Complaint Investigation Report

Allegation: Staff member physically abused resident in care.

The investigation revealed the following:

The complaint alleged that the facility failed to protect a resident from physical abuse when staff allegedly struck a resident on the left eye.

During staff interviews, staff denied witnessing or being aware of any physical altercation involving the resident. Staff reported they did not observe any injuries, bruising, or swelling to the resident’s eye. Staff stated the resident did not report being struck or injured to them during their shifts. Staff further reported they did not hear or observe any disturbances involving the resident and were not aware of any issues related to the resident’s television. S1 was interviewed via cell phone, as staff had been removed from duty. S1 stated the incident occurred on a Saturday 1/3/26 at approximately 10:28 p.m., at the start of their shift. S1 reported entering the bedroom shared by R1 and R2 to check R2’s blood sugar and believed R1 was asleep. S1 stated R1 later turned the television on at a loud volume, causing other residents to become upset. S1 reported asking R1 to lower the volume, but R1 refused and stated, “Don’t touch my property.” S1 admitted to disconnecting the television to reduce the noise and calm other residents. S1 stated R1 said, “I will make sure you don’t have a job by Monday.” S1 denied physically harming or touching R1. During the resident interview, the resident stated that S1 struck them with his right and left fist, causing injury to the resident’s eye. The resident reported the incident occurred at night in their bedroom while watching television and stated that no one witnessed the incident. The resident stated that their eye hurt and asked whether it appeared dark. The resident reported that they feel safe with other staff and stated that they like their home.

During the investigation, the LPA reviewed staff schedules, client and staff rosters, the resident’s face sheet, Individual Program Plan (IPP), daily progress notes, and behavioral data frequency logs. No documentation was found indicating an observed injury to the resident’s eye. Law enforcement responded to the facility on 01/05/2026 and interviewed staff. S1 was removed from duty on 01/05/2026 pending further action. The alleged incident was not witnessed, and there were no documented reports of injury observed by staff.

Based on the investigation conducted, including interviews with staff and resident and review of relevant records, there was insufficient evidence to support the reported allegation. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is UNSUBSTANTIATED . Exit interview was held, and a copy of this report was provided.