Complaint Investigation Report

LPA conducted interviews with an additional ten (10) residents and three (3) staff members. On 10/16/2026 LPA Rios conducted an interview with an additional resident. On 05/06/2026 LPA Rios requested and obtained copies of R1’s documents such as Physician’s Report (LIC602), and Resident Appraisal from the facility.

The investigation revealed the following:

Regarding the allegation, staff discriminate against a resident in care . It is alleged that staff treated a resident differently from other residents. LPA’s interview with sixteen (16) out of twenty (20) residents stated they had not been discriminated against by staff. Three (3) residents stated they may have experienced discrimination at some point in the past by staff but were not sure when. They reported they don’t feel that way now. One (1) resident stated they felt staff were friendlier toward other residents than toward them. The residents could not provide a timeframe, identify who was involved, or describe any specific discriminatory actions. Interviews with nine (9) staff denied any discriminatory conduct and stated they have not witnessed residents being discriminated against by other staff. Staff also reported not receiving complaints from residents related to discrimination.

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 at this time.

Regarding the allegation, staff do not treat a resident with dignity. It is alleged staff ridiculed resident in care. Interviews with seventeen (17) out of twenty (20) residents stated they had not been made fun of by staff. Two (2) residents stated they believed staff talk among themselves and felt staff laugh at them but could not hear what is said. Interviews with nine (9) staff indicated they have not made jokes about residents nor witnessed other staff making jokes or inappropriate comments toward residents. Staff reported they feel comfortable bringing any concerns to management or addressing the issue directly with the staff involved.

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 at this time.