Follow-up·July 12, 2022

On this day Licensing Program Analyst (LPA) Jenifer Tirre conducted an unannounced Case Management visit to follow up on concerns regarding a recent complaint investigation. LPA discussed purpose of visit with Administrator Katherine Trevino. On 04/19/2022, the department received a complaint with the Allegation indicating "Residents engaged in an altercation while in care" from Complaint Control Number 22-AS-20220419154601. Complaint findings resulted Unsubstantiated due to conflicting reports. During Investigation it was brought to LPA's attention that some residents don't feel safe in facility due to other residents bullying. LPA shared these concerns with Administrator, Administrator states that they try their best if an issue arises. LPA discussed with Administrator what preventative measures can be put into place to help with issue. Administrator stated they'll continue to engage in more one to one visits with residents to check on them. Administrator stated they will also update personal rights training's with staff. Administrator indicates that facility has resident meetings every other week to hear about residents concerns regarding facility. Administrator stated they will make notices to let residents know of these meetings. LPA will follow up with facility at a later date to see if these changes are improving residents concerns. An exit interview was conducted with Administrator and copy of this report was left at facility.