Peachtree Assisted Living Home.

“Based on record review and interview, the assisted living home failed to maintain written documentation of emergency responder (EMS) information that included the items listed in Arizona Revised Statutes (A.R.S.) § 36-420.04(A)(1-9) for two of two residents sampled. The deficient practice posed a risk if the emergency responder was not aware of critical health information for the resident. Findings include:  1. A review of R1 and R2's medical records revealed no documentation of the standardized EMS form that includes the following: The reason or reasons the emergency responder was requested; Whether the resident receives medication services and, if the resident had provided this information to the assisted living center, a list of all the resident's prescription and over-the-counter medications, their dosages, and how frequently they were administered; The name, address, and telephone number of the resident's current pharmacy; A list of any known allergies to any medications, additives, preservatives, and materials like latex or adhesive; The name and contact information for the resident's primary care physician and power of attorney or authorized representative; Basic information about the resident's physical and mental conditions and basic medical history, as well as dates of recent episodes, if known; The point-of-contact information for the assisted living center or assisted living home, including the telephone number, if available, cell phone number, and email address; A copy of the resident's health insurance portability and accountability act release authorizing a receiving hospital to communicate with the assisted living center or assisted living home to plan for the resident's discharge; A copy of the resident's advance directives, if any, on file at the assisted living center or assisted living home. 2. In an exit interview, findings were reviewed with E1, and no additional information was provided.”

“Based on documentation review, record review, and interview, the manager failed to ensure a personnel record for each employee included documentation of compliance with the requirements in A.R.S. § 36-411(C)(1), for one of two personnel sampled. The deficient practice posed a risk to the health and safety of residents.   Findings include:   1. A.R.S. § 36-411(C)(1) states: "C. Each residential care institution, nursing care institution and home health agency shall make documented, good faith efforts to: 1. Contact previous employers to obtain information or recommendations that may be relevant to a person's fitness to work in a residential care institution, nursing care institution or home health agency.   2. Review of E2’s personnel record revealed no work history to confirm the references checked were previous employers. On the reference checks there were no titles to the references to confirm the references were previous employers. 3. In an exit interview, the findings were reviewed with E1, and no additional information was provided.”

“Based on record review and interview, the manager failed to ensure that before or at the time of acceptance of a resident, an individual submitted documentation that was dated within 90 calendar days before the resident was accepted by an assisted living facility and if an individual was requesting or was expected to receive supervisory care services, personal care services, or directed care services it included whether the individual required continuous medical services, continuous or intermittent nursing services, restraints; and was dated and signed by a physician, registered nurse practitioner, registered nurse, or physician assistant for two of the four residents sampled. The deficient practice posed a risk if the facility was unable to meet a resident's needs.  Findings include: 1. A review of R2’s medical record revealed that the required elements were documented; however, the documentation was not completed within 90 days of acceptance. 2. In an exit interview, the findings were reviewed with E1, and no additional information was provided.”

“Based on record review and interview, the manager failed to ensure a resident had a written service plan which included the amount, type, and frequency of assisted living services being provided, for two of two residents sampled.      Findings include:     1. A review of R1 and R2’s medical records revealed a written and signed service plan. R1 and R2's service plan included the services “Bathing,” “Hygiene/Grooming,” “Activity,” and “Nutrition/Hydration,” which identified the services to be provided; however, the service plan did not indicate the amount of assistance the resident required or the frequency of either service.      2. In an exit interview, the findings were reviewed with E1, and no additional information was provided.”

“Based on observation and interview, the manager failed to ensure that oxygen containers were secured in an upright position. The deficient practice posed a potential explosion or leak of a compressed gas. Findings include: 1. During the environmental inspection of the facility with E2, the Compliance Officers observed an unsecured oxygen tank in R1's room against the wall in R1's closet. 2. The Compliance Officers also observed an oxygen tank leaning against another oxygen tank and not secured in an upright position. 3. In an exit interview, the findings were reviewed with E1, and no additional information was provided.”

“Based on record review, observation, and interview, the manager failed to ensure medication was administered in compliance with a medication order, for one of three residents reviewed. The deficient practice posed a health risk to the resident. Findings include: 1. Review of R3’s medical record revealed a signed service plan dated February 20, 2025. This service plan indicated R3 received medication administration. 2. Review of R3’s medical record revealed a medication administration record (MAR) for the month of May 2025. This MAR revealed Tramadol HCL 50 mg was administered May 1st - May 14th. 3. Review of R3’s medical record revealed a signed medication order dated May 1, 2025. This order stated, “tramadol HCL oral tablet 50 mg, take one tablet by mouth every night at bedtime”. 4. In an interview, E2 reported the order for Tramadol HCL 50 mg was only for 14 days. However, there was no order provided at the time of the inspection that stated Tramadol was only to be administered for 14 days. A discontinuation order was not provided at the time of inspection. 5. In an interview, E1 and E2 acknowledged a medication was not administered in compliance with a medication order.”

“Based on observation, documentation review, and interview, the manager failed to ensure medication was stored in a separate locked room, closet, cabinet, or self-contained unit used only for medication storage. The deficient practice posed a risk to residents who were not prescribed the accessible medication. Findings include: 1. During the tour of the facility, the Compliance Officer observed a cabinet that held six residents' medications unlocked. The cabinet door had a locking device, however was not locked. 2. The Compliance officer observed a tube of Triple Antibiotic Ointment on the kitchen counter. 3. A review of the facility's policies and procedures revealed a policy titled, "Safe Storage of Medicine," which stated in section two, "When medications are stored in a locking container such as a bin or a cabinet, both the container and the medication room should be kept locked when not in use." 4. In an interview, E2 acknowledged medications were not stored in a separate locked room, closet, cabinet, or self-contained unit.”

“Based on observation, documentation review, and interview, the manager failed to ensure poisonous or toxic materials stored by the assisted living facility were maintained in a locked area inaccessible to residents. The deficient practice posed a risk to the physical health and safety of a resident. Findings include: 1. During a tour of the facility, the Compliance Officer observed a storage cabinet locked with a padlock in the facility. However, the Compliance Officer was still able to partially open the doors and reach into the cabinet. The Compliance Officer was able to pull out the toxic materials that were stored within. The following toxic materials were stored on the top shelf of the cabinet: - A spray canister of Roach & Ant Killer - Lysol Toilet Bowl Cleaner - A spray bottle of Great Value All Purpose Cleaner with Bleach 2. A review of the facility's policies and procedures revealed a policy titled "Environmental Standards" which stated in section two, "Poisonous or toxic materials stored by the facility are stored in the original labeled containers or safety containers in a locked area inaccessible to residents." 3. In an interview, E2 acknowledged poisonous or toxic materials were not maintained in a locked area inaccessible to residents.”