Complaint Investigation Report

Allegation #1: Due to lack of supervision, resident was physically attacked by another resident.

The complaint alleged that one resident attacked another by hitting the other and throwing the victim's TV against the wall. On April 16, 2026, the department interviewed the Executive Director (ED), who denied the allegation. The ED stated that when a resident exhibits aggressive behavior, they are typically removed from the situation and redirected to their seats or rooms.

The department also interviewed the Administrator (A1), who also denied the allegation. A1 explained that this is a memory care facility, where they are aware of a resident who may have shown signs of aggressive behavior. However, they have sufficient staff to help redirect residents, and staff are always present near them.

Additionally, the department interviewed four staff members (S1-S4), all of whom denied the allegation. They stated they are familiar with their residents and emphasized that such incidents are rare. The department also interviewed six residents (R1-R6), all of whom reported that no other residents had hit them. On April 16, 2026, the department reviewed the facility's daily notes for residents; none indicated that any residents were struck by others. No Unusual Incident Report was submitted to the Community Care Licensing Department. On April 17, 2026, the department interviewed the witness (W), who stated that whenever they visit the facility, they see many caregivers around the residents' rooms or nearby, supervising the residents.

Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation (s) did or did not occur, therefore the allegation is unsubstantiated.