Maria's Garden Care Home, LLC

Based on record review and interview, the assisted living home failed to provide written documentation to the emergency responder of emergency responder (EMS) information that included the items listed in Arizona Revised Statutes (A.R.S.) § 36-420.04(A)(1-9) for one of three residents sampled. The deficient practice posed a risk if the emergency responder was not aware of critical health information for the resident. Findings include: 1. A review of R1's medical records revealed no documentation for the standardized emergency responder patient information form. 2. In an interview, E1 reported that R1 had left the facility with emergency medical services due to out-of-control behavior and a medical emergency on October 25, 2025. However, the facility staff did not provide the emergency responders with documentation required in rule Arizona Revised Statutes (A.R.S.) § 36-420.04(A)(1-9 3. In an exit interview, the findings were reviewed with E1, and no additional information was provided.

Based on record review, and interview, the manager of an assisted living home failed to maintain a standardized form for each resident that included the information prescribed in Arizona Revised Statutes (A.R.S.) § 36-420.04(A)(1-9). The deficient practice posed a risk if the emergency responder was not aware of critical health information for a resident. Findings include: 1. A review of R1's, R2’s, and R3’s medical records revealed no documentation for the standardized emergency responder patient information form. 2. In an exit interview, the findings were reviewed with E1, and no additional information was provided.

Based on observation, documentation review, and interview, the manager failed to designate, in writing, a caregiver who was present on the assisted living facility’s premises and accountable for the assisted living facility when the manager is not present on the assisted living facility premises. The deficient practice posed a risk as no qualified employee was present to meet a resident's needs, and the Department was provided false and misleading information. Findings include: 1. The Compliance Officer arrived at the facility around 8:30 AM. The Compliance Officer observed E2, E3, and E4. E2 and E3 identified themselves as caregivers, and E4 reported being an assistant caregiver. E2, E3, and E4 were at the facility alone with R1 and R2. E1 was not at the facility when the Compliance Officer arrived; however, E1 arrived at the facility around 1:30 PM. 2. A review of E2's personnel record revealed that E2 had been hired in March 2025. However, in an interview, E2 reported they had only been in Arizona since 2018 and had not taken any caregiver training program. 3. A review of E3's personnel record revealed that E3 had been hired in October 2025, and it also revealed a caregiver certificate dated May 2, 2013. However, in an interview, E3 reported that they had not taken the caregiver's training program that was in the file. 4. A request for E4's personnel record revealed no personnel file for E4. 5. In an interview, E4 reported being hired on July 1, 2025, and having not completed any caregiver training program. 6. In an exit interview, the findings were reviewed with E1, and no additional information was provided.

Based on record review, documentation review, and interview, the manager failed to ensure a caregiver had the qualifications, experience, skills, and knowledge necessary to meet the needs of a resident. This deficient practice posed a health and safety risk to the residents. Findings include: 1. The Compliance Officer arrived at the facility around 8:30 AM. The Compliance Officer observed E2, E3, and E4. E2 and E3 identified themselves as caregivers, and E4 reported being an assistant caregiver. E2, E3, and E4 were at the facility alone with R1 and R2. E1 was not at the facility when the Compliance Officer arrived; however, E1 arrived at the facility around 1:30 PM. 2. A review of E2's personnel record revealed that E2 had been hired in March 2025. However, in an interview, E2 reported they had only been in Arizona since 2018 and had not taken any caregiver training program. 3. A review of E3's personnel record revealed that E3 had been hired in October 2025, and it also revealed a caregiver certificate dated May 2, 2013. However, in an interview, E3 reported that they had not taken the caregiver's training program that was in the file. 4. A request for E4's personnel record revealed no personnel file for E4. 5. In an interview, E4 reported being hired on July 1, 2025, and having not completed any caregiver training program. 6. In an exit interview, the findings were reviewed with E1, and no additional information was provided.

