complaint·October 2, 2025

On 10/02/25, Licensing Program Analyst (LPA) Talwinder Bains arrived unannounced to deliver complaint findings for allegations listed above. LPA met with Staff, LVN , Tiffany Gibson during today's visit and explained the purpose of the visit. During the course of the investigation, it was learned that R1 and R2 developed a romantic relationship. Facility contacted R1’s responsible party to discuss the relationship as there was a question as to R1’s capacity. Based on documentation from R1’s primary care physician and R1’s responsible party, R1 has the capacity to make decisions on engaging in a physical relationship with R2. The facility puts perimeters in place to ensure R1’s safety while ensuring R1’s personal rights are preserved. As of this date, all parties have agreed to a plan with R1, R2 and facility staff in regard to R1 and R2’s relationship. Furthermore, During the course of the investigation, there is no evidence found that staff threatened residents in care. Based on this information, these allegations were UNSUBSTANTIATED. A finding that the complaint allegations is UNSUBSTANTIATED means that although the allegations may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violations occurred. Exit meeting conducted .A copy of this report has been provided to facility.