complaint·July 1, 2021

executive director and staff revealed R1 is R1's own responsible party. A review of R1's Admission's Agreement, and R1's Identification and Emergency Information form corroborates R1 is R1's own responsible party. R1 has signed all documents and there is no information showing R1 has any other responsible party to report change of condition to. This agency has investigated the above-mentioned allegations and we have found that the complaint was UNFOUNDED, meaning that the allegations were false, could not have happened and is without a reasonable basis. We have therefore dismissed the complaint. An exit interview was conducted, and a copy of this report is being reviewed with and provided to the facility Executive Director Samuel DeGuzman whose signature on this form confirms the above-mentioned documents. clean, safe, sanitary and in good repair. LPA observed the housekeeping schedule for R1's room. The resident’s rooms are cleaned based off of the residents Admission's Agreement. R1's admission's agreement states housekeeping will go into R1's room 1 time per week to dust, vacuum, clean the bathroom and provide towels if needed. Due to R1's health diagnosis LPA is unable to corroborate whether R1's room has health hazards that would affect the health and safety of R1. The third allegation alleges facility did not ensure that needles and syringes are disposed of properly. Interviews with executive director and staff revealed R1 is able to administer R1's insulin shots. Executive Director stated R1 has always taken used syringes to the fire station and recently stopped. The facility provided R1 with a disposable bin to place used syringes in. During interview with R1 LPA observed approximately 5 used insulin needles in a coffee mug. LPA is unable to corroborate when staff started providing the disposable bin and what further steps staff took when R1 would not put used syringes in bin as needed. Although the above-mentioned allegations may have happened, or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore, the allegations are deemed UNSUBSTANTIATED at this time. An exit interview was conducted, and a copy of this report was reviewed with and provided to Executive Director Samuel DeGuzman, whose signature on this form confirm receipt of the above-mentioned documents.