Maryland Gardens Assisted Living

Based on observation and interview, the manager failed to ensure there was a current toxicology reference guide that was available for use by personnel members. Findings include: 1. The Compliance Officer requested the current toxicology reference guide. However, the toxicology reference guide was not provided to the department for review. 2. In an interview, E1 acknowledged that the facility did not have a toxicology reference guide available for use by personnel members

Based on documentation review and interview, the manager failed to ensure documentation of the monthly testing of the facility's smoke detectors was maintained for at least 12 months after the date of the test. The deficient practice posed a risk to the health and safety of residents if the fire alarm system was not working properly. Findings include: 1. During a review of facility documentation the surveyor requested documentation indicating smoke detectors at the facility were tested each month. No documentation was provided. 2. In an interview, E1 acknowledged there was no documentation indicating the facility's smoke detectors were tested monthly.

Based on record review and interview, before or within five working days after a resident's acceptance by an assisted living facility, the manager failed to obtain on the residency agreement, the signature of the resident, the resident's representative, the resident's legal guardian, or another individual who has been designated by the individual under A.R.S § 36-3221 to make health care decisions on the individual's behalf for one of three residents sampled. Findings include: 1. A review of R1's medical record revealed a residency agreement; however, the residency agreement was not signed by R1 or R1's representative. Based on R1's acceptance date , this documentation was required. 2. In an interview, E1 acknowledged that R1 residency agreement did not include the signature of the resident or the resident's representative.