complaint·September 23, 2025

their mouth. Staff intervened and attempted to get R1 removed from R2’s room, R1 became combative but staff was able to remove resident from R2’s bedroom. Staff checked R2 for any injuries, no injuries were noted. The interview with staff stated that they were not present at the time of incident, however per communication book incident was noted to have happened June 1, 2022, around 7:30pm. Copies of communication log reflects incident in question. During the course of the investigation, there was sufficient evidence to substantiate the allegation. The preponderance of evidence standard has been met; therefore, the above allegation is SUBSTANTIATED. See LIC9099-D for cited deficiencies per Title 22 Division 6 of the California Code of Regulations. An exit interview was conducted with the Administrator and a copy of this LIC9099 and LIC9099-D, along with a copy of the appeal rights was left at the facility.