complaint·October 29, 2024

On 12/12/2023, from 12:45 p.m. to 2:30 p.m., Licensing Program Analyst (LPA) Emily Peraldi conducted an unannounced initial complaint visit to the facility. At 12:55 p.m., LPA Peraldi met with the Administrator and explained the reason for the visit. The LPA informed the Administrator that the complaint was assigned to the CCLD IB Investigator Peter Zertuche. From 12:54 p.m. to 1:30 p.m., the LPA conducted an interview with the Administrator, requested copies of pertinent documents, and along with the Administrator conducted a physical plant tour. The LPA determined further investigation was required prior to issuing a finding. Investigator Zertuche conducted interviews on 01/31/2024, at approximately 10:30 a.m., with Administrator, Anna Lee, on 01/31/2024, between 11:30 a.m. and 12:30 p.m., with three (3) residents. On 01/31/2024 at 5:30 p.m., Investigator Zertuche conducted a telephonic interview with R1’s son. On 02/06/2024, between 3:30 p.m. and 4:00 p.m., Investigator Zertuche conducted telephonic interview with hospital social worker and hospital nurse. On 02/14/2024, at 10:30 a.m., Investigator Zertuche conducted a telephonic interview with S1. On 02/14/2024, between 11:00 a.m. and 11:30 a.m., Investigator Zertuche conducted a telephonic interview three (3) facility staff. In addition, the investigator requested an incident report from the local police, however police took an injury report and closed their case with no further investigation after speaking to R1 and R1’s son. Investigator Zertuche also obtained and reviewed R1’s medical records. A review of R1’s Physician Report, dated 6/01/2023, revealed R1 had Dementia, Depression, Hypothyroidism, Insomnia, Seizure Disorder, and Chronic Pain. R1 was non-ambulatory and required assistance with all activities of daily living. R1’s admission agreement was signed and dated on 06/12/2023. During the Department’s investigation, the interview with R1’s son revealed that R1 had a history of making similar allegations in the past and a history of self-harm, where R1 would scratch R1’s genital area. R1’s son stated that the facility was a great place and did not think the abuse occurred. During the investigation, it was revealed that there were no witnesses to the abuse and per hospital staff, there was no Sexual Assault Response Team (SART) exam, and the cause of the labia tears were unknown. During staff interviews, they denied the allegations of S1 inappropriately touching R1. Interviews with multiple residents all denied that they experienced any type of inappropriate behavior from S1 and instead considered S1 to be a “great person.” Furthermore, interviews with hospital staff indicated that R1’s doctors could not identify the source of the vaginal scratches. None of the residents witnessed S1 behave inappropriately towards R1 or have witnessed any inappropriate behaviors from S1. Interviews with the Administrator and staff denied that any inappropriate behaviors form S1. Continued on LIC 9099-C. The Department’s investigation concluded that although the allegation may have happened or is valid, there is insufficient evidence to prove the alleged violation occurred. Therefore, the allegation “Sexual Abuse: S1 inappropriately touched R1 while under the care of the facility” is deemed Unsubstantiated at this time. Exit interview conducted. A copy of this report was issued.