complaint·May 9, 2025

LPA Haddadin conducted four staff interviews, all of whom corroborated that the incident occurred. However, these interviews revealed that the facility conducts hourly rounds. R1 had recently concluded a family visit and had been returned to their room. The subsequent hourly round, during which R1 was found on the floor, took place 15 to 20 minutes after the visitation concluded. Furthermore, LPA Haddadin reviewed R1's medical record, physician's report, admission record, and discharge paperwork from UCI Medical Center, where the resident was taken after the incident. According to the discharge paperwork from UCI, specifically on pages 9 and 10, the findings of the CT head scan revealed "Hemorrhage: None. Brain parenchyma: Moderate generalized volume loss...No herniation. No hydrocephalus...No acute calvarial fracture." Therefore, based on the preponderance of evidence gathered through conducted interviews, medical record reviews, and all pertinent paperwork collected by LPA Haddadin, the allegation: "Due to a lack of supervision, the resident was left on the floor for an extended period following an unwitnessed fall," was found to be UNSUBSTANTIATED. This determination indicates that while the alleged incident may have occurred, or the concerns may be valid, there is not a preponderance of evidence to prove that the alleged violation took place. No deficiencies were cited during today's visit. An exit interview was conducted with the ED, and a copy of this report was provided.