Based on observation, record review, and interview, the manager failed to ensure that a trained caregiver was present on the assisted living facility's premises when the manager was not present. The deficient practice posed a risk as no qualified employee was present to meet a resident's needs. Findings include: 1. The Compliance Officer arrived at the facility around 8:30 AM. The Compliance Officer observed E2, E3, and E4. E2 and E3 identified themselves as caregivers, and E4 reported being an assistant caregiver. E2, E3, and E4 were at the facility alone with R1 and R2. E1 was not at the facility when the Compliance Officer arrived; however, E1 arrived at the facility around 1:30 PM. 2. A review of E2's personnel record revealed that E2 had been hired in March 2025. However, in an interview, E2 reported they had only been in Arizona since 2018 and had not taken any caregiver training program. 3. A review of E3's personnel record revealed that E3 had been hired in October 2025, and it also revealed a caregiver certificate dated May 2, 2013. However, in an interview, E3 reported that they had not taken the caregiver's training program that was in the file. 4. A request for E4's personnel record revealed no personnel file for E4. 5. In an interview, E4 reported being hired on July 1, 2025, and having not completed any caregiver training program. 6. In an exit interview, the findings were reviewed with E1, and no additional information was provided.

Based on observation, record review, and interview, the manager failed to ensure a personnel record was established and maintained for each employee as required for one of four employees sampled. The deficient practice posed a risk as the required information could not be verified. Findings include: 1. The Compliance Officer arrived at the facility around 8:30 AM. The Compliance Officer observed E2, E3, and E4. E2 and E3 identified themselves as caregivers, and E4 reported being an assistant caregiver. E2, E3, and E4 were at the facility alone with R1 and R2. E1 was not at the facility when the Compliance Officer arrived; however, E1 arrived at the facility around 1:30 PM. 2 A request for E4's personnel record revealed no personnel file for E4. 3. In an exit interview, the findings were reviewed with E1, and no additional information was provided.

Based on record review and interview, the manager failed to ensure a resident accepted by the assisted living facility submitted documentation signed by a medical practitioner or a registered nurse that stated whether the individual required continuous medical services, continuous or intermittent nursing services, or restraints, for two of three residents sampled. The deficient practice posed a risk if the facility was unable to meet a resident's needs. Findings include: 1. A review of R1's (admitted in 2025) medical record revealed no documentation that stated whether the resident required continuous medical services, continuous or intermittent nursing services, or restraints. Based on R1's acceptance date, this documentation was required. 2. A review of R2's (admitted in 2017) medical record revealed no documentation that stated whether the resident required continuous medical services, continuous or intermittent nursing services, or restraints. Based on R2's acceptance date, this documentation was required. 3. In an exit interview, the findings were reviewed with E1, and no additional information was provided.

Based on observation and interview, the manager failed to ensure the premises were free from a condition or situation that could cause a resident or other individual to suffer physical injury. The deficient practice posed a risk to the physical health and safety of residents. Findings include: 1. During the environmental inspection of the facility, the Compliance Officer inspected R1's room closet and noticed a hole which was about a 6 inches in diameter in the closet ceiling covered by something black which appeared to resembled mold which had spread to about two feet of the closet ceiling. 2. In an interview, E1 reported there was a water leak which lead to the hole and mold in R1's closet. E1 reported neither the owner nor the licensee want to fix the mold issue in R1's room.

Based on an observation and interview, the manager failed to ensure oxygen containers were secured in an upright position. The deficient practice posed risk of a potential explosion or leak of a compressed gas. Findings include: 1. During a environmental inspection of the facility, the Compliance Officer observed in R2's room, the closet contained seven unsecured oxygen containers. 2. In an interview, E1 acknowledged the seven oxygen containers in R2's room closet were not secured in an upright position.

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 health and safety risk to residents with access to the poisonous or toxic materials. Findings include: 1. During the environmental inspection of the facility, the Compliance Officer observed the following in the backyard and accessible to residents: -two cans of "Rust-oleum Spray paint Crystal Clear"; -a 3 pack of "Clorox bleach"; - a two pack of " Easy-off Heavy Duty Oven and Grill Cleaner"; -twenty-three gallon containers of "Paint"; -four five-gallon buckets of "Paint"; -one "Round up spray." 2. In an interview, E1 acknowledged the poisonous or toxic materials were not stored in a locked location and accessible to residents.