complaint·August 29, 2025

LPA observed that the facility had a 2-day supply of perishable foods and 7-day supply of non-perishable foods, of which included fruits, vegetables, dairy, proteins and carbs. It was alleged that staff left resident in soiled diapers for extended periods of time. LPA conducted 1 out of 1 resident interview, of which did not corroborate with the allegation, and the remaining 2 residents declined in wanting to be interviewed. 1 out of 1 staff interview did not corroborate with the allegation by stating that 2 out of the 3 current residents are able to go to the bathroom unassisted, of which this was confirmed by both their physician reports. Upon entering the facility, LPA observed staff on duty changing resident 1 (R1) diapers. LPA observed R1 to be clean and changed. It was alleged that staff are not showering resident in a timely manner. LPA conducted 1 out of 1 resident interview, of which did not corroborate with the allegation, and the remaining 2 residents declined in wanting to be interviewed. 1 out of 1 staff interview did not corroborate with the allegation by stating that 2 out of the 3 current residents are able to shower unassisted, of which this was confirmed by both their physician reports. It was also confirmed by staff that R3 will get a bath two to three times a week due to being bedridden, while the other 2 residents shower on their own. During LPAs visit to the facility, LPA observed staff on duty giving R3 a bed bath. It was alleged that staff made inappropriate comments towards resident. LPA conducted 1 out of 1 resident interview, of which did not corroborate with the allegation, and the remaining 2 residents declined in wanting to be interviewed. 1 out of 1 staff interview did not corroborate with the allegation, however disclosed that there was a previous resident who would make inappropriate comments but denied of staff making inappropriate comments to residents. Per record review, facility submitted incident reports regarding a previous resident, reporting about inappropriate comments and behaviors. LPA also observed that staff completed trainings on resident personal rights and caring for residents. Continued on LIC9099-C... It was alleged that staff failed to intervene when resident was being verbally abused. LPA conducted 1 out of 1 resident interview, of which did not corroborate with the allegation, and the remaining 2 residents declined in wanting to be interviewed. The 1 resident interview reported satisfaction with the facility and with the staff, and denied of being a victim of, or observing verbal abuse. 1 out of 1 staff interview did not corroborate with the allegation. Per record review, staff are trained on mandated reporting and on the varying forms of abuse. It was alleged that facility is over capacity. LPA conducted 1 out of 1 resident interview, of which did not corroborate with the allegation, and the remaining 2 residents declined in wanting to be interviewed. 1 out of 1 staff interview did not corroborate with the allegation by providing confirmation of the licensed capacity of the facility. LPA conducted a record review and did not observe that the facility had requested for any increase to the capacity. For this visit, LPA observed 3 residents in care, of which the facility is licensed for 6. Per record review, the facility stayed within their license capacity of only having 6 or less residents. It was alleged that staff left residents unattended. LPA conducted 1 out of 1 resident interview, of which did not corroborate with the allegation, and the remaining 2 residents declined in wanting to be interviewed. The 1 resident interview provided confirmation that there is always a staff on duty. Per record review, facility has a staff member scheduled every day. During the tour of the facility, LPA observed that the facility is a two-level structure and observed that there is a live-in caregiver residing on the second floor at tall times. 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, these allegations are deemed UNSUBSTANTIATED. An exit interview was conducted with AD Asawadilo, A copy of this report was provided and explained. Per documentation review, it was observed that there were 2 residents who had a medication distribution record of which some days were documented, and other days were not, therefore, making it incomplete, and AD Asawadilo was unable to confirm if the medications were given or not. LPA observed the facility medication cabinet, and observed multiple medications for the current residents were expired. LPA also observed multiple oral and topical medications that were expired, and labeled for previous residents, such as Nystatin ointment. LPA also observed that the extra medications for the current and previous residents were all mixed together on a shelf, and disorganized. 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 Asawadilo. A copy of this report and appeal rights were provided and explained.