Complaint Investigation Report

Unqualified staff providing care to residents

Staff did not receive on the job training

LPA reviewed a sample of staff training for year 2022 and observed that staff have initial and/or annual training including dementia, medication administration, and caregiver shadowing.

Staff did not prevent resident from engaging in dangerous activities

Interview with staff indicated there was no residents that left the facility and climb on the roof in summer of 2022. Staff stated that R5 attempted to climb out of the bedroom window from the second floor last year, but staff was able to intervene and prevented R5 from climbing out of the window. Facility windows have window screens.

Staff did not prevent residents from wandering from the facility

Interview with residents and staff indicated that no resident wandered outside of the facility and was found on the street in summer of 2022. Staff stated that a resident wandered outside the building, but staff followed the resident and redirected them back inside the facility.

Staff did not check on residents in a timely manner

Interview with staff revealed that residents are checked every 2 hours for incontinence care. Staff stated that residents have pendents and response time is 5-10 minutes.

Although the allegations may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did occur, therefore the allegations are UNSUBSTANTIATED .

Exit interview conducted. A copy of this report provided.