Royalty Home Care Solutions, LLC

Based on record review and interview, the manager failed to ensure that the service plan for a resident receiving directed care services included documentation of the resident’s weight or from a medical practitioner indicating that weighing the resident was contraindicated, for one of two residents sampled. Findings include: 1. A review of R2’s medical record revealed a service plan update dated March 26, 2025. However, R2’s service plan did not include R2’s weight or documentation from R2’s medical practitioner stating that weighing R2 was contraindicated. 2. In an interview, E1 acknowledged that R2’s medical record did not include the resident’s weight or documentation from a medical practitioner stating that weighing the resident was contraindicated.

Based on observation and interview, the manager failed to ensure that medication stored by the facility was stored in a separate locked room, closet, cabinet, or self-contained unit used only for medication storage. The deficient practice posed a risk to residents who were unable to self-administer medications. Findings include: 1. During an environmental tour of the facility, the Compliance Officers observed the following materials stored in R3's bedroom closet: Antifungal Powder with Miconazole Nitrate 2%; Clotrimazole and Betamethasone Dipropionate Cream; Thera Antifungal Body Powder; Mupirocin Ointment; and Triamcinolone Cream. 2. In an interview, E1 acknowledged medication stored by the facility was not stored in a separate locked room, closet, cabinet or self-contained unit used only for medication storage.

Based on observation, documentation review, and interview, the manager failed to ensure that a rechargeable fire extinguisher was serviced at least every 12 months and had a tag attached to the fire extinguisher that specified the date of the last servicing. Findings include: 1. While on-site for the compliance inspection, the Compliance Officers observed a rechargeable fire extinguisher mounted on the wall in a hallway of the facility. However, the extinguisher did not have a tag attached that specified the date of the last servicing. 2. A review of facility documentation revealed documentation that the aforementioned fire extinguisher was purchased on January 13, 2020. 3. In an interview, E1 reported that E1 was unaware of the requirement for service. E1 acknowledged that a rechargeable fire extinguisher was not serviced at least once every 12 months.

Based on observation and interview, the manager failed to ensure that the premises and equipment used at the assisted living facility were free from a condition or situation that may cause a resident or other individual to suffer physical injury. The deficient practice poses a health and safety risk to residents. Findings include: 1. During an environmental tour of the facility, the Compliance Officers observed the following materials stored in the facility's backyard: A hose, draped across the facility's walkway; Landscaping scraps; Empty planters; and An empty storage bucket. 2. The Compliance Officers also observed the following materials leaning against the facility's outdoor shed: Two shovels; A rake; Unused wire fencing; Flooring materials; A hand truck or dolly; Cardboard scraps; and Other building materials. 3. In an interview, E1 acknowledged that the premises and equipment used at the facility were not free from a condition or situation that may cause a resident or other individual to suffer physical injury.

Based on documentation review, observation, and interview, the manager failed to ensure that poisonous or toxic materials stored by the assisted living facility were maintained in a locked area and were inaccessible to residents. The deficient practice posed a risk to the physical health and safety of a resident. Findings include: 1. During an environmental tour of the facility, the Compliance Officers observed a container of Lysol Disinfecting Wipes stored in an unlocked cabinet in a shared resident bathroom. 2. The Compliance Officers also observed a container of Great Value Glass Cleaner stored in the facility's unlocked laundry room. 3. The Compliance Officers also observed the following materials stored on a shelf in the facility's unlocked garage: WD-40 Spray; Plastic Wood-X Wood Filler; and Hormex Rooting Powder. 4. In an interview, E1 acknowledged that the toxic materials stored by the facility were not maintained in a locked area and were not inaccessible to residents.

Based on observation, documentation review, and interview, the manager failed to ensure that a pest control program that complied with A.A.C. R3-8-20l(C)(4) was implemented and documented. Findings include: 1. While on-site for the compliance inspection, the Compliance Officers observed the facility's pantry to have ants crawling throughout. 2. The Compliance Officers also observed the facility's windowsill to have crawling and dead ants. 3. A review of the facility's pest control documentation revealed a receipt from February 10, 2023. However, additional documentation was not available for review. 4. In an interview, E1 reported the facility had not received pest control treatments since 2023. E1 acknowledged that a pest control program that complied with A.A.C. R3-8-20l(C)(4) was not implemented and documented.