Arrowhead Shore Senior Living, LLC

Based on observation, documentation review, and interview, the manager failed to ensure there was a means of exiting the facility for a resident who does not have a key, special knowledge for egress, or the ability to expend increased physical effort to provide access to an outside area from which a resident may exit to a location at least 30 feet away from the facility, and controlled or alerts 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. The Compliance Officer observed six ambulatory residents on the premises. 2. The Compliance Officer observed the front door provided driveway and street access. The Compliance Officer observed a deadbolt on the front door. 3. The Compliance Officer observed the back door provided patio and back yard access. However, the Compliance Officer observed the door did not control or alert employees of the egress of a resident from the facility when the door was opened or closed. 4. A review of Department documentation revealed the facility was licensed to provide directed care services to residents. 5. In an interview, E1 acknowledged the back door did not control or alert employees of the egress of a resident from the facility. E2 reported E2 was unaware of this requirement.

Based on observation and interview, the manager failed to ensure medication was stored in a separate locked room, closet, cabinet, or self-contained unit used only for medication storage. The deficient practice posed a risk to residents who were not prescribed the accessible medication. Findings include: 1. The Compliance Officer observed six ambulatory residents on the premises. 2. The Compliance Officer observed on the door in the unlocked kitchen refrigerator, the following medications: -Bisacodyl suppositories (belonged to R2) -Morphine Sul Sol 100/5ML (belonged to R4) 3. The Compliance Officer observed the unlocked kitchen refrigerator contained a medication lock-box. However, the lock-box was not locked and contained the following medications: -2 boxes of Insulin Lispro 100 mg 100 (belonged to R5) -3 pens of Lantus Solostar 100 units (belonged to R5) -Bisacodyl suppositories (belonged to R2) -Bisacodyl suppositories (belonged to R6) -Bisacodyl suppositories (belonged to R7) 4. The Compliance Officer observed in R1's bedroom, on a dresser, a pill bottle containing a compound of Nystatin and Chamosyn cream. 5. The Compliance Officer observed in R2's bedroom, under an unlocked cabinet sink in the bathroom, a container of Fleet suppositories and a box of Debrox ear wax removal. 6. In an interview, R1 acknowledged the medications in the refrigerator and bedrooms were not locked and were accessible to residents.

Based on observation and interview, the manager failed to ensure oxygen containers were secured in an upright position. The deficient practice posed a potential explosion or leak of a compressed gas. Findings include: 1. The Compliance Officer observed nine unsecured oxygen containers stored upright in R2's bedroom closet. 2. In an interview, E1 acknowledged there were unsecured oxygen containers in R2's closet.

Based on observation and interview, the manager failed to ensure poisonous or toxic materials stored by the assisted living facility were stored in a locked area and were inaccessible to residents. Findings include: 1. The Compliance Officer observed six ambulatory residents on the premises. 2. The Compliance Officer observed the following poisonous or toxic materials sitting on the kitchen window sill ledge: -All-purpose cleaner The item contained a toxic warning label. 3. The Compliance Officer observed the following poisonous or toxic materials under the hallway bathroom sink, in an unlocked cabinet: -Disinfectant cleaner -Air freshener The items contained toxic warning labels 4. The Compliance Officer observed the following poisonous or toxic materials in R2's bathroom, under the sink, in an unlocked cabinet: -Bottle of all-purpose cleaner -Air freshener The items contained toxic warning labels. 5. The Compliance Officer observed the following poisonous or toxic materials under a second hallway bathroom sink, in an unlocked cabinet: -Lysol spray -2 cans of air freshener -Ajax -Lysol toilet cleaner The items contained toxic warning labels. 6. The Compliance Officer observed the following poisonous or toxic materials sitting on the back of the toilet in a hallway bathroom: -Bottle of all-purpose cleaner -Air freshener The items contained toxic warning labels. 7. The Compliance Officer observed the following poisonous or toxic materials in R1's bedroom: -Lysol spray -Air freshener The items contained toxic warning labels. 8. In an interview, E1 acknowledged poisonous or toxic materials were stored unlocked and were accessible to residents.