Emmanuel Care Home II

Based on observation, documentation review, and interview, the manager failed to ensure documentation was maintained, for at least 12 months, of the caregivers and assistant caregivers working each day, including the hours worked by each. Findings include: 1. The Compliance Officer observed E2 working in the facility when the Compliance Officer arrived for an unannounced inspection. 2. A review of the facility staffing schedule revealed E2 was not on the schedule the day of the inspection. 3. In an interview, E1 acknowledged the staffing schedule did not document the caregivers and assistant caregivers working each day, including the hours worked by each.

Based on record review and interview, the manager failed to ensure before or at the time of an individual's acceptance by an assisted living facility, there was a documented residency agreement with the assisted living facility which included the requirements in R9-10-807(D)(1-10) for two of two resident records reviewed. Findings include: 1. A review of R1's medical record revealed a documented residency agreement. However, the residency agreement did not include the following: - The name of the facility contracted in the residency agreement; - The terms of occupancy: Date of occupancy, monthly fee amount and date due, and any prorated fees; and - The manager's signature and date signed. 2. A review of R2's medical record revealed a documented residency agreement. However, the residency agreement did not include the following: - The individual's name; - The name of the facility contracted in the residency agreement; and - The terms of occupancy: Date of occupancy, monthly fee amount and date due, and any prorated fees. 3. In an interview, E1 acknowledged R1's and R2's residency agreements did not include all requirements in R9-10-807(D)(1-10).

Based on record review and interview, the manager failed to ensure a resident had a written service plan when initially developed and when updated, was signed and dated by the resident or resident's representative, the manager, or the nurse or medical practitioner who reviewed the service plan, for one of two records reviewed. Findings include: 1. A review of R1's medical record revealed service plan update dated August 8, 2023, for personal care level of services, behavioral care, and medication administration. The Compliance Officer observed the service plan was signed by the nurse who developed the plan, though did not include the required signatures of the resident or resident's representative, the manager, and a medical practitioner or behavioral health professional. 2. In an interview, E1 acknowledged the service plan was not signed as required by the resident or resident's representative, the manager, and a medical practitioner or behavioral health professional.

Based on observation and interview, the manager failed to ensure medication was stored in a separate locked room, closet, cabinet, or self-contained unit. Findings include: 1. During a tour of the facility, the Compliance Officer inspected the kitchen refrigerator and found the following medications unsecured in the door of the refrigerator: - "OFLOXACIN 0.3% EYE DROPS"; - "CROMOLYN 4% EYE DROPS"; and - "PREDNISOLONE AC 1% EYE DROPS". 3. In an interview, E1 acknowledged the medication was stored unsecured in the refrigerator door.