Complaint·January 11, 2024

Allegation: Staff forged resident’s documents It is alleged that R-1 was asked to sign a document that they believe did not belong to them as all the information on the document was incorrect. On 1/5/24 LPA Shirley reviewed resident files. During file review, found there to be no evidence of forged documents. LPA did not find a description of a document that R-1 claims they were requested to sign. LPA described said document to the director at the facility and director does not recall any such document. LPA verified SSA# on file with R-1. Resident answered with the correct number. LPA verified address on file with R-1 and resident was confused about which side of the facility she lived on, as this facility uses two mailing addresses. The address assigned is determined by the location of your room. On 1/5/24 LPA conducted interviews with both staff and residents. LPA interviewed staff, staff 1 – staff 7 (S-1 – S-7). LPA asked staff, “Do you forge resident’s document.” Of those interviewed 7 out of 7 stated no. LPA interviewed residents 1 – resident 7 (R-1 – R-7). LPA asked residents, if they believe that staff has forged their documentation. Of those interviewed, 6 out of 7 answered, no. Based on information gathered, the department did not find sufficient evidence to support allegations "Staff forged resident’s documents.” Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is unsubstantiated. An exit interview was conducted and a copy of the LIC 9099 was provided to Director Lida Zarafshan.