complaint·October 13, 2025

During a visit to the facility, Additional Witness 1 (AW1) reported interviewing multiple residents and information obtained revealed ongoing issues with hot water availability in Building 2. Through interview with Administrator Andrea Scott, information revealed that Building 2 had a malfunctioning water heater and confirmed the issue initially reported on March 21, 2025. Interview with Staff 1 (S1) revealed they believed the problem had appeared to be resolved, however, S1 noted the water heater began malfunctioning again after a few days. Interviews with 7 out of 9 residents corroborated that Building 2 experienced persistent lack of hot water issues, resulting in residents needing to shower in Building 1. A review of facility records confirmed that a new water heater was purchased and installed on May 27, 2025. Additionally, a review of incident records revealed no documentation indicating that Community Care Licensing Division had been notified of the water heater issue as required by regulation. In response to the allegation that staff do not provide residents with snacks between meals, it was reported that snacks and beverages are consistently unavailable during those times. Interview with AW1 revealed multiple residents reported concerns of the lack of snack availability between meals. AW1 also noted during multiple visits to the facility, they did not observe any snacks being available or offered to residents. Information obtained through Interview with Administrator revealed facility staff provides snacks daily noting they are stored in the kitchen pantry of Building 2. Administrator added that while the snack offering is consistent, some residents decline the snacks and most do not actively request them. Interview with 9 out 9 residents contradicted Administrators statement and corroborated that snacks between meals are not offered consistently or at all. Through file review, food menus were reviewed and observed to not include snack information. Additionally, LPA could not obtain clear information if a snack procedure is implemented. LPA toured the kitchen and documented the presence of snack items stored in the pantry. LPA noted that the snacks were limited in both quantity and quality. Based on interviews, record reviews, and observations, the allegation that staff do not ensure hot water can be accessed throughout the facility to residents and staff do not provide residents with snacks between meals is Substantiated. A finding that the complaint is SUBSTANTIATED means that the allegation is valid because the preponderance of the evidence standard has been met. The facility will be cited. An exit interview was conducted. A copy of this report was provided to Administrator Andrea Scott, along with a copy of the LIC9099-C, LIC9099D, and Appeal Rights were provided.