CANYON VIEW BY PLATINUM CARE HOMES

Based on documentation review, observation, and interview, for a facility authorized to provide directed care services, the manager failed to ensure there was a means of exiting the facility that provided access to an outside area which allowed a resident to be at least 30 feet away from the facility and controlled or alerted employees of the egress of a resident from the facility. The deficient practice posed a risk if the facility was unaware of the general or specific whereabouts of a resident.


Findings include:

1. A review of Department records revealed the facility was licensed to provide directed care services.

2. During an environmental inspection of the facility, the Compliance Officer observed a door located in the dining room leading to the back yard of the facility. The door was equipped with a door alarm; however, the alarm did not sound when the door was opened. The Compliance Officer observed door alarm had been turned off.

3. During an environmental inspection of the facility, the Compliance Officer observed a door located in a hallway adjacent to the living room leading to the back yard of the facility. The door was equipped with a door alarm; however, the alarm did not sound when the door was opened. The Compliance Officer observed door alarm was turned on but was not functioning.

4. In an interview, E1 acknowledged a means of exiting the facility to an outside area allowing a resident to be at least 30 feet away from the facility did not control or alert employees of the egress of a resident from the facility. E1 immediately asked the staff to turn on the door alarm in the kitchen and replace the batteries in the second exit door.

Based on record review, documentation review, and interview, the governing authority failed to ensure compliance with A.R.S. \'a7 36-411, for one of two employees sampled.

A.R.S. \'a7 36-411 states, "A. Except as provided in subsection F of this section, as a condition of licensure or continued licensure of a residential care institution, a nursing care institution or a home health agency and as a condition of employment in a residential care institution, a nursing care institution or a home health agency, employees and owners of residential care institutions, nursing care institutions or home health agencies, contracted persons of residential care institutions, nursing care institutions or home health agencies or volunteers of residential care institutions, nursing care institutions or home health agencies who provide medical services, nursing services, behavioral health services, health-related services, home health services or direct supportive services and who have not been subject to the fingerprinting requirements of a health professional's regulatory board pursuant to title 32 shall have valid fingerprint clearance cards that are issued pursuant to title 41, chapter 12, article 3.1 or shall apply for a fingerprint clearance card within twenty working days of employment or beginning volunteer work or contracted work.

B. A health professional who has complied with the fingerprinting requirements of the health professional's regulatory board as a condition of licensure or certification pursuant to title 32 is not required to submit an additional set of fingerprints to the department of public safety pursuant to this section.

C. Owners 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. Verify the current status of a person's fingerprint clearance card.

D. An employee, an owner, a contracted person or a volunteer or a facility on behalf of the employee, the owner, the contracted person or the volunteer shall submit a completed application that is provided by the department of public safety within twenty days after the date the person begins work or volunteer service.

E. Except as provided in subsection F of this section, a residential care institution, nursing care institution or home health agency shall not allow an employee to continue employment or a volunteer or contracted person to continue to provide medical services, nursing services, behavioral health services, health-related services, home health services or direct supportive services if the person has been denied a fingerprint clearance card pursuant to title 41, chapter 12, article 3.1, has been denied approval pursuant to this section before May 7, 2001 or has had a fingerprint clearance card suspended or revoked.

F. An employee, volunteer or contractor of a residential care institution, nursing care institution or home health agency who is eligible pursuant to section 41-1758.07, subsection C to petition the board of fingerprinting for a good cause exception and who provides documentation of having applied for a good cause exception pursuant to section 41-619.55 but who has not yet received a decision is exempt from the fingerprinting requirements of this section if the person provides medical services, nursing services, behavioral health services, health-related services, home health services or direct supportive services to residents or patients while under the direct visual supervision of an owner or employee who has a valid fingerprint clearance card.

G. If a person's employment record contains a six-month or longer time frame during which the person was not employed by any employer, a completed application with a new set of fingerprints shall be submitted to the department of public safety.

H. For the purposes of this section:

1. "Direct supportive services":

(a) Means services other than home health services that provide direct individual care and that are not provided in a common area of a health care institution, including:

(i) Assistance with ambulating, bathing, toileting, grooming, eating and getting in and out of a bed or chair.

(ii) Assistance with self-administration of medication.

Findings include:

1. A review of E3's personnel record revealed E3 had been hired as a caregiver in May of 2024. E3's personnel record included a valid fingerprint clearance card and a list of previous employers. However, E3's personnel record did not include documentation of good faith efforts to contact more previous employers to obtain information or recommendations that may have been relevant to E3's fitness to work in a residential care institution, and did not include documentation of verification of the status of E3's fingerprint clearance card.

2. In an interview, E1 acknowledged the personnel record provided for E3 did not include documentation of compliance with all subsections of A.R.S. \'a7 36-411.

