Baraka at Rosegardens II Assisted Living

Based on observation, record review, and interview, the manager failed to ensure that a complete personnel record was available for two of eight personnel sampled. The deficient practice posed a risk as required information could not be verified, and the department was provided false and misleading documentation. Findings include: 1. When the Compliance Officers arrived at the facility on July 14, 2025, E2 arrived at the facility at the same time. Two employees, originally identified as E3 and E4, were the only personnel at the facility providing services to residents. 2. In an interview, E3 identified themselves as E5, an assistant caregiver, and E4 identified themselves as E6, an assistant caregiver. Both provided photo identification to the Compliance Officers. 3. In an interview, E2 reported that E3 was terminated in 2023 and E4 was terminated in December 2024, and neither was employed in 2025. 4. A review of the E5's personnel record revealed no documentation for the following; -The individual’s starting date of employment or volunteer service -The individual’s qualifications, including skills and knowledge applicable to the individual’s job duties -The individual’s education and experience applicable to the individual’s job duties -The individual’s completed orientation and in-service education required by policies and procedures -The individual’s license or certification, if the individual is required to be licensed or certified in this Article or in policies and procedures -Compliance with the requirements in A.R.S. § 36-411 (C) (1-4): A.R.S. § 36-411.C. Each residential care institution, nursing care institution and home health agency 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. 3. Beginning January 1, 2025, verify that a potential employee is not on the adult protective services registry pursuant to section 46-459. If a potential employee is found to be on the adult protective services registry, the residential care institution, nursing care institution or home health agency may not hire the potential employee. 4. On or before March 31, 2025, verify that each employee is not on the adult protective services registry pursuant to section 46-459. If an employee is found to be on the adult protective services registry, the residential care institution, nursing care institution or home health agency shall take action to terminate the employment of that employee. However, based on E5's hire date, the above documents were required. 5. A review of the personnel records revealed no personnel record for E6. 6. In an interview, E2 acknowledged that the above-mentioned documents were not in E5’s personnel record, no personnel record was available for E6, and that the Departmen

Based on the documentation review, record review, and interview the manager of an assisted living home failed to maintain a standardized form for each resident that included the information prescribed in Arizona Revised Statute (A.R.S.) § 36-420.04(A)(1) through (9) for two of two residents sampled. The deficient practice posed a risk if the emergency responder was not aware of critical health information for a resident. Findings include: 1. A.R.S. 36-420.04.A states, "A. An assisted living center or assisted living home that contacts an emergency responder on behalf of a resident shall provide to the emergency responder a written document that includes all of the following: -1. The reason or reasons the emergency responder was requested on behalf of the resident. -2. Whether the resident receives medication services and, if the resident has provided this information to the assisted living center or assisted living home, a list of all the resident's prescription and over-the-counter medications, their dosages and how frequently they are administered. -3. The name, address and telephone number of the resident's current pharmacy. -4. A list of any known allergies to any medications, additives, preservatives or materials like latex or adhesive. -5. The name and contact information for the resident's primary care physician and power of attorney or authorized representative. -6. Basic information about the resident's physical and mental conditions and basic medical history, such as having diabetes or a pacemaker or experiencing frequent falls or cardiovascular and cerebrovascular events, as well as dates of recent episodes, if known. -7. The point-of-contact information for the assisted living center or assisted living home, including the telephone number, if available, cell phone number and email address. A point of contact must be available to respond to questions regarding the information provided twenty-four hours a day, seven days a week. -8. A copy of the resident's health insurance portability and accountability act (HIPAA) release authorizing a receiving hospital to communicate with the assisted living center or assisted living home to plan for the resident's discharge. This paragraph does not preclude a resident from revoking the resident's health insurance portability and accountability act release authorization. -9. A copy of the resident's advance directives, if any, on file at the assisted living center or assisted living home. This paragraph does not preclude a resident from revoking or modifying the resident's advance directives." 2. A review of the medical records for R1 and R2 did not include a standardized form for each resident that included the information as required in A.R.S. 36-420.04(A)(1) through (9). 3. In an interview, E1 acknowledged that the documentation provided to the Compliance Officers was blank and not prefilled with the required information as prescribed in A.R.S. § 36-420.04(A).

