complaint·December 10, 2025

All were found to be in compliance at the time of this investigation. Care notes for R1 were reviewed from 1/10/25 - 06/21/25 as well as R1's hospital medical records from 06/20/25 - 07/11/25. LPA did not find anything that could be related to abuse based on review of all documentation received. Through interviews conducted, 2 individuals who knew R1 and were not employed by the facility believed that R1, due to their own "mental history" and previous behaviors, put the soap there themselves. Based on Department interviews neither of these individuals had “any concerns about Royal Gardens Elder Care or had any suspicion of staff sexually of physically abusing R1." The Department’s investigation revealed that,"R1 was placed on hospice care on 08/17/25 and based on their condition, R1 was not interviewed." The department found the allegation, "Staffed sexually abused resident" to be UNFOUNDED.  A finding of unfounded means that the allegation is false, could not have happened, and/or is without a reasonable basis.  There was no preponderance of evidence established during this investigation. LPA conducted a walkthrough of the facility and observed 2 residents in the living room, one had a visitor and the other was watching TV. LPA observed 2 other residents, asleep in bed, both receiving hospice services. There were no bars of soap observed in any of the bathrooms and the staff on duty reported that they only use liquid soap in the facility. A case management visit will follow this one regarding the fact that R1 was able to obtain a bar of soap and that no one at the facility discovered this until the hospital reported it. According to the California Code of Regulations, Title 22, no other deficiencies were observed or cited during today's visit. A copy of this report was provided and an exit interview conducted.