GIFT OF LOVE ASSISTED LIVING, LLC

Assisted Living Home | Assisted Living

Facility Information

Address 4644 East Lavender Lane, Phoenix, AZ 85044
Phone 4807059118
License AL10200H (Active)
License Owner GIFT OF LOVE ASSISTED LIVING, LLC
Administrator Tito Gobantes
Capacity 5
License Effective 11/1/2025 - 10/31/2026
Services:
1
Total Inspections
2
Total Deficiencies
1
Complaint Inspections

Inspection History

INSP-0068464

Complete
Date: 8/14/2024
Type: Complaint;Compliance (Annual)
Worksheet: Assisted Living Home
SOD Sent: 2024-09-23

Summary:

The following deficiencies were found during the on-site compliance inspection and investigation of complaint AZ00189503 conducted on August 14, 2024:

Deficiencies Found: 2

Deficiency #1

Rule/Regulation Violated:
B. A manager shall ensure that before or at the time of acceptance of an individual, the individual submits documentation that is dated within 90 calendar days before the individual is accepted by an assisted living facility and:
1. If an individual is requesting or is expected to receive supervisory care services, personal care services, or directed care services:
a. Includes whether the individual requires:
i. Continuous medical services,
ii. Continuous or intermittent nursing services, or
iii. Restraints; and
b. Is dated and signed by a:
i. Physician,
ii. Registered nurse practitioner,
iii. Registered nurse, or
iv. Physician assistant; and
Evidence/Findings:
Based on record review and interview, the manager failed to ensure before or at the time of acceptance the individual submitted documentation dated within 90 calendar days before the individual was accepted by the facility, to include whether the individual required continuous medical services, continuous or intermittent nursing services, or restraints, dated and signed by a physician, registered nurse practitioner, registered nurse, or physician assistant, for three of three residents. The deficient practice posed a risk if the facility was unable to meet a resident's needs and the Department was unable to determine substantial compliance as the required documentation was not in the medical records at the time of the inspection.

Findings include:

1. A review of R2's medical record revealed no evidence of a "Pre-Admission Determination," or any documentation dated within 90 calendar days before the individual was accepted by the assisted living facility and included whether the individual required continuous medical services, continuous or intermittent nursing services, or restraints, and was dated and signed by a physician, registered nurse practitioner, registered nurse, or physician assistant.

2. In an interview, E3 acknowledged there was no evidence of "Pre-Admission Determination" documentation and no documentation whether R2 required continuous medical services, continuous or intermittent nursing services, or restraints, dated and signed by a physician, registered nurse practitioner, registered nurse, or physician assistant was not available for review.

Deficiency #2

Rule/Regulation Violated:
A. A manager shall ensure that:
5. An evacuation drill for employees and residents:
a. Is conducted at least once every six months; and
Evidence/Findings:
Based on documentation review and interview, the manager failed to ensure an evacuation drill for employees and residents was conducted at least once every six months. The deficient practice posed a risk if personnel members were unable to safely evacuate residents in an emergency situation.

Findings include:

1. A review of facility documentation revealed documentation of an evacuation drill conducted at the facility in December of 2023; however, no other documentation of evacuation drills within the last 12 months.

2. In an interview, E1 acknowledged the facility's last evacuation drill was conducted in December of 2023, no other documentation was available at the time of the inspection to indicate evacuation drills for employees and residents were conducted at least once every six months.