Complaint Investigation Report

Investigation consisted of the following:

On 07/11/2025, a facility tour was conducted, and records were gathered. Facility records were gathered which consisted of Resident Roster dated 06/01/2025 and Personnel Report dated 07/01/2025. Resident 1’s (R1) records were gathered which consisted of Admission Agreement dated 03/11/2020; Physicians Report dated 05/24/2024; Appraisal/Needs and Services Plan dated 05/12/2024; Resident Appraisal dated 03/21/2023; Identification and Emergency Information dated 03/22/2020; and other pertinent records were provided. On 07/23/2025, Staff 1 (S1) to Staff 3 (S3) were interviewed. On 09/26/2025, Staff 4 (S4) and Witness 1 (W1) were interviewed. On 10/14/2025, R1 was interviewed. On 10/15/2025, W1 and Witness 2 (W2) were interviewed. On 1/7/2026, Staff 2 (S2) to S3 and Resident 2 (R2) to Resident 5 (R5) were interviewed.