Based on documentation review, record review and interview, the manager failed to ensure a caregiver's or assistant caregiver's skills and knowledge were verified and documented before providing physical health services and according to policies and procedures, for one of two caregivers sampled. The deficient practice posed a health and safety risk to residents if a caregiver did not have the documented skills and knowledge to provide services for residents.

Findings include:

1. A review of E3's personnel record revealed E3 had been hired as a caregiver in May of 2024. E3's personnel record contained a skills verification checklist, however, the checklist had not been filled out.

2. In an interview, E1 acknowledged E3's personnel record did not contain documented verification of E3's skills and knowledge.

Based on record review and interview, the manager failed to ensure a caregiver and an assistant caregiver provided evidence of freedom from infectious tuberculosis, (TB) on or before the individual began providing services at or on behalf of the assisted living facility, and as specified in R9-10-113, for one of two employees sampled.

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 E3's personnel record revealed E3 had been hired as a caregiver in May of 2024. However, E3's personnel record did not include documentation of E3's evidence of freedom from TB.

4. In an interview, E1 acknowledged the personnel file provided for E3 had not included documentation of evidence of freedom from infectious TB as required by R9-10-113.

Based on record review, documentation review, and interview, the manager failed to ensure one of two personnel records sampled contained documentation indicating a caregiver or assistant caregiver received orientation before providing assisted living services to a resident.

Findings include:

1. A review of E3's personnel record revealed E3 was hired as a caregiver in May of 2024.

2. A review of E3's personnel record revealed an orientation checklist. However, the checklist had not been filled out.

3. In an interview, E1 acknowledged the personnel record provided for E3 did not include documentation of orientation.

Based on record review and interview, the manager failed to ensure a resident's written service plan was signed and dated by the resident or resident's representative when initially developed and when updated, for one of two residents sampled.

Findings include:

1. A review of R2's medical record revealed a service plan dated March 14, 2023, for personal care services. However, the service plan was not signed and dated by R2 or R2's representative. The signature section of R2's service plan was marked, "Out to Hospital, Moved to Skilled Nursing."

2. A review of R2's medical record revealed a form titled, "Monthly ADL's," (ADL) Dated March 2023. The ADL indicated R2 was out of the facility between March 9, 2023 and March 31, 2023.

3. A review of R2's medical record revealed an ADL dated April 2023. The ADL indicated R2 was at the facility between April 1, 2023 and April 13, 2024 and was out of the facility starting on April 14, 2023.

4. In an interview, E1 acknowledged the service plan provided for R2 had not been signed and dated by R2 or their representative when the plan was developed or updated, or when R2 returned from the hospital in April 2023.

Based on record review and interview, the manager failed to ensure a caregiver documented the services provided in the resident's medical record, for one of two residents sampled.

Findings include:

1. A review of R1's medical record revealed a current service plan listing the services required by R1.

2. A review of R1's medical record revealed a form titled, "Monthly ADL's," dated June 2024. however, the form had not been completed on the following dates:
- June 6, 2024 on the overnight shift;
- June 7, 2024 on the day shift;
- June 8, 2024 on the day shift; and
- June 9, 2024 on the overnight shift.

3. A review of R1's medical record revealed a form titled, "Monthly ADL's," dated May 2024. however, the form had not been completed on the following dates:
- May 1, 2024 on the overnight shift;
- May 13, 2024 on the overnight shift;
- May 14, 2024 on the overnight shift;
- May 15, 2024 on the overnight shift;
- May 17, 2024 on the overnight shift;
- May 19, 2024 on the overnight shift;
- May 20, 2024 on the overnight shift;
- May 21, 2024 on the overnight shift;
- May 22, 2024 on the overnight shift;
- May 28, 2024 on the overnight shift;
- May 29, 2024 on the overnight shift; and
- May 30, 2024 on the overnight shift.

4. In an interview, E1 acknowledged the services provided to R1 had not been documented in R1's medical record.

Based on record review, interview, and documentation review, the manager failed to ensure a caregiver or an assistant caregiver immediately notified the resident's emergency contact and primary care provider when a resident had an accident, emergency, or injury that resulted in the resident needing medical services.

Findings include:

1. A review of R2's medical record revealed a form titled, "Monthly ADL's," dated April 2023. The form indicated R2 was "Out" between April 14, 2023 and April 30, 2023.

2. In an interview, E1 reported R2 had been sent to the hospital on April 14, 2023 and did not return to the facility.

3. A review of facility documentation revealed an incident report for R2, dated April 14, 2023, was not available for review..

4. In an interview, E1 acknowledged an incident report for R2's hospitalization on April 14, 2023 had not been provided for review during the on-site inspection.