Inspection Reports for Lake View Terrace Memory Care Residence
320 Lake Havasu Avenue North, Lake Havasu City, AZ 86403, AZ, 86403
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Inspection Report
Complaint Investigation
Capacity: 72
Deficiencies: 25
Feb 25, 2025
Visit Reason
State-compiled facility profile showing 6 inspections from 2024-01 to 2025-02 with deficiency history and complaint investigations.
Findings
Across six inspections, multiple deficiencies were cited including failures in documentation of tuberculosis freedom, residency agreements, medication administration compliance, caregiver qualifications, and incident documentation. Some inspections found no deficiencies, while others revealed repeated and new violations posing risks to resident health and safety.
Complaint Details
Multiple complaint investigations were conducted on 2024-01-30 to 2025-02-25 involving various complaint numbers including 00105652, 00104353, 00103975, 00108616, 00108576, AZ00214623, AZ00213517, AZ00212951, AZ00212098, AZ00211686, AZ00211491, AZ00210715, AZ00210574, AZ00210391, AZ00210182, AZ00209042, AZ00206161, AZ00206200, and AZ00206669.
Deficiencies (25)
| Description |
|---|
| A. Except as provided in R9-10-808(B)(2), a manager shall ensure that a resident provides evidence of freedom from infectious tuberculosis: 1. Before or within seven calendar days after the resident's date of occupancy, and 2. As specified in R9-10-113. |
| B. A manager shall ensure that before or at the time of acceptance of an individual, the individual submits documentation that is dated within 90 calendar days before the individual is accepted by an assisted living facility and: 1. If an individual is requesting or is expected to receive supervisory care services, personal care services, or directed care services: a. Includes whether the individual requires: i. Continuous medical services, ii. Continuous or intermittent nursing services, or iii. Restraints; and b. Is dated and signed by a: i. Physician, ii. Registered nurse practitioner, iii. Registered nurse, or iv. Physician assistant; and |
| D. Before or at the time of an individual's acceptance by an assisted living facility, a manager shall ensure that there is a documented residency agreement with the assisted living facility that includes: 1. The individual's name; 2. Terms of occupancy, including: a. Date of occupancy or expected date of occupancy, b. Resident responsibilities, and c. Responsibilities of the assisted living facility; 3. A list of the services to be provided by the assisted living facility to the resident; 4. A list of the services available from the assisted living facility at an additional fee or charge; 5. For an assisted living home, whether the manager or a caregiver is awake during nighttime hours; 6. The policy for refunding fees, charges, or deposits; 7. The policy and procedure for a resident to terminate residency, including terminating residency because services were not provided to the resident according to the resident's service plan; 8. The policy and procedure for an assisted living facility to terminate residency; 9. The complaint process; and 10. The manager's signature and date signed. |
| A. Except as required in subsection (B), a manager shall ensure that a resident has a written service plan that: 4. Is reviewed and updated based on changes in the requirements in subsections (A)(3)(a) through (f): b. As follows: iii. At least once every three months for a resident receiving directed care services; |
| A. Except as required in subsection (B), a manager shall ensure that a resident has a written service plan that: 5. When initially developed and when updated, is signed and dated by: a. The resident or resident's representative; |
| A. Except as required in subsection (B), a manager shall ensure that a resident has a written service plan that: 1. Is completed no later than 14 calendar days after the resident's date of acceptance; 2. Is developed with assistance and review from: a. The resident or resident's representative, b. The manager, and c. Any individual requested by the resident or the resident's representative; 3. Includes the following: a. A description of the resident's medical or health problems, including physical, behavioral, cognitive, or functional conditions or impairments; b. The level of service the resident is expected to receive; c. The amount, type, and frequency of assisted living services being provided to the resident, including medication administration or assistance in the self-administration of medication; d. For a resident who requires intermittent nursing services or medication administration, review by a nurse or medical practitioner; e. For a resident who requires behavioral care: i. Any of the following that is necessary to provide assistance with the resident's psychosocial interactions to manage the resident's behavior: (1) The psychosocial interactions or behaviors for which the resident requires assistance, (2) Psychotropic medications ordered for the resident, (3) Planned strategies and actions for changing the resident's psychosocial interactions or behaviors, and (4) Goals for changes in the resident's psychosocial interactions or behaviors; and ii. Review by a medical practitioner or behavioral health professional; and f. For a resident who will be storing medication in the resident's bedroom or residential unit, how the medication will be stored and controlled; 4. Is reviewed and updated based on changes in the requirements in subsections (A)(3)(a) through (f): a. No later than 14 calendar days after a significant change in the resident's physical, cognitive, or functio |
| C. A manager shall ensure that a resident's medical record contains: 4. The date of acceptance and, if applicable, date of termination of residency; |
