Little Touch of Europe

Based on observation, 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 personnel members sampled. The deficient practice posed a risk if E2 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. The Compliance Officer observed E2 working on the premises. The Compliance Officer observed E2 lived on the premises. 2. A review of facility documentation revealed a staffing schedule for September 2023. The staffing schedule revealed E2 was scheduled to work from 6:00AM to 6:00PM on Mondays, Tuesdays, Wednesdays, Thursdays, and Fridays. 3. A review of E2's personnel record revealed E2 was the owner of AL1610 and was hired as a caregiver at AL1610. 4. A review of E2's personnel record revealed a fingerprint clearance card issued June 17, 2014 and expired June 17, 2020. However, documentation of a current fingerprint clearance card or a fingerprint clearance card application was not available for review. 5. A review of the Arizona Department of Public Safety (AZDPS) fingerprint clearance card website (https://psp.azdps.gov/services/cardStatusRequest), conducted on September 28, 2023, revealed the fingerprint clearance card for E2 (issued June 17, 2014 and expired June 17, 2020) was not valid. 6. A review of the AZDPS fingerprint clearance card website (https://psp.azdps.gov/services/cardStatusRequest), conducted on September 28, 2023, revealed a fingerprint clearance card application was not submitted for E2. 7. In an interview, E2 reported E2 did not have a valid fingerprint clearance card. E2 reported E2 completed a fingerprint clearance card application but did not remember where E2 maintained the documentation. 8. In an interview, E3 reported E3 was not aware of the changes made to A.R.S. \'a7 36-411 in September 2022. 9. In an interview, E2 acknowledged E2 did not have a valid fingerprint clearance card.

Based on documentation review, record review, and interview, the manager failed to ensure a personnel record for each employee included documentation of first aid training, for one of four caregivers sampled. The deficient practice posed a risk if an employee was unable to meet a resident's needs during an emergency. Findings include: 1. A review of facility documentation revealed a staffing schedule for September 2023. The staffing schedule revealed E4 was scheduled to work alone from 6:00AM to 10:00PM on Saturdays and Sundays. 2. In a joint interview, E2 and E3 reported the caregivers scheduled to work on Saturdays and Sundays worked together and not alone. 3. A review of E4's personnel record revealed E4 was hired as a caregiver. The personnel record revealed documentation of first aid training was not available for review. 4. In an interview, E2 reported E2 was not sure where E4's documentation of first aid training was located or whether E4 had documentation of first aid training. 5. In an interview, E3 reported E3 was sure E4 had documentation of first aid training because E4 works at a surgical center full-time. 6. In an interview, E3 acknowledged personnel record for E4 did not include documentation of first aid training.

Based on record review and interview, the manager failed to ensure before or at the time of acceptance the individual submitted documentation, dated within 90 calendar days before the individual was accepted by the facility, to include whether the individual required continuous medical services, continuous or intermittent nursing services, or restraints; dated and signed by a physician, registered nurse practitioner, registered nurse, or physician assistant, for one of two residents sampled. The deficient practice posed a risk as the facility is not authorized to provide continuous medical services, continuous nursing services or restraints and would not be able to meet the needs of a resident who required these services. Findings include: 1. A review of R1's (accepted in 2022 and received personal care services) medical record revealed documentation, dated within 90 calendar days before the individual was accepted by the facility, to include whether the individual required continuous medical services, continuous or intermittent nursing services, or restraints; dated and signed by a physician, registered nurse practitioner, registered nurse, or physician assistant was not available for review. 2. In an interview, E3 reported E3 does not know where the aforementioned documentation would be located if the documentation was completed. 3. In an interview, E3 reviewed R1's medical record and reported E3 could not find the aforementioned documentation. 4. In an interview, E3 acknowledged documentation to include whether R1 required continuous medical services, continuous or intermittent nursing services, or restraints; dated and signed by a physician, registered nurse practitioner, registered nurse, or physician assistant was not available for review.

Based on observation and interview, the manager failed to ensure a calendar of planned activities was prepared at least one week in advance of the date the activity was provided. Findings include: 1. The Compliance Officer observed a calendar of planned activities dated for May 21, 2023 to May 27, 2023 posted in a location easily seen by residents. However, a current calendar of planned activities was not posted. 2. In an interview, E3 reported E3 posted the incorrect calendar of planned activities. 3. In an interview, E3 acknowledged the facility did not have a current calendar of planned activities conspicuously posted.

Based on record review and interview, the manager failed to ensure a resident's medical record contained the name, address, and telephone number of an individual to be contacted in the event of emergency, significant change, or termination of residency, for one of two residents sampled. The deficient practice posed a risk if the facility was unable to contact an individual in the event of emergency, significant change in the resident's condition, or termination of residency. Findings include: 1. A review of R1's (accepted in 2022) medical record revealed the name, address, and telephone number of an individual to be contacted in the event of emergency, significant change, or termination of residency was not available for review. 2. A review of R1's medical record revealed a document titled "Health Care (Medical) Power of Attorney with Mental Health Authority" (dated in April 2019). The document stated the name and address of a designated "agent for all matters relating to my health." However, this individual was not documented as an individual to be contacted in the event of emergency, significant change, or termination of residency. 3. In an interview, E3 reported E3 did not have an individual to be contacted in the event of emergency, significant change, or termination of residency. E3 reported E3 has a power of attorney. 4. In an interview, E3 acknowledged R1's medical record did not contain the name, address, and telephone number of an individual to be contacted in the event of emergency, significant change or termination of residency.

Based on observation and interview, the manager failed to ensure a calendar of planned activities was prepared at least one week in advance of the date the activity was provided. Findings include: 1. The Compliance Officer observed a food menu conspicuoulsy posted dated for May 22, 2023 to May 28, 2023. 2. In an interview, E3 reported E3 posted the incorrect food menu. 3. In an interview, E3 acknowledged a food menu was not conspicuously posted at least one calendar day before the first meal on the food menu was served.