Angel's Adult Group Home, LLC

Based on documentation review, observation, and interview, the manager failed to ensure there was a means of exiting the facility for a resident who did not have a key, special knowledge for egress, or the ability to expend increased physical effort, that provided access to an outside area, 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. Review of Department documentation revealed the facility was authorized to provide directed care services. 2. During the facility tour with E1, the Compliance Officer observed the door leading out to the backyard. The outside area, in the backyard, allowed residents to be at least 30 feet away from the facility. The door leading out to the backyard had a device that was intended to alert employees to the egress of a resident to the outside area. However, the device was switched off. 3. In an interview, E1 acknowledged there was not a means of exiting the facility that controlled or alerted employee of the egress of the resident.

Based on record review and interview, the manager failed to ensure if a verbal order for a resident's medication was received from a medical practitioner by the assisted living facility, a written order verifying the verbal order was obtained from the medical practitioner within 14 calendar days after receiving the verbal order for one of two resident sampled. The deficient practice posed a risk as medication administered could not be verified against a medication order. Findings include: 1. A review of R1's medical record revealed a verbal order dated July 18, 2024, signed by a registered nurse for the following medication: - Promethazine Tab 25mg, one tablet by mouth every 8 hours or as needed 2. Further review of R1's medical record revealed no documentation of written order verifying the aforementioned verbal order was obtained from the medical practitioner. 3. In an interview, E1 acknowledged a written order verifying the verbal order was not obtained from the medical practitioner within 14 calendar days after receiving the verbal order.

Based on observation and interview, the manager failed to ensure that hot water temperatures were maintained between 95\'ba F and 120\'ba F in areas of an assisted living facility used by residents. The deficient practice posed a health and safety risk for residents. Findings include: 1. During an environmental tour of the facility, the Compliance Officer observed a water temperature of 131\'ba F in a shared bathroom for residents. 2. In an interview, E1 acknowledged the hot water temperature was not maintained between 95\'ba F and 120\'ba F in areas used by residents.

Based on observation and interview, the manager failed to ensure toxic materials stored by the facility were stored in a locked area and inaccessible to residents. The deficient practice posed a risk to the physical health and safety of residents with access to the poisonous or toxic materials. Findings include: 1. During the environmental inspection of the facility, the Compliance Officer observed the following under the sink in an unlocked cabinet in the kitchen: -One container of Finish automatic dishwasher detergent -One container of Root & Grow -One container of Dawn detergent -One canister of Glade Aerosol Air Freshener spray 2. In an interview, E1 acknowledged poisonous or toxic materials stored by the facility were not stored in a locked area and inaccessible to residents at the time of the inspection.