Complaint Investigation Report

Regarding the allegation that staff did not prevent a resident from threatening another resident, interviews with involved parties and witnesses confirmed a verbal disagreement occurred, but there was no evidence to support that staff failed to act. Staff redirected both residents appropriately. R3 has been aggressive towards staff, residents, professional staff, and LPA. R3 tends to leave the facility early morning and will not take medication timely. The Administrator has attempted to schedule an appointment with the psychiatrist, but the psychiatrist will no longer see R3 because of the verbal and aggressive behaviors. The administrator had scheduled another appointment with a new psychiatrist, but R3 did not show up for the appointment. R3 has been given a 30-day eviction notice for non-compliance of the rules of the facility.

For the allegation that staff are not providing a safe environment, LPA conducted a facility tour and observed that the environment was clean, orderly, and free from safety hazards. Staff were present and monitoring residents appropriately. Residents interviewed stated they felt safe in the facility. The facility is not a locked facility, and residents are free to come and go from the facility with proper notification of informing staff.

Regarding the allegation that staff did not prevent a resident from wandering, review of staff notes and interviews confirmed that a resident did briefly leave the facility grounds but remained within the designated perimeter and returned. Staff were aware of the resident’s movements and redirected the resident back to the facility.

Based on the information obtained through interviews, documentation review, and observations, there is not enough evidence to support that the alleged violations occurred as reported. Therefore, all allegations are determined to be: Unsubstantiated – Meaning that although the allegations may have occurred or are valid, there is not a preponderance of evidence to prove the alleged violation occurred.

An exit interview was conducted with the Administrator. A copy of this report and Licensee's Rights (LIC 9058 03/22) were provided to the Administrator, and his signature on this report confirms receipt of the Licensee Rights.