Complaint·March 19, 2024

residents, following up with psychiatrist, conduct room change, and continued monitoring of resident’s behaviors to ensure this type of situation does not occur. ED also reported this was the first incident involving R1 and R2 as there has been no history of aggression for neither resident while in care. On 03/19/24 LPA interviewed R1-R10, 8 of the 10 residents interviewed denied the allegation above and reported feeling safe and believe staff would assist if they were being assaulted. On 03/19/24 LPA interviewed R1 regarding the above allegation, R1 reported being pushed by R2 after a verbal confrontation over a remote control. On 03/19/24 LPA interviewed R2 regrading the above allegation, R2 denied the allegation above and reported R2 did not physically touch R1. R2 continued to report that both R2 and R1 were pulling on a remote control and when R2 let the remote control go R1 lost R1s balance and stumbled but R1 did not fall or obtain injury. On 03/19/24 LPA interviewed S1-S5 regarding the above allegation, 4 of 5 staff interviewed denied the above allegation. 4 of 5 staff reported residents are separated, residents are talked to, and residents are assessed and are offered activities. 1 of 5 staff interviewed reported witnessing the incident and was able to intervene, per staff residents were pulling the remote control back and forth from each other when staff asked R2 to stop, let the remote go, and let staff handle the situation. As R2 let the remote go it is being reported that R1 lost R1s balance and took a step back but did not fall nor obtained injury. On 03/19/24 LPA spoke to W1 regarding the allegation above, per W1 W1 was made aware of the incident and after receiving the information of incident W1 does not have any safety concerns regarding R1. On 03/19/24 LPA conducted a review of R1 and R2s file and did not observe any prior incidents involving R1 and R2. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegation is Unsubstantiated. Exit interview conducted with Executive director (ED) Janie Acosta, and a copy of this report was provided.