Parc Joule Assisted Living Home

Based on observation, record review, and interview, the manager failed to designate, in writing, a caregiver who was present on the facility's premises and accountable for the facility when the manager was not present, as the manager's designee. Findings include: 1. When the compliance officer arrived at the facility, the manager was not present. 2. The compliance officer observed E4's manager's certificate conspicuously posted, however, there was no documentation by E4 available for review that indicated that E3, who was the only employee working at the facility, as the manager's designee when the manager was not present at the facility. 3. Review of E3's personnel record indicated that E3 was hired on May 29, 2023 and was a certified caregiver, however, was not designated as a manager's designee. 4. Later when E1 arrived at the facility, E1 acknowledged that E4 had not designated E3 as a manager's designee.

Based on observation and interview, the manager failed to ensure the location at which a copy of the most recent Department inspection report and any plan of correction resulting from the Department inspection may be viewed was conspicuously posted. Findings include: 1. During a facility tour, E1 and the compliance officer observed no posted notification of the location of the most recent Department inspection report and any plan of correction resulting from the inspection. The definition of "conspicuously posted" per the definition in A.A.C. R9-10-101(54) as a visible and available area that the public enters the premises of the health care institution. 2. In an interview, E1 acknowledged the required inspection notice was not conspicuously posted as required. Technical assistance was provided during the initial inspection conducted on October 28, 2022.

Based on observation, record review, and interview, the manager failed to ensure that a bell, intercom, or other mechanical means to alert employees to a resident's needs or emergencies is available in a bedroom being used by one of four sampled residents receiving directed care services; which posed a health and safety risk. Findings include: 1. During a facility tour, E1 and the surveyor observed R4's bedroom was not equipped with bell, intercom, or other mechanical means to alert employees to a resident's needs or emergencies. 2. Review of R4's medical record indicated that R4 was unable to ambulate even with assistance and was receiving directed care services. 3. In an interview, E1 acknowledged the sampled resident's bedroom was not equipped with a working bell or other mechanical means available to the residents to alert employees of a residents' needs.

Based on observation and interview, the manager failed to ensure there was a means of exiting the facility for a resident who does not have a key, special knowledge for egress, or the ability to expend increased physical effort that provides access to an outside area that controls or alerts employees of the egress of a resident from the facility, which posed a safety risk to residents. The facility is licensed to provided directed care services. Findings include: 1. During a facility tour of the residents' proposed secured outdoor area where residents may walk, E3 and the compliance officer observed the exit gate from this proposed secured outdoor area could easily be opened that led to the front of the facility and the City street. There were no activated alarms to alert the employees of the egress of a resident from the facility. 2. In an interview, E1 and E3 acknowledged the unsecured outdoor area.

Based on observation and interview, the manager failed to ensure medications stored by the facility were stored in a locked room, closet, cabinet, or self-contained unit; which posed a health and safety risk. Findings include: 1. During a facility tour, E1, E3, and the compliance officer observed in the facility's unlocked garage in an unlocked refrigerator there was stored Robitussin liquid, Ozempic insulin pens, cold and mucus liquid, and allergy relief liquid. 2. In an interview, E1, E2, and E3 acknowledged the unlocked medications the facility was storing.

Based on documentation review and interview, the manager failed to ensure an employee disaster drill was conducted at least once every three months on each shift and documented. Findings include: 1. During an interview, E1 reported the facility had two shifts: First shift from 6:30 AM to 6:30 PM, and the second shift from 6:30 PM to 6:30 AM. 2. Review of the employee disaster drill documentation for the past 12 months revealed no employee disaster drills were conducted on the second shift. 3. In an interview, E1 acknowledged there were no employee disaster drills conducted on the second shift during the past 12 months as required.

Based on record review and interview, the manager failed to ensure a resident's orientation to the exits from the assisted living facility and the route to be used when evacuating the assisted living facility was completed within 24 hours after the resident's acceptance by the facility and documented; for four of four sampled residents' records reviewed, which posed a safety risk. Findings include: 1. Review of R1's, R2's, R3's, and R4's records, based on their dates of acceptance, revealed there was no documentation indicating the sampled residents received orientation to the exits from the facility and the route to be used when evacuating the facility within 24 hours after the resident was accepted by the facility. 2. During an interview, E1 acknowledged there was no documentation to indicate the sampled residents had received evacuation orientation to the exits from the facility within 24 hours after the residents' acceptance, nor anytime since.