First Adult Care Home.

“Based on documentation review, record review, and interview, the manager failed to ensure that a caregiver provided evidence of freedom from infectious tuberculosis (TB) as specified in R9-10-113, for one of two employees sampled who were expected to have more than eight hours per week of direct interaction with residents.  Findings include:  1. R9-10-113.A states, "If a health care institution is subject to the requirements of this Section, as specified in an Article in this Chapter, the health care institution's chief administrative officer shall ensure that the health care institution establishes, documents, and implements tuberculosis infection control activities that...2. Include: a. For each individual who is employed by the health care institution, provides volunteer services for the health care institution, or is admitted to the health care institution and who is subject to the requirements of this Section, screening, on or before the date specified in the applicable Article of this Chapter, that consists of: i. Assessing risks of prior exposure to infectious tuberculosis, ii. Determining if the individual has signs or symptoms of tuberculosis, and iii. Obtaining documentation of the individual's freedom from infectious tuberculosis according to subsection (B)(1)..." 2. A review of the Centers for Disease Control and Prevention website revealed a web page titled, "Guidelines for Preventing the Transmission of Mycobacterium tuberculosis in Health-Care Settings, 2005." The web page stated, "If TST (Mantoux Skin Test) is used for baseline testing, two-step testing is recommended for HCWs (Health Care Workers) whose initial TST results are negative. If the first-step TST result is negative, the second-step TST should be administered 1-3 weeks after the first TST result was read." 3. A review of E2’s personnel record revealed evidence of documentation of a negative skin test for infectious tuberculosis (TB) within twelve months of E2’s date of hire, however, evidence of documentation of a second negative skin test for infectious TB within one week of the initial test and within twelve months of E2’s date of hire was unavailable for review. 4. In an interview, E1 agreed E2’s personnel record did not include documentation of freedom from infectious TB as required. E1 stated they must have misplaced E2's second TB skin test. 5. In an exit interview, the findings were reviewed with E1 and no further information was provided.”

“Based on observation and interview, the manager failed to ensure poisonous or toxic materials stored by the assisted living facility were maintained in labeled containers in a locked area separate from food preparation and storage, dining areas, and medications, and were inaccessible to residents.   Findings include:     1. During a tour of the facility, the Compliance Officer observed a cabinet over the kitchen sink, which was not secured. The Compliance Officer opened the cabinet and observed six 2-liter bottles of soda, a bottle of cooking oil, one spray bottle of “Multi-purpose cleaner,” and one can of disinfectant. Both the cleaner and disinfectant were marked “CAUTION KEEP OUT OF REACH OF CHILDREN.”     2. In an interview, E1 acknowledged cleaners were not kept in a secure area, separate from food storage, and inaccessible to residents.      Technical assistance was provided regarding this rule during an on-site compliance inspection conducted on April 25, 2024.”