Royal Caribbean Assisted Living Home, LLC.

“Based on record review, documentation review, and interview, the manager failed to ensure that a personnel record for each employee included initial training and continued competency training in fall prevention and fall recovery for one of four employees sampled. The deficient practice posed a risk as the caregiver received no organized instruction or information related to physical health services provided to residents. Findings Include: 1. A review of E4’s personnel record revealed a certificate titled "Fall Prevention Training" that was completed on August 13, 2024. The training certificate did not document if Fall Recovery was also a component of this training. 2. A review of the facility's staff schedule revealed E4 provided services to the residents. 3. In an exit interview, the findings were reviewed with E2, and no additional information was provided. This is a repeat deficiency from the compliance inspection and complaint investigation conducted on August 10, 2023.”

“Based on documentation review and interviews, the manager failed to ensure that personnel provided appropriate first aid in accordance with its certification training for first aid before the arrival of emergency medical services to a resident who is in distress and to a non-injured resident who has fallen, as required under Arizona Revised Statutes (A.R.S.) 36-420.B.1-3. Findings include: 1. A review of the medical record for R3 revealed a narrative note dated December 16, 2025, that stated "staff show pt on the floor on the hallway. was using walker at the time...Pt fell did not complain of any pain at the time alert and oriented. 911 called. Pt did not want to go to ER." 2. Department documentation revealed an intake report dated December 16, 2025, which stated, "A resident sustained a ground level fall without injury. The resident needed help up and the staff refused until EMS arrived. The resident repeatedly stated that they were not injured and just needed help up." 3. In an interview with E2, E2 stated "There were two staff on shift, but not able to get R3 off the floor as no assistance from the resident, so was dead weight so 911 was called to assist." 4. In an exit interview, the findings were reviewed with E3 for the inappropriate utilization of the 911 system, as 911 was called for a noninjured resident who had fallen, appeared to be uninjured, and was unable to reasonably recover independently. No additional information was provided.”

“Based on documentation review, record review, and interview, the manager failed to ensure that documentation of medication administration showed the name and signature of the individual administering or providing assistance in the self-administration of medication for two of three residents reviewed.    Findings include:   1.   A review of documentation contained a policy and procedure titled “recording of medication assistance provided to residents and maintenance of medication record,” which stated, "The trained caregiver will sign off the medication for the date and time the medication was given to the resident and the medications taken by initialing the medication administration record."   2.   A review of R1's medical record contained a Medication Administration Record for February 2026. The MAR did not contain caregiver initials documenting the medication was administered for the following medications on February 12, 2026: Gabapentin 100 mg - 2:00 pm and 7:00 pm administration 3.A review of R2's medical record contained a Medication Administration Record for February 2026. The MAR did not contain caregiver initials documenting the medication was administered for the following medications on February 12, 2026: Seroquel 25 mg - 7:00 pm administration Ferrous Sulfate 325mg - 7:00 pm administration   4.   In an interview, E2 reported the medication was provided to the residents but "forgot" to document on the record.     5.   In an exit interview, the findings were reviewed with E2 and no additional information was provided.”

“Based on documentation review and interview, the manager failed to ensure that; if the assisted living facility was authorized to provide directed care services, an elopement drill for employees was conducted every six months on each shift and document the date, time, and description of each drill. Findings include: 1. A review of the facility's license revealed that the facility was licensed to provide Directed Care services. 2. A documentation review revealed no documentation of elopement drills. 3. In an interview, E2 acknowledged that the manager failed to ensure an elopement drill for employees was conducted every six months on each shift and to document the date, time, and description of each drill. 4. In an exit interview, the findings were reviewed with E2, and no additional information was provided.”