Cozy Home Care LLC

Based on record review and interview, the manager failed to ensure a manager, a caregiver, and an assistant caregiver provided evidence of freedom from infectious tuberculosis (TB) before the individual provided services at or on behalf of the assisted living facility, for one of three personnel sampled. Findings include: 1 . A review of E3's personnel record included documentation of a TB screening and one TB skin test dated April 17, 2024. However, documentation of a second TB skin test was not available for review at the time of inspection. 2 . In an exit interview, the findings were explained to E1 and no additional information was provided.

Based on record review, documentation review, and interview, the manager failed to ensure before providing assisted living services to a resident, a caregiver or an assistant caregiver received orientation that is specific to the duties to be performed by the caregiver or assistant caregiver, for one of three personnel sampled. Findings include: 1 . A review of E3's personnel record revealed documentation of a signed orientation. However, the following items were not documented as reviewed: -Taking and documenting doctors orders; -Infection control practices; -Medication administration, Assistance in self-administration medication; -Location and use of first aid kit, drug reference and toxicology guide; -Taking and recording vital signs; and -Documentation of treatments and ADL. 2 . A review of facility documentation revealed a policy titled "Orientation and in-service training." The policy stated, "New employee orientation is required to be completed by all new employees and volunteers before providing assisted living services to the residents and will contain the following... 15. Taking and documenting doctors orders; 16. Infection control practices; 17. Medication administration, Assistance in self-administration medication; 18. Location and use of first aid kit, drug reference and toxicology guide; 19. Taking and recording vital signs; 20. Documentation of treatments and ADL." 2 . In an interview, E1 acknowledged E3's orientation was not completed.

Based on documentation review, record review, and interview, the manager failed to ensure compliance with A.R.S. \'a7 36-411, for two of three sampled employees. The deficient practice posed a risk if the employee was a danger to a vulnerable population. Findings include: 1. A.R.S. \'a7 36-411 states, "A... 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 or contracted persons or volunteers who provide medical services, nursing services, behavioral health services, health-related services, home health services or 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..." 2. A review of E1's personnel record revealed E1 had been hired as the manager in October of 2012. The personnel record revealed an expired fingerprint clearance card issued by the State of Arizona's Department of Public Safety (DPS) on May 29, 2018, with an expiration date of May 29, 2024. There was no additional documentation of a fingerprint card or that an application for a fingerprint card was submitted to DPS. 3. A review of the DPS website revealed E1 was issued a fingerprint clearance card dated May 29, 2018, with an expiration date of May 29, 2024. 4. A review of E2's personnel record revealed E2 had been hired as a caregiver in June of 2012. The personnel record revealed an expired fingerprint clearance card issued by DPS on May 29, 2018, with an expiration date of May 29, 2024. There was no additional documentation of a fingerprint card or that an application for a fingerprint card was submitted to DPS. 5. A review of the DPS website revealed E2 was issued a fingerprint clearance card dated May 29, 2018, with an expiration date of May 29, 2024. 6. In an interview, E1 acknowledged E1 and E2 did not have a valid fingerprint clearance card.

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 three 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 an assistant caregiver in May of 2024. E3's personnel record did not contain documentation of E3's skills and knowledge. 2. A review of the facility's policies and procedures dated January 5 2023, revealed a policy that the hiring individual or manager shall ensure, check, and document that each caregiver,or assistant caregiver providing physical health services or behavioral health services have the required skills and knowledge before providing any services to the residents. 3. In an interview, E1 acknowledged E3's personnel record did not contain documented verification of E3's skills and knowledge. E1 was not able to provide E3's skills and knowledge during the inspection.