Complaint Investigation Report

The investigation consisted of the following continued: A tour of the facility was conducted on 03/21/2024 at 10:23 am. LPA España interviewed Resident 1- Resident 5 (R1-R5). LPA España interviewed Staff 1-Staff 3 (S1-S3). LPA Espana requested and received the following documents: Staff and resident roster; SIR reports; dated weekly employee time schedule; RCFE license certificate; verification of first aid training; criminal record statement; verification of staff training; personal rights; client resident personal property and valuables; centrally stored medication and destruction record; identification and emergency information; physician's report; resident appraisal; admission agreement; home health agency (list of all who provide services to residents/contact information); daily notes/staff notes/facility notes (1-month records); records or procedures of eviction; records of all evictions (log records) of the past 1 month (30 days); records of diapers or pull-ups of all residents in the facility and other pertinent records associated with this complaint.

The investigation revealed the following:

Allegation: Staff behavior is preventing a resident from sleeping.

Administrator Josephine Hauf was interviewed by LPA España on 03/21/2024 at 9:07 am. Administrator stated that the night shift is managed by the Administrator and that staff do not prevent residents from sleeping. Administrator mentioned a ratio of 10 residents to 3 staff members, with herself covering the night shift. LPA España interviewed Resident 1- Resident 5 (R1-R5). LIC9099 Continued