Complaint Investigation Report

did not occur. S1-S5 stated they have never yelled at a client. The Licensee denied this has happened.

Regarding the allegation, Staff did not ensure that tobacco is inaccessible to residents in care. It is being alleged a client left tobacco on the kitchen table. C1 stated this occurred; C2-C4 stated this has never occurred. S1-S5 confirmed tobacco is not left out on the kitchen table. The Licensee denied this occurred. During LPA’s 3/13/2025 visit, LPA did not observe tobacco on the kitchen table.

Regarding the allegation, Staff did not ensure that a hazardous item was inaccessible to residents in care: It is being alleged a client left a lighter out on the kitchen table. C1 confirmed this occurred. C2-C4 denied this occurred. S1-S5 stated the client who uses the lighter will ask staff for the lighter, the staff member will give the lighter to the client, the client will go outside to use the lighter, and the client will then give the lighter to staff members. S1-S5 unanimously stated the lighter is always locked in a kitchen cabinet. The Licensee denied this occurred.

During LPA’s visit on 5/16/2025, LPA observed a client asked for the lighter, staff unlocked a kitchen cabinet, gave the lighter to the client and the client went outside. Upon returning into the kitchen, the client handed the lighter to the staff member.

Regarding the allegation, Staff did not accompany resident to a medical appointment: It is being alleged a client was left alone during a client’s medical appointment. C1 stated this occurred. C2-C4 stated staff always drives them to the appointment and accompanies them to the medical office. S1-S5 and the Licensee denied this occurred.

Regarding the allegation, Staff used foul language in the presence of a resident. It is being alleged a staff member cursed in the presence of a client. C1 stated this occurred. C2-C4 denied the allegation. S1-S5 and the Licensee also denied this occurred.

Based upon LPA’s review of client records, interviews and LPA’s observations, the above allegations are unsubstantiated .

Exit interview conducted and a copy of the report was given.