Complaint Investigation Report

Allegation: Resident sustained an unexplained injury while in care.

During LPA investigation visits on August 11, 2021, February 23, 2022 and March 22, 2022, LPA observed client (C1) without injuries. LPA conducted interview with Administrator. Administrator stated that on August 9, 2021 staff reported discoloration around client’s (C1) right eye. Administrator stated that the cause of injury was unwitnessed. Administrator stated it is believed that client (C1) caused the discoloration around the right eye during a self-injurious behavioral episode. Administrator stated client (C1) has a behaviorist and a behavioral intervention plan in place. LPA obtained and reviewed behavior intervention plan on 06/08/2022. LPA conducted interview with neurologist (W3) and obtained documentation from neurologist (W3) dated August 12, 2021, stating client (C1) has history of self-injurious behaviors. LPA conducted an interview with client’s (C1) Conservator (W1) who stated that client (C1) does have a history of self-injurious behavioral episodes which has decreased since client (C1) has been residing at the facility since February 15, 2019. The Conservator (W1) stated the facility is provided client (C1) with necessary support and care and visits client (C1) on a weekly basis at the facility. LPA conducted interviews with staff (S1 and S3) who stated staff have observed client (C1) during behavioral episodes where client (C1) has attempted self-harm and during these episodes staff (S1 and S3) apply behavioral support interventions training. LPA obtained and reviewed staff intervention training for client (C1) on 05/20/2022.

Based on the interviews conducted, observation and records review, LPA was unable to find evidence to support the allegation.