Based on documentation review and interview, the health care institution's chief administrative officer failed to ensure the health care institution documented and implemented tuberculosis (TB) infection control activities required in R9-10-113(A)(2)(d). Findings include: 1. A review of facility documentation revealed no documentation of annually assessing the health care institution's risk of exposure to infectious tuberculosis per R9-10-113(A)(2)(d) was available for review. 2. In an interview, E2 acknowledged that the health care institution had no documentation of annually assessing the health care institution's risk of exposure to infectious tuberculosis per R9-10-113(A)(2)(d) available for review.

Based on record review and interview, the manager failed to ensure a resident's medical record contained any information provided by the hospice service agency or a copy of follow-up instructions provided to the resident. Findings include: 1. A review of R1’s service plan revealed that R1 was receiving services from Haven Hospice. 2. A review of R1’s medical record revealed no documentation of any information provided by the hospice service agency or a copy of follow-up instructions provided to the resident. 3. The Compliance Officers requested to review R1's hospice binder or any information provided by the hospice service agency, or a copy of follow-up instructions provided to the resident. 4. In an interview, E2 reported that there were no documents available for review from Haven Hospice.

Based on documentation review and interview, the manager failed to submit a documented report to the governing authority that included an identification of each concern about the delivery of services related to resident care, and any change made or action taken as a result of the identification of a concern about the delivery of services related to resident care. The deficient practice posed a risk as a quality management program documents the necessary information required to effectively manage services provided. Findings include: 1. A review of facility policy and procedure revealed a policy titled "POLICY TOPIC: 31. Quality Management Program." The policy stated "A “Quality Plan - Licensee Summary Report” is divided into two areas, (1) Resident Care Concern Identification and (2) Corrective Actions for Concerns. (Note: Blank Forms and Example Forms of “Quality Plan - Licensee Summary Report”, “Detail List of Services”, “Risk Assessment”, “Corrective Action”, and “Incident / Accident Report” are located in the facility manual.) The report and the supporting documentation are maintained for at least 12 months after the date the report is submitted to the licensee." 2. The Compliance Officers requested to review the facility's quality management report and supporting documentation for the report. However, a quality management report was not available for review. 3. In an interview, E2 reported that the facility’s quality management report had not been completed. E2 acknowledged that the quality management reports were not available for review by the Compliance Officers during the inspection.

Based on documentation review, record review, and interview, the manager failed to ensure that an assistant caregiver interacted with residents under the supervision of a manager or caregiver, for two of three assistant caregivers reviewed. The deficient practice posed a risk as the individuals were not qualified to provide the required services, and the department was provided with false and misleading documentation. Findings include: 1. A review of Department records revealed the facility is licensed at the directed care level. 2. A review of A.R.S. § 36-401.A.49 revealed "Supervision" means direct overseeing and inspection of the act of accomplishing a function or activity. 3. When the Compliance Officers arrived at the facility on July 14, 2025, E2 arrived at the facility at the same time. Two employees, originally identified as E3 and E4, were the only personnel at the facility providing services to residents. 4. In an interview, E3 identified themselves as E5, an assistant caregiver, and E4 identified themselves as E6, an assistant caregiver. Both provided photo identification to the Compliance Officers. 5. On July 15, 2025, the Compliance Officers completed the compliance inspection. When the Compliance Officers arrived at the facility, E5 was the only employee at the facility. E2 arrived a few minutes after. 6. A review of the personnel records revealed no personnel record for E6. E5's personnel record contained no documentation of caregiver training. 7. In an interview, E2 acknowledged that E5 and E6 interacted with residents without the supervision of a manager or caregiver. E2 also acknowledged that the department was provided false and misleading documentation by providing fake personnel files for E5 and E6 as E3 and E4, trained caregivers.

