Manantial De Vida, LLC

Based on documention review, record review, and interview, the manager failed to ensure that before or at the time of acceptance of an individual, the individual submitted documentation dated within 90 calendar days before the individual was accepted by an assisted living facility, and, if an individual was requesting or expected to receive supervisory care services, personal care, services, or directed care services, was dated and signed by a Physician, Registered nurse practitioner, Registered nurse, or Physician assistant, for one of two residents sampled. Findings include: 1. A review of R1's medical record revealed a document titled, "Determination for Admission," which stated R1 was to receive personal services. The document was signed by a Registered Nurse, however, the signature was not dated. 2. In an interview, E1 acknowledged R1's "Determination for Admission" form had not been dated when signed by a Registered Nurse.

Based on observation and interview, the manager failed to ensure poisonous or toxic materials were maintained in labeled containers in a locked area and inaccessible to residents. Findings include: 1. During an environmental inspection of the facility, the Compliance Officer observed the laundry room was open and unoccupied. Inside the laundry room, the Compliance Officer observed a cabinet above the washing machine had a lock, however, the cabinet had been left open. Inside the cabinet, the Compliance Officer observed bottles of bleach and floor cleaner. 2. In an interview, E1 acknowledged poisonous or toxic materials had not been maintained in labeled containers in a locked area and inaccessible to residents.