Complaint Investigation Report

(PAGE 2) Report continued from LIC 9099...

At 12:13 p.m. conducted one (1) telephonic interview with the Power of Attorney (POA) for R1 and obtained copies of pertinent documentation relevant to the investigation. On 01/13/2026 at 1:42 p.m. conducted a telephonic interview with the facility DOS. At 2:25 p.m. and 4:00 p.m. attempted a telephonic interview with R1. At 2:28 p.m. and 4:40 p.m., attempted a telephonic interview with POA of R1.

During today's visit LPA and DOS briefly toured the physical plant areas inside and outside to ensure there are no immediate health and safety hazards, and obtained copies of pertinent documentation relevant to the investigation .

On the allegations, Staff does not ensure resident is kept clean and dry at all times, and Staff does not ensure resident is kept free of mal odors it is the concern of the Reporting Party (RP) that R1 was covered in urine, had poor hygiene, and smelled foul. To investigate this complaint, LPA conducted in person interviews, telephonic interviews, file and record review and obtained copies of pertinent documentation relevant to the investigation.

Interviews with POA revealed that R1 is considered independent living by receiving minimal assistance / basic services from the facility at the time. They have no concerns related to the care or hygiene of R1. POA stated that they believe the facility may no longer be the best place for R1’s care noting that they do not have additional funds to cover extra services and believe R1 may be declining due to age. They are in the process of relocating R1 to their hometown and do not see R1 returning to the facility after their current hospitalization.

Interviews with DOS revealed that on 12/13/2025 R1 was transported to the hospital via ambulance due to congestion and shortness of breath. As of 12/19/2025 R1 has not returned to the facility. R1 does not receive hands-on services from the facility, noting that the family is aware of R1’s level of independence and capabilities. R1 always appeared presentable and did not smell of a mal odor. They had no prior issues related to R1. To their knowledge and observation R1 upkept themselves. R1 would occasionally participate in activities but generally kept to themselves.

Report continued on LIC 9099-C PAGE 3.. .