Based on observation, interview, and documentation review, the manager failed to ensure that documentation was maintained of the caregivers and assistant caregivers working each day, including the hours worked by each. The deficient practice posed a risk as there was no documentation to identify the staff that was present each day to ensure the health and safety of residents, and the department was provided with false and misleading documentation. Findings include: 1. When the Compliance Officers arrived at the facility on July 14, 2025, E2 arrived at the facility at the same time. Two employees, originally identified as E3 and E4, were the only personnel at the facility providing services to residents. 2. In an interview, E3 identified themselves as E5, an assistant caregiver, and E4 identified themselves as E6, an assistant caregiver. Both provided photo identification to the Compliance Officers. 3. In an interview, E2 reported that E3 was terminated in 2023 and E4 was terminated in December 2024, and neither was employed in 2025. 4. A review of facility documentation revealed that E5 and E6 were not on the work schedule for the following months: -May 2025 -June 2025 and, -July 2025. However, the work schedule revealed E3's and E4's names. 5. In an interview, E2 acknowledged that documentation of caregivers and assistant caregivers, including hours worked, was not maintained, and that the Department was provided false and misleading documentation showing E5 and E6 as E3 and E4. This is a repeat deficiency from the compliance inspection conducted on July 18, 2024.

Based on observation, record review, and interview, the manager failed to ensure that a trained caregiver was present on the assisted living facility's premises when the manager was not present. The deficient practice posed a risk as no qualified employee was present to meet a resident's needs, and the department was provided false and misleading documentation. Findings include: 1. When the Compliance Officers arrived at the facility on July 14, 2025, E2 arrived at the facility at the same time. Two employees, originally identified as E3 and E4, were the only personnel at the facility providing services to residents. 2. In an interview, E3 identified themselves as E5, an assistant caregiver, and E4 identified themselves as E6, an assistant caregiver. Both provided photo identification to the Compliance Officers. 3. On July 15, 2025, the Compliance Officers completed the compliance inspection. When the Compliance Officers arrived at the facility, E5 was the only employee at the facility. E2 arrived a few minutes after. 4. A review of E5's personnel record revealed no documentation of completing a caregiver training program approved by the Department or the Board of Examiners for Nursing Care Institution Administrators and Assisted Living Facility Managers. In addition, E5's record did not include documentation that showed an administrator's license, a nursing license, or employment as a caregiver prior to November 1, 1998. Therefore, E5 was not qualified to be left alone with the residents based on the lack of caregiver training. 5. A review of the personnel records revealed no personnel record for E6. Therefore, E6 was not qualified to be left alone with the residents based on the lack of caregiver training. 6. In an interview, E2 reported E5 and E6 were not caregivers and worked as assistant caregivers, and E2 acknowledged neither a manager nor a caregiver was present at the facility when the Compliance Officers arrived on July 14, 2025, and July 25, 2025.

Based on record review and interview, the manager failed to ensure a resident accepted by the assisted living facility submitted documentation signed by a medical practitioner or a registered nurse that stated whether the individual required continuous medical services, continuous or intermittent nursing services, or restraints, for one of two residents sampled. The deficient practice posed a risk if the facility was unable to meet a resident's needs. Findings include: 1. A review of R1's medical record revealed no documentation that stated whether the resident required continuous medical services, continuous or intermittent nursing services, or restraints. Based on R1's acceptance date, this documentation was required. 2. In an interview, E1 acknowledged R1's medical record did not contain documentation signed by a medical practitioner or a registered nurse that stated whether the resident required continuous medical services, continuous or intermittent nursing services, or restraints.

Based on documentation review, record review, and interview, the manager failed to ensure that a resident's medical record contained documentation of the resident's notification of the availability of vaccination for influenza (flu) and pneumonia, according to A.R.S. § 36-406(1)(d), for two of two residents sampled. The deficient practice posed a potential illness risk to residents. Findings include: 1. A.R.S. § 36-406(1)(d) states, "The department shall: Require as a condition of licensure that nursing care institutions and assisted living facilities make vaccinations for influenza and pneumonia available to residents on site on a yearly basis. The department shall prescribe the manner by which the institutions and facilities shall document compliance with this subdivision, including documenting residents who refuse to be immunized. The department shall not impose a violation on a license for not making a vaccination available if there is a shortage of that vaccination in this state as determined by the director." 2. A review of R1's medical record revealed R1 was offered the flu and pneumonia vaccines in 2023. However, documentation of additional offers was not available for review. 3. A review of R2's medical record revealed R2 was offered the flu and pneumonia vaccines in 2023. However, documentation of additional offers was not available for review. 4. In an interview, E2 acknowledged R1's and R2's medical record did not contain documentation of R1's and R2's notification of the availability of vaccinations according to A.R.S. § 36-406(1)(d). 5. In an exit interview, the findings were reviewed with E2, and no additional information was provided.

