Faubush Family Homes

Based on record review and interview, the manager failed to ensure that a resident had a written service plan that when initially developed was signed and dated by the resident or resident's representative, the manager, and the nurse who reviewed the service plan, for one of two residents sampled. The deficient practice posed a risk if the service plan was not developed to articulate decisions and agreements. Findings include: 1. A review of R2's medical record revealed a completed service plan dated February 1, 2025. However, the service plan was not signed and dated by the approving nurse, resident or resident's representative, and the manager. 2. In an interview, E1 acknowledged R2's service plan was not signed and dated by the resident or the resident's representative, the manager, and the nurse who reviewed the service plan.

Based on record review and interview, the manager retained a resident who was confined to a bed or chair without meeting the requirements of R9-10-814(B)(2), 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. R9-10-814(B)(2) states, "A manager of an assisted living facility authorized to provide personal care services may accept or retain a resident who is confined to a bed or chair because of an inability to ambulate even with assistance if: the resident's primary care provider... examines the resident... at least once every six months throughout the duration of the resident's condition; reviews the assisted living facility's scope of services; and signs and dates a determination stating that the resident's needs can be met by the assisted living facility..." 2. A review of R1's service plan (dated February 1, 2025) revealed that R1 received personal care services and was confined to a bed or chair. 3. A review of R1's medical record revealed a determination for continued residency dated August 28, 2023. However, no further documentation was available for Compliance Officer review. 4. In an interview, E1 acknowledged R1's medical record did not include the required determination per R9-10-814(B)(2) updated at least once every six months.

Based on record review, observation, and interview, the manager failed to ensure that a medication administered to a resident was administered in compliance with a medication order for one of two residents sampled. The deficient practice posed a risk if the resident experienced a change in condition due to improper administration of medication. Findings include: 1. A review of R2’s medical record revealed a medication order for Amlodipine 5 milligrams (mg), 1 tablet by mouth (po) twice a day (bid). 2. A review of R2’s medication administration record (MAR) for June 2025 revealed R2 was administered Amlodipine 10 mg, 1 tablet po once a day (qd). 3. While on-site for the compliance inspection, the Compliance Officer observed Amlodipine 10 mg stored at the facility for administration to R2. 4. In an interview, E1 acknowledged that medication administered to R2 was not administered in compliance with a medication order.

Based on observation and interview, the manager failed to ensure that a life preserver or shepherd's crook was available in the swimming pool area. Findings include: 1. While on-site for the compliance inspection, the Compliance Officer observed the facility's backyard, which included a swimming pool. However, a life preserver or shepherd's crook was unavailable. 2. In an interview, E1 acknowledged a life preserver or shepherd's crook was not available in the swimming pool area.

Based on documentation review, record review and interview, the governing authority failed to ensure compliance with A.R.S. \'a7 36-411(A), for one of four caregivers sampled. The deficient practice posed a risk if E5 was a danger to a vulnerable population. Findings include: A.R.S. \'a7 36-411(A) Except as provided in subsections F, G, H and I of this section, 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. (This A.R.S. was amended and went into effect on September 24, 2022.) 1. A review of facility documentation revealed a staffing schedule for August 2023. The staffing schedule revealed E5 was scheduled to work alone on the following dates and shift: -Every Saturday and Sunday from 6:00 AM to 2:00 PM. 2. A review of E5's (hired in 2023) personnel record revealed documentation of a fingerprint clearance card application. 3. A review of the Arizona Department of Public Safety (DPS) fingerprint verification website revealed E5's application was received on July 26, 2023 and the results were mailed to the applicant. However, documentation of the status of E5's fingerprint clearance card was not available for review. 4. In a joint interview, E1 and E2 acknowledged E5 did not have a valid fingerprint clearance card.

Based on observation and interview, the manager failed to ensure the current phone number of the unit in the Department responsible for licensing and monitoring the assisted living facility was conspicuously posted. Findings include: 1. The Compliance Officer observed the current phone number of the unit in the Department responsible for licensing and monitoring the assisted living facility was not posted. 2. In an interview, E1 reported the posting has been removed. 3. In a joint interview, E1 and E2 acknowledged the current phone number of the unit in the Department responsible for licensing and monitoring the assisted living facility was not posted.

Based on observation and interview, the manager failed to ensure the current phone number of Adult Protective Services in the Department of Economic Security was conspicuously posted. Findings include: 1. The Compliance Officer observed the current phone number of Adult Protective Services in the Department of Economic Security was not posted. 2. In an interview, E1 reported the posting has been removed. 3. In a joint interview, E1 and E2 acknowledged the current phone number of Adult Protective Services in the Department of Economic Security was not posted.

Based on observation and interview, the manager failed to ensure the current phone number of The State Long-Term Care Ombudsman was conspicuously posted. Findings include: 1. The Compliance Officer observed the current phone number of The State Long-Term Care Ombudsman was not posted. 2. In an interview, E1 reported the posting has been removed. 3. In a joint interview, E1 and E2 acknowledged the current phone number of The State Long-Term Care Ombudsman was not posted.

Based on observation and interview, the manager failed to ensure the current phone number of The Arizona Center for Disability Law was conspicuously posted. Findings include: 1. The Compliance Officer observed the current phone number of The Arizona Center for Disability Law was not posted. 2. In an interview, E1 reported the posting has been removed. 3. In a joint interview, E1 and E2 acknowledged the current phone number of The Arizona Center for Disability Law was not posted.

Based on record review and interview, the manager failed to ensure a resident's medical record contained documentation of the resident's orientation to exits from the assisted living facility, for one of five residents sampled. Findings include: 1. A review of R5's medical record revealed documentation of R5's orientation to exits from the assisted living facility was not available for review. 2. In an interview, E1 reported R5 received orientation to exits from the facility. 3. In a joint interview, E1 and E2 acknowledged R5's medical record did not contain documentation of the R5's orientation to exits from the facility.

Based on documentation review and interview, the manager failed to ensure the disaster plan required in subsection (A)(1) 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 Department documentation revealed the facility's license was effective February 6, 2019. 2. A review of facility documentation revealed an undated disaster plan. 3. The Compliance Officer requested to review the facility's annual disaster plan review. However, documentation of the annual disaster plan review was not provided for review. 4. In a joint interview, E1 and E2 acknowledged the facility's annual disaster plan was not available for review.