Inspection Reports for Blue Sky Manor Assisted Living & Memory Care
1510 W 5th Pl, Mesa, AZ 85201, USA, AZ, 85201
Back to Facility ProfileDeficiencies (last 1 years)
Deficiencies (over 1 years)
16 deficiencies/year
Deficiencies are regulatory violations found during state inspections.
332% worse than Arizona average
Arizona average: 3.7 deficiencies/yearDeficiencies per year
16
12
8
4
0
Enforcement Action
Enforcement
Fines: 3
Total: $1,750.00
Oct 25, 2023
Summary
The enforcement resulted in civil fines totaling $1,750 for multiple violations including inadequate personnel records, missing service plans for residents, and providing false or misleading documentation.
Fines & Penalties (3)
| Amount | Reason | Status |
|---|---|---|
| $250.00 | Failure to ensure personnel records included documentation of skills and knowledge for two caregivers | — |
| $500.00 | Failure to ensure two residents had written service plans completed within 14 calendar days | — |
| $500.00 | Repeat deficiency for failure to ensure caregiver documented services in medical records and providing false or misleading documentation | — |
Enforcement Action
Enforcement
Fines: 1
Total: $1,750.00
Oct 10, 2023
Summary
The enforcement resulted in a fine of $1,750.00 which has been paid in full.
Fines & Penalties (1)
| Amount | Reason | Status |
|---|---|---|
| $1,750.00 | Fine imposed as part of enforcement action | Paid |
Inspection Report
Complaint Investigation
Capacity: 10
Deficiencies: 16
Sep 18, 2023
Visit Reason
Inspection history summary covering complaint and compliance inspections
Findings
Multiple deficiencies found related to management failures in policy review, documentation, personnel records, resident service plans, medication administration, food storage, disaster planning, premises safety, and tuberculosis screening.
Complaint Details
Complaint AZ00194259 investigated on September 18, 2023
Deficiencies (16)
| Description |
|---|
| C. A manager shall ensure that policies and procedures are: 3. Reviewed at least once every three years and updated as needed. |
| E. A manager shall ensure that documentation required by this Article is provided to the Department within two hours after a Department request. |
| A. A manager shall ensure that documentation is maintained for at least 12 months after the last date on the documentation of the caregivers and assistants. |
| C. A manager shall ensure that a personnel record for each employee or volunteer includes documentation of the individual's qualifications and skills. |
| C. A manager shall not accept or retain an individual if the facility cannot provide the assisted living services needed. |
| G. A manager may terminate residency of a resident as follows: without notice if the resident exhibits behavior that is an immediate threat. |
| A. Except as required in subsection (B), a manager shall ensure that a resident has a written service plan completed no later than 14 calendar days after acceptance. |
| C. A manager shall ensure that a caregiver or assistant caregiver provides assistance with activities of daily living according to the resident's service plan. |
| C. A manager shall ensure that a caregiver or assistant caregiver documents the services provided in the resident's medical record. |
| C. A manager shall ensure that a resident's medical record contains required resident information. |
| B. If an assisted living facility provides medication administration, a manager shall ensure medication is administered in compliance with orders. |
| C. A manager shall ensure that food is obtained, prepared, served, and stored properly including refrigerator thermometer use. |
| A. A manager shall ensure that the disaster plan required is reviewed at least once every 12 months. |
| A. A manager shall ensure that the premises and equipment are free from conditions that may cause harm. |
| A. A manager shall ensure hot water temperatures are maintained between 95º F and 120º F in resident areas. |
| R9-10-113. Tuberculosis Screening: The health care institution must implement tuberculosis infection control measures. |
Report Facts
Total inspections: 1
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| TAMARA PULVER | Administrator | Named as facility administrator in relation to management deficiencies |
Enforcement Action
Enforcement
Fines: 1
Total: $250.00
Jan 17, 2023
Summary
A fine of $250.00 was imposed and has been paid in full.
Fines & Penalties (1)
| Amount | Reason | Status |
|---|---|---|
| $250.00 | Fine imposed as part of enforcement action | Paid |
Enforcement Action
Enforcement
Fines: 1
Total: $250.00
Oct 24, 2022
Summary
The enforcement outcome resulted in a civil fine for the facility due to failure to document services provided to a resident, which was a repeat deficiency from a prior inspection.
Fines & Penalties (1)
| Amount | Reason | Status |
|---|---|---|
| $250.00 | Civil fine for failure to document services provided to one resident, a repeat deficiency. | — |
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