Based on observation, record review, and interview, the manager failed to ensure that a bell, intercom, or other mechanical means to alert employees to a resident’s needs or emergencies is available and accessible in a bedroom or residential unit being used by a resident receiving personal care services. The deficient practice posed a risk if the facility was unable to meet a resident's needs. Findings include: 1. During the environmental inspection of the facility, the Compliance Officers observed that residents in bedrooms 1, 2, and 4, which were occupied by R1, R2, and R3, had no bell, intercom, or other mechanical means to alert employees to a resident's needs or emergencies available. 2. A review of R1's, R2's, and R3's service plans revealed R1, R2, and R3 received personal care services. 3. In an interview, E2 acknowledged that the residents in bedrooms 1, 2, and 4, which were occupied by R1, R2, and R3, had no bell, intercom, or other mechanical means to alert employees to a resident's needs or emergencies available.

Based on 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 that monitored 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 licensed for directed level of care. 2. The Compliance Officers observed multiple ambulatory residents. 3. The Compliance Officers observed an unlocked door leading to a garage, which was not monitored and did not alert an employee of the egress of a resident from the facility. 4. In an interview, E2 acknowledged that the garage door inside the facility was left open, which leads to another unlocked door that leads outside the facility, as well as the garage door itself, and the residents would be able to exit the facility without employees knowing. 5. Technical assistance was provided on this Rule during the inspection conducted on July 18, 2024.

Based on observation, documentation review, and interview, the manager failed to ensure that medication administration policies and procedures were reviewed and approved by a medical practitioner, registered nurse, or pharmacist. Findings include: 1. During the environmental inspection, the Compliance Officers observed that the facility provided medication administration services. 2. A review of facility policies and procedures, dated February 10, 2023, revealed a policy titled “Medication Policy and Procedure.” However, the medication policy and procedure were not reviewed, signed, or dated by a medical practitioner, registered nurse, or pharmacist. 3. In an interview, E2 acknowledged that the facility's policies and procedures for medication administration were not reviewed and approved by a medical practitioner, registered nurse, or pharmacist.

Based on observation and interview, the manager failed to ensure there was a current drug reference guide that was available for use by personnel members. This posed a health and safety risk to the resident if the caregiver was unable to reference a medication a resident was taking. Findings include: 1. During the environmental inspection, the Compliance Officers observed that the facility was providing medication administration services. 2. The Compliance Officers requested the current drug reference guide. However, the drug reference guide was not provided for the department to review. 3. In an interview, E1 and E2 acknowledged that the facility did not have a drug reference guide available for use by personnel members.

Based on observation and interview, the manager failed to ensure medication was stored in a separate locked room, closet, cabinet, or self-contained unit. The deficient practice posed a risk to residents who were not prescribed the accessible medication. Findings include: 1. The Compliance Officers observed an ambulatory resident. 2. The Compliance Officers observed an unlocked medication box in the kitchen refrigerator that contained: 1- Bottle of Lorazepam 0.25 ml (0.5mg by mouth) 3. In an interview, E2 acknowledged that medications were not stored in a locked area and inaccessible to residents.

