complaint·June 29, 2025

and between 1pm and 3:30pm LPA conducted interviews with staff #2-9 (S2-S9). On 06/29/25 LPA conducted a review of R1’s and S1’s file. The investigation revealed the following: Allegation: Facility staff member functional forged residents’ signature. It is being alleged that facility staff forged residents’ signature for the facility to bill for a higher level of care. On 06/28/25 from 8:45 am- 12pm LPA conducted Interviews with R#2-11 regarding the allegation above, 10 of 10 residents denied the allegation above and reported feeling safe and comfortable when assisted by facility staff. On 06/28/25 between 1pm and 3:30pm LPA conducted interviews with S#2-9 regarding the allegation above, 8 of 8 staff interviewed denied the allegation above. On 06/28/25 LPA unable to interview S1 as S1 is no longer employed at Atria Hacienda. On 06/28/25 LPA unable to interview R1 as R1 passed away while receiving care outside of Atria Hacienda. On 06/27/25 LPA conducted telephone interview with Witness #1 (W1) regarding the allegation above, Per W1 an assessment was conducted on R1 on 11/30/22, the assessment resulted in a change from level 1 care to level 6 care which is a difference of $4500 in care charges. W1 continued to report that the signature on the assessment agreeing to the additional care fees is not R1’s signature. On 06/29/25 LPA conducted a review of R1’s file, LPA observed 7 service plan assessment conducted on 5/25/23, 4/15/23, 2/25/23, 1/25/23, 11/29/22, 11/1/22,10/16/2022. Per assessment conducted on 11/29/22, R1 level of care was a 3, LPA did not observe any signatures on the assessment document. Per assessment dated 11/29/22 it is indicated facility staff would coordinate with resident and family to assure that services are in place to maintain safety for resident while in care. Additionally, during file review LPA did not observe any documentation indicating that R1 had a conservator nor power of attorney. Per R1’s file R1 was self responsible. On 06/29/25 LPA conducted a review of S1’s file, LPA did not observe any corrective action documentation linked to the allegation above. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegation is unsubstantiated. Exit interview conducted, and a copy of this report was provided.