AT HOME CHOLLA

Based upon record review and interview, the manager failed to ensure that a disaster drill for employees was conducted on each shift at least once every three months and documented. The deficient practice posed a risk as a disaster plan reinforces and clarifies standards expected of employees. Findings include: 1. A review of a record titled "Disaster Drill" revealed that a disaster drill was conducted on March 1, 2024 from 11:10am to 11:30am. There was not a second shift disaster drill conducted. 2. A review of a record titled "Disaster Drill" revealed that a disaster drill was conducted on December 1, 2024 from 10:00am to 10:15am. There was not a second shift disaster drill conducted. 3. In an interview, E1 acknowledged that there was not a second shift disaster drill conducted on the above days and that there was no further evidence of a second shift disaster drill being conducted.

Based upon observation and interview, the manager failed to ensure that the premises of the facility was free from a condition or situation that may have caused a resident or other individual to suffer physical injury. The deficient practice posed potential egress dangers to the residents. Findings include: 1. The Compliance Officer observed a path on the outdoor, east side of the facility that was blocked by debris and garbage. The blocked path did not allow for safe exit on the east side of the facility moving northbound. 2. In an interview, E1 acknowledged that there was debris and garbage along the outdoor, east side of the facility that did not allow for safe exit.