Complaint Investigation Report

On 08/06/2020, between 3:44 p.m. and 4:50 p.m., LPA Heffernan conducted the initial complaint visit. Due to the situation surrounding the Coronavirus Disease 2019 (COVID-19), and to implement mitigation measures, the complaint investigation was conducted telephonically with the Administrator Ivy Sudjati and House Manager Allan Santos. The LPA conducted an interview with the administrator at 3:44 p.m. and physical plant tour via FaceTime at 4:10 p.m. The LPA requested copies of pertinent documents relevant to the investigation and noted further investigation would be required.

On 09/18/2020, LPA Lyndia Sager was reassigned to this complaint investigation. On 12/04/2020 at 3:07 p.m. and on 12/08/2020 at 4:44 p.m. LPA Sager received pertinent records from the administrator. On 12/04/2020 at approximately 5:00 p.m., LPA Sager conducted a telephonic interview with a witness.

On 03/18/2022, LPA Camara conducted an unannounced subsequent complaint visit. LPA met with House Manager Allan Santos and spoke with Administrator Ivy Sudjati over the phone. During the visit, LPA conducted a brief physical plant tour at 3:49 p.m., interviewed the house manager at 3:52 p.m. and interviewed the administrator at 3:57 p.m. over the phone. The administrator was unable to meet LPA at the facility and R1’s records were located offsite. LPA requested the administrator provide any logs they may have kept regarding R1’s incontinence care and repositioning schedule. The administrator notified LPA she did not think they had such logs, but she would check. LPA noted further investigation was required.

On 03/21/2022, LPA Camara received an email from the administrator which stated they do not have any logs for the times staff repositioned R1 nor do they have logs regarding R1’s incontinence care. The administrator provided LPA Camara with documents she previously provided to LPA Sager.