Based on observation, record review, documentation review and interview, for two of two residents sampled, who received a controlled substance, the manager failed to ensure policies and procedures were implemented for inventorying controlled substances. The deficient practice posed a risk if controlled substances were not inventoried and accounted for by the facility. Findings include: 1. During an observation of R1’s and R2's medications, the Compliance Officers observed that the medications included controlled substances. 2. A review of R1's medical record revealed medication orders that included the following prescribed medication: - TRAMADOL HCL TAB 50MG TAKE 1 TABLET BY MOUTH EVERY 12 HOURS AS NEEDED FOR PAIN 3. A review of R1's medical record revealed medication orders that included the following prescribed medication: -Alprazolam 0.25mg tab – Take one tablet PO TID -Zolpidem Tartrate 5mg – Take one tablet PO at bedtime 3. In an interview, E2 reported that the facility does not inventory controlled substances. 4. A review of the facility's policies and procedures revealed a policy titled "26. Medications - E. Controlled Substances - 3) Inventorying." The policy stated: "a. There are no additional rules required for inventorying narcotic medications other than R9-10-816(E) item (3) above. Some facilities elect to have narcotic medication counted with at least two individuals present. b. This facility [blank box] elects to have two individuals present or [blank box] does not elect to have two individuals present for counting narcotic medication." 5. In an interview, E2 acknowledged that the policies and procedures were not implemented for inventorying controlled substances.

Based on documentation review, observation, and interview, the manager failed to ensure that an evacuation path was conspicuously posted in each hallway of the assisted living facility. The deficient practice posed a risk as there was no plan to ensure the health and safety of residents in an emergency. Findings include: 1. R9-101.54 states, "Conspicuously posted" means placed: a. At a location that is visible and accessible; and b. Unless otherwise specified in the rules, within the area where the public enters the premises of a health care institution." 2. During the environmental inspection, the Compliance Officers observed that an evacuation path was not conspicuously posted in each hallway of each floor of the assisted living facility. 3. In an interview, E1 and E2 acknowledged that an evacuation path was not conspicuously posted in each hallway of the assisted living facility.

Based on observation and interview, the manager failed to ensure a first-aid kit was maintained in the assisted living facility in a location accessible to caregivers and assistant caregivers. Findings include: 1. The Compliance Officers requested the facility's first-aid kit. However, the first-aid kit was not available for the department to review. 2. In an interview, E2 acknowledged that a first-aid kit was not available.

Based on documentation review and interview, the manager failed to ensure a pest control program compliant with Arizona Administrative Code (A.A.C.) R3-8-201(C)(4) was implemented and documented. Findings include: 1. A.A.C. R3-8-201(C)(4) states: "4. An individual may not provide pest management services at a...health care institution...unless the individual is a certified applicator in the certification category for which services are being provided." 2. The Compliance Officers requested documentation of a pest control program; however, no documentation was available for review to demonstrate a pest control program compliant with A.A.C. R3-8-201(C)(4). 3. In an interview, E2 reported that the facility did not have a pest control program and acknowledged the facility did not implement a pest control program compliant with A.A.C. R3-8-201(C)(4).

Based on observation and interview, the manager failed to ensure that hot water temperatures were maintained between 95º F and 120º 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 134.4º F in a resident room and 134.7º F in the common bathroom. 2. In an interview, E2 acknowledged that the hot water temperatures were not maintained between 95º F and 120º F in areas used by residents. This is a repeat deficiency from the compliance inspection conducted on July 18, 2024.

Based on documentation review and interview, the manager failed to ensure that a smoke detector was tested at least once a month. The deficient practice posed a health and safety risk to the residents. Findings include: 1. A review of the facility's smoke detector inspection log revealed an inspection date of February 22, 2024. No further documentation of tests was available for Compliance Officer review. 2. In an interview, E1 acknowledged the smoke detectors were not tested at least once a month.

Based on documentation review and interview, the manager failed to ensure documentation was maintained for at least 12 months after the last date on the documentation of the caregivers and assistance caregivers working each day, included the hours worked by each. The deficient practice posed a risk as there was no documentation to identify if qualified staff were present each day to ensure the health and safety of residents. Findings include: 1. A review of the facility's employee work schedule revealed a schedule for July 2024, that included the names of employees working each day, with no record of hours worked by each. No further documentation of the hours worked by employees each day was available for Compliance Officer review. 2. In an interview, E1 acknowledged the employee work schedule did not include documentation of the hours the caregivers worked each day.

Based on record review and interview, the manager failed to ensure that a resident had a written service plan that was reviewed and updated at least once every three months for a resident receiving directed care services for one of two residents sampled. Findings include: 1. A review of R1's medical record revealed R1 received directed care services. 2. A review of R1's medical record revealed a service plan dated March 4, 2024. No further documentation of a current, updated service plan was available for Compliance Officer review. 3. In an interview, E1 acknowledged R1's medical record did not include a written service plan updated at least once every three months.

