Desert Winds I Alh, INC

Based on documentation review, observation, and interview, the manager failed to ensure that 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. A review of the facility license revealed the facility was licensed at the directed care level. 2. During an environmental inspection of the facility with E1, the Compliance Officer observed there was no monitoring system or alert on the sliding door leading to the backyard. 3. During an environmental inspection of the facility with E1, the Compliance Officer observed there was no monitoring system or alert on the door leading to the backyard in the bedroom of R3. 4. A review of R3's medical record revealed R3 had a diagnosis of dementia and was ambulatory. 5. In an exit interview, the findings were reviewed with E1 and no additional information was provided.

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 reviewed. The deficient practice posed a risk if the facility was unable to meet a resident's needs. Findings include: 1. A review of R2's medical record revealed no documentation that stated whether the resident required continuous medical services, continuous or intermittent nursing services, or restraints. Based on R2's acceptance date, this document was required. 2. In an interview, E1 acknowledged R2'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 record review, observation and interview, the manager failed to ensure the caregiver documented the services provided in the resident's medical record, for one of two residents reviewed. The deficient practice posed a health and safety risk. Findings include: 1. Review of R2's medical record revealed a current written service plan for directed care services dated September 25, 2024. This service plan stated the following services were needed: -"Shaving Frequency QOD"; and -"Washing Face and Hands Frequency: BID and PRN". However, documentation was not available indicating these services were provided. 2. An observation of R2 indicated these services were provided recently. 3. During an interview, E1 acknowledged R2's medical record did not include documentation of shaving, hand washing, and face washing. Technical assistance was provided on this Rule during the compliance inspection on March 22, 2023.

Based on observation and interview, the manager failed to ensure medication stored by the assisted living facility 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 could access the medication. Findings include: 1. During the facility tour with E1, the Compliance Officer observed a bottle of "Carbidopa 25/Levodopa 100mg tab", containing tablets, on a kitchen counter. 2. During an observation, the caregivers were not accessing the medications at the time of arrival. 3. In an interview, E1 reported that the medication had been left out to remind E1 to call the pharmacy to schedule a refill. E1 acknowledged the medication was not stored in a separate locked room, closet, cabinet, or self-contained unit used only for medication storage.

Based on observation and interview, the manager failed to ensure 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 the facility tour, the Compliance Officer observed the following in an unlocked kitchen cabinet: -One container of "Comet with Bleach" which stated "Caution: Keep out of Reach of Children"; and -One container of "Weiman Glass Cook Top Cleaner" which stated "Keep out of Reach of Children". The cabinet was equipped with a locking mechanism, however, the cabinet was unlocked. 2. The Compliance Officer observed the following in an unlocked laundry room: -One container of "Simply Value Bleach" which stated "Warning: Keep out of Reach of Children"; -Two containers of "Great Value Toilet Bowl Cleaner" which stated "Caution: Keep out of Reach of Children"; and -One container of "CLR" which stated "Warning: Harmful if Swallowed". The laundry room door was equipped with a locking mechanism, however, the door was unlocked and the key had been left in the lock. 3. The Compliance Officer observed that the toxic materials were not being accessed by caregivers at the time of inspection. 4. In an interview, E1 stated "In the morning, everything is unlocked," and "I can not keep them locked all of the time." E1 acknowledged poisonous or toxic materials stored by the assisted living facility were not maintained in a locked area inaccessible to residents.