complaint·October 27, 2025

LPA conducted interviews with three (3) other residents and their relevant parties, all of whom stated the staff have provided good care for the residents, including regular checks throughout the day and night. LPA conducted an interview with S1 who stated they checked on R1 a few hours before they found R1 on the floor. LPA’s interview with the Administrator corroborated the statements of S1 and the residents. Based on the record review and interviews conducted, there is insufficient evidence to support the allegation that staff left resident on the floor for an extended period of time. The allegation is unsubstantiated . It was alleged that staff left resident soiled for an extended period of time. According to the information received, R1 was found soaked in urine, and their bed had multiple absorbent pads with significant amount of urine. LPA’s file review revealed medical condition affecting R1’s appetite. LPA conducted an interview with R1, who stated staff have provided regular checks and incontinence care throughout the day. LPA conducted an interview with R1’s relevant party (RP), who stated that staff have provided regular checks and incontinence care. RP stated they have visited R1 every other day and have never noticed any issue with staff providing incontinence care. RP also acknowledged R1’s medical condition related to their appetite. LPA conducted interviews with three (3) other residents and their relevant parties, all of whom denied ever being left soiled or experiencing neglect in incontinence care. LPA conducted interviews with two (2) staff members, all of whom stated that all residents receive regular checks and incontinence care throughout the day. Both staff members emphasized that the facility operates as a small home setting, allowing staff to remain in close proximity to residents at all times. Based on the record review and interviews conducted, there is insufficient evidence to support the allegation that staff left resident soiled for an extended period of time. The allegation is unsubstantiated . It was alleged that staff did not provide resident with clean linen. According to the information received, R1’s bed had multiple absorbent pads soaked with significant amount of urine. LPA’s file review revealed that R1 required incontinence care. LPA conducted an interview with R1, who stated that the absorbent pads on the bed are for extra protection in case of any leak from incontinence briefs. R1 stated staff have provided linen change whenever necessary or after bathing. LPA conducted an interview with R1’s relevant party (RP), who stated that staff have provided linen changes regularly. RP has visited R1 every other day and has never noticed soiled linen or bedding. LPA conducted interviews with three (3) other residents and their relevant parties, all of whom stated staff have provided linen change with every bath. Continued on LIC9099-C.... LPA observed that R1 was the only resident who had absorbent pads on their bed. LPA’s interviews with two (2) staff members corroborated the statements from the residents and their relevant parties. Based on the record review and interviews conducted, there is insufficient evidence to support the allegation that staff did not provide resident with clean linen. The allegation is unsubstantiated . A finding of Unsubstantiated means that the allegation may have occurred or is valid, but there is not a preponderance of evidence to prove that the alleged violation occurred. LPA toured the interior and exterior areas of the facility and did not find any health and safety concerns. An exit interview was conducted where a copy of this report was provided.