Based on record review, observation, and interview, the manager failed to ensure that a resident's medical record contained a medication order from a medical practitioner for each medication that was administered to the resident for one of two residents 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 R1 received medication administration. 2. A review of R1's medical record revealed no documentation of a signed medication order or a verbal medication order for Trazodone HCL 50 milligrams (mg), Carbidopa-Levodopa 25-100 mg, Seroquel 25 mg, and Docusate Sodium 100 mg. 3. A review of R1's medication administration record (MAR) for July 2024 revealed the administration of the following medications: - Trazodone HCL 50 mg, 1.5 tablet by mouth (po) at bedtime (qhs) and indicated 1.5 tabs were administered at 8:00PM July 1 - present; - Carbidopa-Levodopa 25-100 mg, 1 tablet po daily (qd) and indicated 1 tablet was administered at 8:00AM July 1 - present; - Seroquel 25 mg, 1 tablet po three times a day (tid) and indicated 1 tablet was administrated at 8:00AM, 12:00PM, and 5:00PM July 1 - present; and - Docusate Sodium 100 mg, 2 capsules po qd and indicated 2 capsules were administered at 8:00AM July 1 - present. 4. The Compliance Officers observed the following medications stored by the facility for administration to R1: - Trazodone HCL 50 mg, 1.5 tablet po qhs; - Carbidopa-Levodopa 25-100 mg, 1 tablet po qd; - Seroquel 25 mg, 1 tablet po tid; and - Docusate Sodium 100 mg, 2 capsules po qd. 5. In an interview, E1 acknowledged R1's medical record did not contain a medication order from a medical practitioner for each medication that was administered to the resident.

Based on observation, documentation review and interview, the manager failed to ensure medications stored by the facility were stored in a separate locked room, closet, cabinet, or self-contained unit. The deficient practice posed a risk to residents who were not prescribed the accessible medication. Findings include: 1. During an environmental tour of the facility, the Compliance Officers observed the following medications stored in the door of the unlocked refrigerator: - Lorazepam 2 milligram/milliliters (mg/ml) SOL; and - Insulin Lispro Subcutaneous Solution 100 unit/ml. 2. A review of the facility's policies and procedures revealed a policy titled, "Medications, Storing." The policy stated, "Medications requiring refrigeration need to be kept in a lock container in the refrigerator or the refrigerator needs to be locked or the area where the medication refrigerator is located is locked." 2. In an interview, E1 reported they did not have a secured storage container for medications stored in the refrigerator. E1 acknowledged medication was not stored in a locked area used only for medication storage.

Based on documentation review and interview, the manager failed to ensure the disaster plan was reviewed at least once every 12 months. The deficient practice posed a risk as a disaster plan reinforces and clarifies standards expected of employees. Findings include: 1. A review of facility documentation revealed a disaster plan review dated September 9, 2022. No documentation of a more recent disaster plan review was available for Compliance Officer review. 2. In an interview, E1 acknowledged the facility's disaster plan was not reviewed at least once every 12 months.

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 Officers observed a water temperature of 130\'ba F in the shared bathroom for residents. 2. In an interview, E1 acknowledged the hot water temperatures were 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 that poisonous or toxic materials stored by the assisted living facility were maintained in a locked area inaccessible to residents. The deficient practice posed a risk to the physical health and safety of a resident. Findings include: 1. During an environmental tour of the facility, the Compliance Officers observed a bottle of Lysol All Purpose Cleaner and a tub of Clorox Wipes in an unlocked cabinet under the sink of a shared resident bathroom. These chemicals were stored by the facility in the shared bathroom. 2. During an environmental tour of the facility, the Compliance Officers observed a bottle of Stainless Steel Cleaner and Polish, and AJAX Ultra Liquid Dish Soap in an unlocked cabinet under the kitchen sink. 3. In an interview, E1 acknowledged the poisonous or toxic materials stored by the facility were not maintained in a locked area inaccessible to residents. This is a repeat citation from the compliance and complaint inspection conducted on October 12, 2022.