amlodipine 5 MG 2 tablets daily; -Metoprolol 25 MG 1 tablet twice daily; -Clopidogrel 75 MG 1 tablet daily; -Famotidine 40 MG 2 tablets twice daily; -Levothyroxine 100 MG 1 tablet daily; and -Hydralazine 100 MG 1 tablet three times a day. However, a review of R3's medication administration record (MAR) sheet for April 2026 revealed the above medications were not documented as administered from April 15, 2026 and April 16, 2026. 5 . A review of R4's medical record revealed a signed medication order list for the following: -Hydroxyzine 25 MG 1 tablet twice daily; -Tylenol 650 MG 2 tablet twice daily; -Gabapentin 100 MG 1 capsule three times daily; -Isosource 300 ML three times daily; -Bupropion 150 MG 1 tablet daily; -Metoprolol 25 MG 1 tablet daily; -Levothyroxine 50 MCG 1 tablet daily; and -Lisinopril 20 MG 1 tablet daily. However, a review of R4's medication administration record (MAR) sheet for April 2026 revealed the above medications were not documented as administered from April 15, 2026 and April 16, 2026. 6 . In an exit interview, the findings were discussed with E2 and no additional information was provided.”

“Based on observation review, documentation review, and interview, the manager failed to ensure policies and procedures were implemented for storing medication. The deficient practice posed a risk as the standards expected of employees were not followed. Findings include: 1. During the environmental inspection, the Compliance Officers observed an unattended magnetic key on the counter underneath the locked medication cabinet. The Compliance Officers were able to unlock and access the medication cabinet using the key. 2. Upon review of the facility's policies and procedures, titled "Part III - Receiving, Storing, Inventorying, Tracking, Dispensing Medication Including Opioids and Narcotics", the policy read "Only the manager and trained caregivers shall be in possession of the keys to the medication storage area." 3. In an exit interview, the findings were reviewed with E2, an no additional information was provided.”

“Based on observation and interview, the manager failed to ensure poisonous or toxic materials were maintained in a locked area and 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 an unattended magnetic key on one of the kitchen counters. The Compliance Officers also observed residents present in the common area nearby. The Compliance Officers observed one of the residents being ambulatory and walking around the facility. The key was able to provide access to the cabinets underneath the sink containing Windex, dishwasher packs, and Cascade. 2. In an exit interview, the findings were reviewed with E2 and no additional information was provided.”

“Based on observation and interview, the manager failed to ensure poisonous or toxic materials stored by the assisted living facility were inaccessible to residents. Findings include: 1 . During an environmental inspection of the facility, the Compliance Officer observed a kitchen cabinet with locks. However, the locks were disengaged and the Compliance Officer was able to access the cabinet. The cabinet contained the following: -One container of "Member's Mark" dishwasher packs; -Two bottles of "Cascade" dishwasher detergent; and -One bottle of "Method" all-purpose cleaner. 2 . In an interview, E1 acknowledged poisonous or toxic materials stored by the assisted living facility were accessible to residents.”