Complaint Investigation Report

Investigation consisted of the following:

On 5/23/2025, a facility tour was conducted, interviews were conducted, and records were reviewed. The facility tour consisted of 5 resident bedrooms. Interviews conducted consisted of 5 staff interviews [Staff 1 (S1) to Staff 5 (S5) were interviewed], 2 informal staff interviews [Staff 6 (S6) to Staff 7 (S7) were interviewed] and 5 resident interviews [Resident 1 (R1) to Resident 5 (R5) were interviewed]. Resident 1’s records were reviewed which consisted of Admission Agreement dated 4/30/2025, Physicians Report dated 5/1/2025, Identification and Emergency Information, Physician’s Report dated 5/1/2025, Medication Administration Record (MAR) for the month of May 2025, Medical documentation and other pertinent documents. Facility records reviewed consisted of Employee roster dated 4/21/2025, Resident Roster dated 5/12/2025, and Fumigation Records from 1/20/2025 to 5/16/2025.