Magic Touch Adult Care

Based on documentation review, record review, and interview, the health care institution failed to ensure the health care institution developed and administered a training program for all staff regarding fall prevention and fall recovery that included initial training and continued competency training. The deficient practice posed a risk to the physical health and safety of a resident. Findings include: 1. A review of the facility's policies and procedures revealed a policy titled "Fall Prevention and Recovery Training Programs." The policy stated, "...1. All employees will have an initial training on fall prevention and recovery. Training shall be included in the orientation for new hire..." 2. A review of E2's personnel record revealed E2's hired date of February 1, 2020. A review of E2's personnel record revealed no fall prevention and fall recovery training. 3. A review of E3's personnel record revealed E3's hire date of October 1, 2025. A review of E3's personnel record revealed no fall prevention and fall recovery training. 4. In an exit interview, the findings were reviewed with E3, and no additional information was provided.

Based on record review and interview, the health care institution failed to implement tuberculosis (TB) infection control activities, including providing training and education related to recognizing the signs and symptoms of TB to individuals employed by the health care institution, for two of three personnel records reviewed. The deficient practice posed a risk as the caregiver received no organized instruction or information related to TB surveillance. Findings include: 1. A review of E2's personnel record revealed E2 worked as a caregiver and had a hire date of February 1, 2020. The personnel record did not include documentation of training and education related to recognizing the signs and symptoms of TB. 2. A review of E3's personnel record revealed E3 worked as a caregiver and had a hire date of October 1, 2025. The personnel record did not include documentation of training and education related to recognizing the signs and symptoms of TB. 3. In an exit interview, the findings were reviewed with E3, and no additional information was provided.

Based on documentation review, record review, and interview, the governing authority failed to ensure compliance with A.R.S. § 36-411 for three of three personnel sampled. The deficient practice posed a risk if E1, E2, and E3 were a danger to a vulnerable population. Findings include: 1. A.R.S. § 36-411(C) states, "Each residential care institution, nursing care institution and home health agency shall make documented, good faith efforts to: 1. Contact previous employers to obtain information or recommendations that may be relevant to a person’s fitness to work in a residential care institution, nursing care institution or home health agency. 2. Verify the current status of a person's fingerprint clearance card. 3. Beginning January 1, 2025, verify that a potential employee is not on the adult protective services registry pursuant to section 46-459. If a potential employee is found to be on the adult protective services registry, the residential care institution, nursing care institution or home health agency may not hire the potential employee. 4. On or before March 31, 2025, verify that each employee is not on the adult protective services registry pursuant to section 46-459. If an employee is found to be on the adult protective services registry, the residential care institution, nursing care institution or home health agency shall take action to terminate the employment of that employee." 2. A review of E1's personnel record did not include documentation of verification that E1 was not on the adult protective services registry. 3. A review of E2's personnel record did not include documentation of verification that E2 was not on the adult protective services registry. 4. A review of E3's personnel record did not include documentation of verification that E3 was not on the adult protective services registry. 5. In an exit interview, the findings were reviewed with E3, and no additional information was provided.

Based on record review and interview, the manager failed to ensure a caregiver provided current documentation of first aid and cardiopulmonary resuscitation (CPR) training before providing assisted living services, for one of three caregivers reviewed. The deficient practice posed a risk if a caregiver was unable to meet a resident's needs during an emergency. Findings include: 1. A review of E1's personnel record revealed a first aid and CPR card with an expiration date of August 2025. There was no other current documentation of first aid and CPR training in E1's record. 2. In an exit interview, the findings were reviewed with E3, and no additional information was provided.

Based on record review and interview, the manager failed to ensure there was a documented residency agreement with the assisted living facility that included whether the manager or a caregiver was awake during nighttime hours, for two of two residents sampled. The deficient practice posed a health and safety risk if a resident was unable to awaken the caregivers during nighttime hours. Findings include: 1. A review of R1's medical record revealed a residency agreement. However, this residency agreement did not include documentation of whether the manager or a caregiver was awake during nighttime hours. 2. A review of R2's medical record revealed a residency agreement. However, this residency agreement did not include documentation of whether the manager or a caregiver was awake during nighttime hours. 3. In an exit interview, the findings were reviewed with E3, and no additional information was provided.

Based on record review and interview, the manager failed to ensure a written service plan was reviewed and updated at least once every three months, for two of two residents sampled who received directed care services. The deficient practice posed a risk as a service plan reinforces and clarifies services to be provided to a resident. Findings include: 1. A review of R1's medical record revealed a written service plan for directed care services dated July 8, 2025. However, a service plan after July 8, 2025 was not available for review. 2. A review of R2's medical record revealed a written service plan for directed care services dated July 8, 2025. However, a service plan after July 8, 2025 was not available for review. 3. In an exit interview, the findings were reviewed with E3, and no additional information was provided.

Based on record review and interview, the manager failed to ensure a caregiver or an assistant caregiver documented the services provided to a resident in the resident's medical record, for two of three sampled residents. The deficient practice posed a health and safety risk as services could not be verified as provided against a service plan. 1. A review of R1's medical record revealed a service plan, dated July 8, 2025, that indicated R1 would receive the following services: Assistance with bathing; Assistance with oral care; Assistance with grooming; Assistance with toileting; Brief changes; and Assistance with feeding. 2. A review of R1's ADL documentation for December 2025 did not include documentation of the services provided to R1 after December 2, 2025. 3. A review of R2's medical record revealed a service plan, dated July 8, 2025, that indicated R2 would receive the following services: Assistance with bathing; Assistance with grooming; Assistance with oral care; Brief changes; Assistance with toileting; and Assistance with feeding. 4. A review of R2's ADL documentation for December 2025 did not include documentation of services provided to R2 after December 2, 2025. 5. In an exit interview, the findings were reviewed with E3, and no additional information was provided.

