complaint·October 26, 2023

4 interviews conducted with staff stated that if there was abuse occurring, the facility would have reported it immediately. LPA De Perio conducted reviews of incident reports from the facility, and it was observed that the facility did not submit a written incident report. Based on LPA’s interviews which were conducted, review of documents obtained, and observations, the preponderance of evidence standard has been met, therefore the allegation is SUBSTANTIATED. An exit interview was conducted with AD Rodriguez. A copy of this report and appeal rights were provided and explained. Following that statement, R1 became visibly and verbally agitated and stated, “let me go, let me go”. R1 then refused to answer any more questions, and upon the conclusion of the interview, R1’s demeanor had changed, and was smiling. Per R1’s physician report dated for March 8, 2023, R1 has mild cognitive impairment, is non-ambulatory, is unable to transfer self independently, on and off the bed, and was on hospice. The investigation revealed that R1 never provided any disclosure regarding sexual assault or being hurt by any staff. LPA De Perio interviewed 5 out of 5 residents who confirmed not being hurt or witnessing anyone being hurt. 4 interviews conducted with staff, denied observing any resident being hurt or abused in the facility. It was alleged that staff did not contact the police/doctor upon resident request. On August 31, 2023, interviews were conducted with staff and residents at the facility. The 5 interviews conducted with residents stated that if needed or requested, the facility contacts 911 upon resident’s request. Resident 1 (R1), resident 2 (R2), resident 3 (R3) and resident 4 (R4) specified that the facility does a “good job” at communicating with each resident’s medical team. 4 interviews conducted with staff stated that the facility contacts the appropriate responders such as police, and 911 regardless if the resident requests it or not and depending on the incident. Staff 1 (S1) specified “we would rather be safe than sorry”. Based on LPA’s interviews which were conducted, review of documents obtained, and observations, LPA is unable to ascertain if the allegation occurred as reported. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove or refute the alleged violation occurred; therefore, this allegation is deemed UNSUBSTANTIATED. An exit interview was conducted with AD Rodriguez. A copy of this report was provided an explained.