Legacy Senior Care

Based on documentation review, observation, interview, and record review, the manager failed to ensure an assistant caregiver interacted with residents under the supervision of a manager or caregiver. The deficient practice posed a risk as residents were alone with an individual who was not a certified caregiver. Findings include: 1. Arizona Revised Statutes § 36-401(A)(49) states, "'Supervision' means directly overseeing and inspecting the act of accomplishing a function or activity." 2. Upon entering the facility at approximately 3:05 PM, the Compliance Officer observed E3 and two residents. The Compliance Officer observed no other personnel members. 3. In an interview, E3 reported E3 was an assistant caregiver. When the Compliance Officer asked for a caregiver, E3 reported E1 recently left for the store. E3 reported E3 was the only personnel member present at the facility with the residents. 4. A review of E3’s personnel record confirmed E3 was hired as an assistant caregiver. The review revealed no documentation of completion of a caregiver training program approved by the Department or the Board of Examiners for Nursing Care Institution Administrators and Assisted Living Facility Managers. 5. A review of the caregiver certificate verification website (azcg.tmutest.com) revealed no valid caregiver certificate under E3's name. 6. On several occasions throughout the inspection, the Compliance Officer observed E3 interacting with residents while not under the supervision of a manager or caregiver. 7. At approximately 3:25 PM, the Compliance Officer observed E1 enter the facility. 8. In an interview, when the Compliance Officer reminded E1 assistant caregivers were only able to interact with residents while under the supervision of a manager or caregiver, E1 stated, “I know” and “I’m fully aware.”

Based on observation, interview, record review, and documentation review, the manager failed to ensure at least the manager or a caregiver was present at an assisted living home when a resident was present in the assisted living home. The deficient practice posed a risk as residents were alone with an individual who was not a certified caregiver. Findings include: 1. Upon entering the facility at approximately 3:05 PM, the Compliance Officer observed E3 and two residents. The Compliance Officer observed no other personnel members. 2. In an interview, E3 reported E3 was an assistant caregiver. When the Compliance Officer asked for a caregiver, E3 reported E1 recently left for the store. E3 reported E3 was the only personnel member present at the facility with the residents. 3. A review of E3’s personnel record confirmed E3 was hired as an assistant caregiver. The review revealed no documentation of completion of a caregiver training program approved by the Department or the Board of Examiners for Nursing Care Institution Administrators and Assisted Living Facility Managers. 4. A review of the caregiver certificate verification website (azcg.tmutest.com) revealed no valid caregiver certificate under E3's name. 5. In a telephonic interview, E1 confirmed E1 was not present at the facility. When the Compliance Officer asked if there was a caregiver present at the facility, E1 paused then stated, “That would be me.” E1 reported E1 would return to the facility momentarily. 6. At approximately 3:25 PM, the Compliance Officer observed E1 enter the facility. 7. In an interview, when the Compliance Officer reminded E1 a manager or a caregiver had to be present at the facility when residents were present, E1 stated, “I know” and “I’m fully aware.”

Based on observation and interview, the manager failed to ensure poisonous or toxic materials stored by the assisted living facility were maintained in labeled containers in a locked area inaccessible to residents. The deficient practice posed a risk to residents with access to the poisonous or toxic materials. Findings include: 1. The Compliance Officer observed a spray can of air freshener on the back of the toilet in an unlocked common bathroom. The Compliance Officer further observed an unlocked cabinet under the sink in the kitchen. Inside the cabinet, the Compliance Officer observed a variety of poisonous or toxic materials, including dishwasher tablets, glass cleaner, and two unlabeled spray bottles containing what appeared to be cleaning agents. 2. In an interview, E1 and E2 acknowledged the poisonous or toxic materials were not maintained in a locked area inaccessible to residents. E1 reported the unlabeled spray bottles contained a mixture of lavender Pine Sol, water, and alcohol.