Complaint Investigation Report

At the time the complaint was filed R1 did not respond to messages left by the LPA. R1 has since passed away. R1 was never interviewed. 5 out of 5 staff interviewed reported that they have never touched any resident inappropriately and had no knowledge of any staff touching R1 inappropriately. Based on the evidence gathered through a review of records and interviews the allegation, resident was touched inappropriate by staff is deemed unsubstantiated, although the allegation may have happened or is valid, there is no preponderance of evidence to prove the alleged violation did or did not occur.

The investigation into the allegation, resident has fallen multiple times while in care , revealed the following. It was alleged that the resident fell multiple times while in care because the staff did not assist the resident. R1 was not interviewed at the time of the complaint because they did not respond to calls from the LPA investigating the complaint. R1 has since passed away and was never interviewed. 5 out of 5 staff interviewed stated that they had been informed that R1 was a fall risk and had been advised to use their walker and/or wheelchair but R1 did not always use them. 5 out of 5 staff interviewed reported that R1 was checked on regularly and informed to request assistance when transferring or needing any type of assistance. 5 out of 5 staff interviewed reported they had never seen R1 fall and were unaware of any recent falls by R1. R1’s responsible party reported that they knew R1 had multiple falls prior to moving into the facility but was unaware of any falls during 2021. 5 out of 5 staff interviewed reported that R1 has never reported any falls. The Administrator and Health Wellness Director reported that R1 has not suffered any falls recently. A review of special incident reports (SIRs) submitted to the Agency (Community Care Licensing) from the facility for the period of March 1, 2021, through June 30, 2021, showed that out of the 35 SIRs received there were no incidents with R1. Based on the evidence gathered through a review of records and interviews the allegation, resident has fallen multiple times while in care is deemed unsubstantiated, although the allegation may have happened or is valid, there is no preponderance of evidence to prove the alleged violation did or did not occur.

The investigation into the allegation, staff are denying resident food revealed the following. 5 out of 5 staff interviewed reported that normally R1 went to the dining room on her own and did not request assistance when going to the dining room. 5 out of 5 staff interviewed reported that sometimes R1 requested that food be brought to her room, but they informed her that the facility only provided tray service free of charge during the Covid lockdown period in 2020. 2 out of 5 staff interviewed reported that on a few occasions they brought R1 meals to their room even though they were not on tray service.