Complaint Investigation Report

** This page was amended to include relevant information and correct a typo ** - LPA NR, 10/16/24

LPA received three (03) photographs on 09/16/24 of R1 using their walker on the plastic tarp in the hallway. The tarp was not taped down and was wrinkled, posing a tripping hazard to all residents. Record review of R1’s assessment from 12/06/22 revealed they were not a tripping hazard and did use a walker to ambulate. Interview with Staff #4 (S4) at 10:30 a.m. today revealed an outside vendor laid down the tarp in around June 2024 during kitchen repairs. Interviews with S4 and the Wellness Director at 2:30 p.m. today revealed the tarp was eventually taped down. The Wellness Director added that R1 is now nonambulatory and uses a walker. LPA did not observe any tripping hazards in the facility today or on 09/17/24. Based on observations, interviews, and record review, the plastic tarp posed a tripping hazard to R1, and the facility did not ensure the hallway was free of tripping hazards. Therefore, the allegation is deemed SUBSTANTIATED at this time. Deficiency is cited on the corresponding LIC 9099-D page.

Exit interview conducted. Appeal rights discussed. Copy of report provided.