complaint·January 26, 2024

Interviews with staff and a tour of the facility determined that R2 had a room next to R1. Interviews with staff revealed that all residents at the facility had major cognitive impairments and had occasional behaviors of undressing and exiting their rooms. Staff denied that any of the undressing behaviors were done with a malicious intent. R2 would occasionally disrobe in their room in preparation for a shower. Staff indicated that R2 was a friendly individual and would attempt to say hello to R1 by waving their hand, which R1 would angrily react to. R1 was described by staff to be easily agitated by interactions with other residents. Ongoing negative interactions between the two residents were due to their cognitive impairment, however, no form of sexual abuse or misconduct could be verified. Interviews with staff did not support the allegation that R2 engaged in any sexual misconduct with R1 or any other residents. The Department has investigated the above-mentioned allegation and based on interviews and records review, the preponderance of the evidence has not been met, therefore, this allegation is deemed unsubstantiated. An exit interview was conducted with Licensee Rigoberto Garcia, whose signature below confirms receipt of a copy of this report and the Licensee Appeal Rights (LIC9058 01/16).