Inspection Reports for Gems Assisted Living II
2136 Senita Dr, Lake Havasu City, AZ 86403, USA, AZ, 86403
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Inspection Report
Annual Inspection
Capacity: 6
Deficiencies: 16
Apr 8, 2025
Visit Reason
State-compiled facility profile showing 2 inspections from 2024-01 to 2025-04 with deficiency history including complaint and annual compliance inspections.
Findings
Across two inspections, multiple deficiencies were found including failure to provide required staff training, inadequate documentation and certification, environmental safety issues, medication administration errors, and noncompliance with licensing requirements.
Complaint Details
Complaint investigation AZ00205459 was conducted on January 29, 2024, resulting in multiple deficiencies related to care, safety, and compliance.
Deficiencies (16)
| Description |
|---|
| A.R.S. § 36-420.01.A. Health care institutions; fall prevention and fall recovery; training programs; definition: Failed to administer a training program for all staff regarding fall prevention and fall recovery. |
| R9-10-113.A.2.a-f. Tuberculosis Screening: Failed to implement tuberculosis infection control activities including annual training and education on TB signs and symptoms for personnel. |
| R9-10-806.A.10. Personnel: Failed to ensure manager provided current documentation of first aid and CPR training certification specific to adults before providing assisted living services. |
| R9-10-819.A.10. Environmental Standards: Failed to ensure oxygen containers were secured in an upright position. |
| R9-10-819.A.11. Environmental Standards: Failed to ensure poisonous or toxic materials were maintained in labeled containers in a locked area inaccessible to residents. |
| 36-420. Health care institutions; cardiopulmonary resuscitation; first aid; immunity; falls; definition: Failed to provide appropriate first aid before EMS arrival to a non-injured resident who had fallen and was unable to recover independently. |
| A. A governing authority shall: 9. Ensure compliance with A.R.S. § 36-411: Failed to ensure compliance with fingerprint clearance card requirements for personnel. |
| C. A manager shall ensure that policies and procedures are: 1.j.i. Cover termination of residency, including termination initiated by the manager: Failed to implement policies and procedures covering termination of residency as required. |
| C. A manager shall ensure that policies and procedures are: 1.m. Cover methods by which the assisted living facility is aware of the whereabouts of a resident: Failed to establish and implement policies and procedures to monitor resident whereabouts. |
| A. A manager shall ensure that: 5. An assisted living facility has qualified caregivers to provide services and ensure resident health and safety: Failed to ensure caregivers had necessary qualifications and skills. |
| A. A manager shall ensure that: 10. Manager or caregiver provides current documentation of first aid and CPR training certification before providing services: Failed to ensure caregivers had current certifications. |
| D. Before or at acceptance, manager shall ensure documented residency agreement includes whether manager or caregiver is awake during nighttime hours: Failed to include this in residency agreement. |
| F. Manager shall ensure means of exiting facility for residents without keys or special knowledge controls or alerts employees of egress: Failed to ensure means of exit controlled or alerted staff. |
| B. Manager shall ensure medication administered complies with medication orders: Failed to administer medications as ordered for residents. |
| F. Manager shall ensure medication stored in separate locked area used only for medication storage: Failed to store medication securely. |
| R9-10-110. Modification of a Health Care Institution: Failed to submit request for approval of modification for building used as resident bedroom not licensed. |
Report Facts
Inspections on page: 2
Total deficiencies: 16
Complaint inspections: 1
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| E2 | Manager | Named in multiple findings including lack of training, expired certifications, and interview statements |
| E4 | Caregiver | Named in findings related to fingerprint clearance card noncompliance and training deficiencies |
| E5 | Caregiver and Housekeeper | Named in findings related to lack of training |
| E6 | Caregiver | Named in findings related to lack of training |
| Charlene Pruden | Licensed Manager | Person responsible for corrective actions in deficiencies |
| Tiffany Shaputis | House Manager | Person responsible for corrective actions in deficiencies |
| Carlos Serrano | House Manager | Person responsible for corrective actions in deficiencies |
| Vilma Urbina | Owner | Person responsible for corrective actions in deficiencies |
| E1 | Interviewed in relation to multiple findings | |
| E3 | Caregiver | Named in findings related to expired first aid and CPR certification |
| R1 | Resident | Referenced in medication and residency termination findings |
| R2 | Resident | Referenced in residency agreement and medication findings |
| R5 | Resident | Referenced in fall and caregiver qualification findings |
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