Complaint Investigation Report

ALLEGATION: Staff did not properly report an incident involving the residents

During investigation, the department conducted interviews of facility staff (ADM), residents (R1, R2), reporting party (RP) and reviewed R1 & R2 documents.

On 03/24/25 at 10AM, LPA interviewed reporting party (RP) who stated that R1 and R2 had a physical altercation the evening of 02/16/25 and also the next morning before breakfast in their bedroom resulting in R2 sustaining bruising in his right cheek and a cut to his nose.

On 03/27/25 at 1PM, ADM confirmed with LPA that they failed to timely report the incident to Community Care Licensing (CCLD) and Ombudsman (OMB) within the required 48 hours timeline. Based on observations and interviews which were conducted and record review(s), the department has substantiated the allegation that staff did not properly report an incident involving residents. The preponderance of evidence standard has been met. Therefore, the above allegation was found to be substantiated.

Continued on the next page, LIC 9099-C pg2