| B. If an assisted living facility provides medication administration, a manager shall ensure that: 3. A medication administered to a resident: b. Is administered in compliance with a medication order, and |
| A. A manager shall ensure that: 5. An assisted living facility has a manager, caregivers, and assistant caregivers with the qualifications, experience, skills, and knowledge necessary to: b. Meet the needs of a resident; and |
| D. When a resident has an accident, emergency, or injury that results in the resident needing medical services, a manager shall ensure that a caregiver or an assistant caregiver: 2. Documents the following: c. The names of individuals who observed the accident, emergency, or injury; |
| 36-420.04. Emergency responders; patient information; hospitals; discharge planning; patient screenings; discharge document D. An assisted living center or assisted living home shall maintain a copy of the document provided to the emergency responder and documentation of the actions required by subsection B of this section for a period of two years after the date of the emergency. |
| A. A governing authority shall: 9. Ensure compliance with A.R.S. § 36-411. |
| A. A manager shall ensure that: 10. Before providing assisted living services to a resident, a manager or caregiver provides current documentation of first aid training and cardiopulmonary resuscitation training certification specific to adults. |
| A. A manager shall ensure that a resident has a written service plan that: 5. When initially developed and when updated, is signed and dated by: a. The resident or resident's representative; |
| C. A manager shall ensure that: 1. A caregiver or an assistant caregiver: g. Documents the services provided in the resident's medical record; and |
| A. A manager shall ensure that: 2. Meals and snacks provided by the assisted living facility are served according to posted menus; |
| D. When a resident has an accident, emergency, or injury that results in the resident needing medical services, a manager shall ensure that a caregiver or an assistant caregiver: 2. Documents the following: f. Any action taken to prevent the accident, emergency, or injury from occurring in the future. |
| A. A governing authority shall: 3. Designate, in writing, a manager who: b. Except for the manager of an adult foster care home, has either a: i. Certificate as an assisted living facility manager issued under A.R.S. § 36-446.04(C), or ii. A temporary certificate as an assisted living facility manager issued under A.R.S. § 36-446.06; |
| A. A governing authority shall: 9. Ensure compliance with A.R.S. § 36-411. |
| A. A manager shall ensure that: 10. Before providing assisted living services to a resident, a manager or caregiver provides current documentation of first aid training and cardiopulmonary resuscitation training certification specific to adults. |
| A. A manager shall ensure that: 8. A manager, a caregiver, and an assistant caregiver, or an employee or a volunteer who has or is expected to have more than eight hours per week of direct interaction with residents, provides evidence of freedom from infectious tuberculosis: a. On or before the date the individual begins providing services at or on behalf of the assisted living facility, and b. As specified in R9-10-113; |
| A. A manager shall ensure that: 9. Before providing assisted living services to a resident, a caregiver or an assistant caregiver receives orientation that is specific to the duties to be performed by the caregiver or assistant caregiver; and |
| B. If an assisted living facility provides medication administration, a manager shall ensure that: 3. A medication administered to a resident: b. Is administered in compliance with a medication order, and |
| D. When a resident has an accident, emergency, or injury that results in the resident needing medical services, a manager shall ensure that a caregiver or an assistant caregiver: 1. Immediately notifies the resident's emergency contact and primary care provider; and |
| D. When a resident has an accident, emergency, or injury that results in the resident needing medical services, a manager shall ensure that a caregiver or an assistant caregiver: 2. Documents the following: a. The date and time of the accident, emergency, or injury; b. A description of the accident, emergency, or injury; c. The names of individuals who observed the accident, emergency, or injury; d. The actions taken by the caregiver or assistant caregiver; e. The individuals notified by the caregiver or assistant caregiver; and f. Any action taken to prevent the accident, emergency, or injury from occurring in the future. |
Report Facts
Inspections on page: 6
Total deficiencies: 28
Complaint inspections: 6
Total capacity: 72
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| E1 | Named in multiple findings related to management, documentation, and compliance failures | |
| E2 | Named in findings related to tuberculosis documentation and service plan acknowledgments | |
| E3 | Caregiver | Named in findings related to tuberculosis screening, orientation, and qualifications |
| E4 | Assistant Caregiver / Caregiver | Named in findings related to fingerprint clearance, skills verification, and qualifications |
| E5 | Caregiver/Medication Technician | Named in findings related to tuberculosis screening, orientation, and fingerprint clearance |
| E6 | Assistant Caregiver | Named in findings related to fingerprint clearance, orientation, and skills verification |
| O1 | Named as emergency room doctor and contact person in medication and emergency findings |
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