Senita Ridge

Based on documentation review, record review, and interview, the governing authority failed to ensure the health, safety, or welfare of a resident was not placed at risk of harm. The deficient practice posed a risk as the facility was unaware of the general or specific whereabouts of a resident and the resident eloped from the facility. Findings include: 1. A review of Department documentation revealed the facility was authorized to provide directed care services. 2. A review of R2's medical record revealed a document titled "Resident Incident Report" dated August 5, 2025. This document stated "On 8/5/25 around 10:03pm Peoria Police Officer...notified the facility that resident [R2] was found wandering on 91st Ave and Lake Pleasant Pkwy around 8:87PM (sic)..The officer called EMS due to residents current condition and symptoms and resident was transported to Arrowhead Hospital...Hospital dx dehydration, dementia, heat stress, pneumonia..." 3. In an interview, E1 and E2 reported R2 eloped from the facility through the south side door. At the time of the elopement, the south door sounded, however staff did not respond. 4. A review of an internal investigation document revealed E4 reported E4 was in a resident's room administering medications around 7PM. E4 continued, E4 did not respond to the alarm because another resident told E4 that the alarm was malfunctioning from the day before and didn't respond. E4 also reported that E4 asked caregivers to check and make sure all of the residents were in bed. 5. In an exit interview, the findings were reviewed with E1, and no additional information was provided.

Based on record review, interview, and documentation review, the manager failed to ensure a personnel record for each caregiver included documentation of cardiopulmonary resuscitation (CPR) training, which included a demonstration of the individual's ability to perform CPR, before providing assisted living services, for one of two employees reviewed. The deficient practice posed a risk if an employee was unable to meet a resident's needs during an emergency. Findings include: 1. A review of E3's personnel record revealed a CPR card that was obtained from "NationalCPRFoundation" issued on January 22, 2025. There was no other current documentation of CPR training available for review that included a demonstration of E3's ability to perform CPR. 2. In an email exchange, a representative from NationalCPRFoundation stated, "Our courses are online only." 3. A documentation review revealed the employee schedule, dated from January 21, 2025 to July 29, 2025, showed E3 had worked the following days: -January 21st, 23rd, 29th; -February 3rd, 5th, 6th, 8th, 11th, 20th, 26th, 27th; -March 5th, 6th, 26th, 27th; -April 2nd, 3rd, 4th, 9th, 10th, 21st, 23rd, 24th, 25th, 28th, 30th; -May 1st, 5th, 7th, 8th,12th, 22nd, 28th, 29th; -June 4th, 5th, 11th, 12th, 23rd, 25th, 26th, 27th, 30th; and -July 2nd, 3rd, 4th, 9th, 10th, 13th, 23rd, 24th, and 25th. 4. In an interview, E2 reported that E2 was unaware that online classes were not acceptable. 5. In an interview, E2 stated that E3 covered the day shift and the night shift. 6. In an exit interview, the findings were reviewed with E2, and no additional information was provided.