Complaint Investigation Report

Client and staff interviews revealed the clients are free to enjoy the snacks provided by the facility and the facility takes clients shopping who want to purchase additional snacks on a regular basis. Regulation does require nourishment or snacks be made available for all clients between meals, but does not specifically state the type, variety, or category of snacks that must be offered. Regarding meal menus, the facility was able to provide LPA with menus for February through July of 2025. Staff state the facilities printer broke and they have not been able to print the menu’s, but the menu’s have been available on the facility computer for clients; and the LPA during the visit. Based on all interviews conducted, documents obtained and LPA observation, the above allegation was found to be unsubstantiated at this time. LPA reviewed the regulation, to make weekly menus available for review by the clients or their authorized representatives and the licensing agency upon request, with the Administrator and provided the regulation as technical assistance.

On the allegation: Licensee did not ensure residents were provided with planned activities. It was alleged the staff do not take residents on outings as a household, so the residents are mostly inside the house 24/7. Resident and staff interviews revealed residents went on an outing on October 18 th , 2025 for a community event and barbecue that included the client representatives and on November 5 th , 2025 they went to the local park. The facility October 2025 activity calendar included outings to church, costume shopping for Halloween, shopping, walk to the park, flea market and the community event on the 18 th . Interviews also revealed the staff offer to take clients with them grocery shopping. Based on all interviews conducted and documents obtained, the above allegation was found to be unsubstantiated at this time.

On the allegation: Staff did not treat residents with dignity and respect. It was alleged Staff #1 (S1) is mean, rude and yells at clients. Staff and client interviews reveal S1 has not been mean or rude to clients, but S1 does at times raise their voice to ensure clients can hear them and may speaks in a firm or commanding tone. Based on all interviews conducted, at this time the above allegation was found to be unsubstantiated , meaning that the allegation may have happened or is valid, but there is not a preponderance of the evidence to prove that the alleged violation occurred. LPA reviewed with S1 and the facility Administrator the importance of addressing clients with dignity and respect.

No deficiencies were cited at this time. Exit interview conducted, report signed, and report provided to the Administrator.