Based on record review, documentation review, and interview, the manager failed to ensure that a resident’s medical record contained documentation of medication administered to the resident that includeed the date and time of administration; the name, strength, dosage, and route of administration; the name and signature of the individual administering the medication; and and unexpected reaction the resident has to the medication for one of two residents sampled. The deficient practice posed a risk as medication could not be verified as administered against a medication order. Findings include: 1. A review of R1's medical record revealed no documentation of a December 2025 medication administration record (MAR). 2. A review of the facility's documentation revealed a policy titled "Medications". The policy stated, "...B. If an assisted living facility provides medication administration, a manager shall ensure that...21. Documentation of medication administered to the resident...includes: a. The date and time of administration or assistance; b.The name, strength, dosage, and route of administration; c.The Name and signature of the individual administering...d.An unexpected reaction in the resident has to the medication..." 3. In an interview, E2 reported E2 did not know where the December MAR was at the time of the inspection. 4. In an exit interview, the findings were discussed with E3, and no additional information was provided.

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)(b)(iii), 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)(b)(iii) 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 July 8, 2025) revealed R1 received directed care services and was confined to a bed or chair. 3. A review of R1's medical record revealed documentation of the determination required dated February 6, 2025. However, additional documentation signed by R1's primary care provider was not available for review. 4. In an exit interview, the findings were reviewed with E3, and no additional information was provided.

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 an environmental inspection of the facility, the Compliance Officer observed an unlocked storage room that contained the following medications for R3: -Quetiapine Fumarate, 50 milligram (MG) tablet; -Atorvastatin, 40 MG tablet; and -Atenolol, 25 MG tablet. The door was equipped with a locking mechanism; however, it was unlocked at the time of the inspection. 2. In an exit interview, the findings were reviewed with E3, and no additional information was provided.

Based on documentation review and interview, the manager failed to ensure the facility's disaster plan was reviewed at least once every 12 months. The deficient practice posed a health and safety risk to residents and employees if the disaster plan was not up-to-date to adequately meet the needs of the residents during a disaster. Findings include: 1. A review of the facility's documentation revealed no documentation indicating the disaster plan was reviewed once every 12 months as required. 2. In an exit interview, the findings were reviewed with E3 and no additional documentation was provided.

Based on observation and interview, the manager failed to ensure poisonous or toxic materials stored by the facility were stored in a locked area and inaccessible to residents. The deficient practice posed a risk to the physical health and safety of residents with access to the materials. Findings include: 1. During an environmental tour of the facility, the Compliance Officer observed a bottle of Max Strength drain cleaner, Method Antibac bathroom cleaner spray bottle, Clorox Cleaner and Bleach spray bottle, a can of Lysol disinfectant a bottle of Super Tech Engine Degreaser, Comet Bleach container, a bottle of Multi-Purpose Disinfenctig Cleaner, a bottle of Ammonia All Purpose Cleaner, and a can of Home Defense Flying Insect Killer in an unlocked laundry room. 2. In an interview, E3 acknowledged the toxic materials were not stored in a locked area and were inaccessible to residents. 3. In an exit interview, the findings were reviewed with E3 and no additional information was provided.

Based on documentation review and interview, the manager failed to ensure a plan was documented and implemented to ensure that the manager or a caregiver was available as back-up to provide assisted living services to a resident if the manager or a caregiver assigned to work is not available or not able to provide the required assisted living services. The deficient practice posed a risk to the health and safety of residents. Findings include: 1. A review of the facility's policies and procedures (reviewed and approved August 16, 2022) revealed a policy titled, "Facility process of selecting a "Manager" and "Designated Managers." The policy stated, "Designated Manager - The manager shall designate in writing a caregiver to be the "Designated Manager''. To assist in understanding who the designated manager is when more than one designated manager is present, the "Designated Manager Delegation" document will be posted in area of the facility that will allow for easy access to this document." 2. In an on-site compliance inspection, the Compliance Officer observed a posting on the kitchen refrigerator titled, "Delegation of Authority." The posting listed O1 as the manager designee. 3. In an interview, E1 reported O1 was no longer employed at the facility as of June 2023 (specific day unknown). 4. In an interview, E1 acknowledged the facility did not have a plan documented and implemented to ensure a caregiver was available as back-up to provide assisted living services if a caregiver assigned to work is not available or not able to provide the required assisted living services. E1 reported E1 has been working alone since July 2023.

Based on record review and interview, the manager failed to ensure the service plan for a resident receiving directed care services included documentation of the resident's weight or documentation from a medical practitioner which stated weighing the resident was contraindicated for one of two residents sampled. The deficient practice posed a health and safety risk to the resident. Findings include: 1. A review of R2's medical record revealed a service plans dated July 2023 and October 2023. The service plans indicated R2 received directed care services. However, the service plans did not show documentation of R2's weight. The medical record for R2 did not contain documentation from a medical practitioner stating weighing R2 was contraindicated. 2. In an interview, E1 acknowledged the service plans did not contain documentation of R2's weight and the medical record did not contain documentation from a medical practitioner stating weighing R2 was contraindicated.