Complaint Investigation Report

Allegation: Staff did not prevent an altercation between residents

The detail of the complaint alleges that “C1 was transferred via AMR to RUHS on 09/23/22 because C1 was struck in the face by roommate.”

On 9/15/25 at 12:17pm, the Department interviewed the Administrator (A1) regarding the allegation above. A1 denied the allegation, stating that a staff member was present when the altercation occurred and de-escalated the situation. A1 went on to state that his staff are trained to properly address behaviors of the clients in care.

On 9/15/25, between 1:00pm and 2:30pm, the Department interviewed 2 staff regarding the above allegation, and of those interviewed 2 out of 2 were not around during this incident, they were hired after it occurred. However, they stated that in general, staff are always around and they intervene and de-escalate situations as they occur. Additionally, 2 of the 2 staff interviewed state that they receive training on how to handle client behaviors in the home.

On 9/15/25, LPA obtained, reviewed and evaluated the following documents: Staff training (dated 7/15/20 and 8/22/25), which indicated that staff are trained to handle client behaviors in the home. Lastly, 2 out of 2 staff interviewed stated that there are sufficient staff to meet the client’s needs.

Based on interviews conducted, and documents reviewed, there is insufficient evidence to support the above allegation. 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.