Nurtured Valley Assisted Living, LLC

Based on documentation review, observation, and interview, for a facility authorized to provide directed care services, the manager failed to ensure there was a means of exiting the facility that provided access to an outside area from which a resident could exit to a location at least 30 feet away from the facility and controlled or alerted employees of the egress of a resident from the facility. The deficient practice posed a risk if the facility was unaware of the general or specific whereabouts of a resident. Findings include: 1. A review of Department records revealed the facility was licensed to provide directed care services. 2. During the environmental tour, the Compliance Officer observed a sliding glass door leading to the backyard. The door was unsecured, and the device to alert employees of a resident's egress from the facility was previously available; however, it was not present at the door during the inspection. 3. During the environmental tour, the Compliance Officer observed another door adjacent to the sliding doors leading to the backyard. The door was unsecured, and the device to alert employees of a resident's egress from the facility was previously available; however, it was not present at the door during the inspection. 4. A review of facility policies and procedures revealed a policy titled "Safety of Wandering Residents," the policy stated "If alarms are being used on doors and or windows, the caregiver will check them daily for operation and security. Alarms that are triggered will be investigated immediately by the caregiver on duty." 5. In an interview, E1 and E2 acknowledged a means of exiting the facility to an outside area did not control or alert employees of the egress of a resident from the facility.

Based on observation and interview, the manager failed to ensure the bathroom accessible from a common area contained paper towels in a dispenser or a mechanical air hand dryer. The deficient practice posed a potential risk to infection control. Findings include: 1. During the environmental tour, the Compliance Officer observed there were no paper towels in a dispenser or a mechanical air hand dryer available for two bathrooms in a common area used by residents, personnel and visitors. 2. In an interview, E1 acknowledged the bathrooms accessible from the common area did not contain paper towels in a dispenser or a mechanical air hand dryer.