complaint·August 29, 2024

Records review further revealed that the resident census on the 1st floor and 2nd floor had an average of 36 residents. The AM staffing ratio on both floors was regularly at; three caregivers and one med-tech. The PM staffing ratio was regularly at three caregivers and one med-tech . The NOC staffing ratio was regularly at two caregivers and one med-tech for both floors. The staffing schedule also revealed an outside agency had been utilized to assist with staff vacancies. Analysis of staffing schedules showed that the facility maintained adequate staffing ratios to address the needs of residents. LPA interviewed a 2nd floor resident who stated that they have lived at the facility for 2.5 years. Resident stated that they are very happy at the facility. Resident stated the facility staff are "wonderful" and they feel "blessed" to live there. Resident further stated that they get "fast help from staff" whenever needed. It was also alleged that the facility did not have adequate supplies to meet residents needs. It was reported that the facility was low on various sanitary and medical supplies. It was also reported that staff did not have access to the supply room during the NOC shift. LPA visited the facility on July 29,2024. LPA inspected two supply rooms on the second floor. One main supply room with large boxes and supplies that was locked and a second unlocked supply closet with various materials and supplies stored on shelves. LPA observed that the facility had an adequate supply of materials necessary for resident care, including medical supplies, personal hygiene items, and other essential resources. A review of facility records revealed a supply invoice dated July 5, 2024. The invoice included a sufficient amount of small, medium, large, and extra-large adult briefs, wipes, and gloves. Interview with Resident Services Director (RSD) revealed that the main supply room can be accessed by two other staff members and the maintenance worker. RSD stated that the supply closet is available to all of the staff members and the main supply room can be accessed any time of day if needed. RSD further explained that although she purchases supplies for all of the resident's, some residents' choose to purchase their own incontinence supplies, etc. RSD explained that the main supply room has boxes labeled for specific residents that purchase their own supplies and/or receive supplies from various programs. ED stated that as a result the main supply room must be closely monitored so that staff members do not disperse the various supplies incorrectly. LPA reviewed the facility standardized admission agreement. The agreement revealed residents have the option of purchasing their own incontinence supplies or they can pay an additional monthly fee to have the facility provide the supplies. LPA interviewed outside agency (OA). OA also reviewed the facility’s supply inventory and agreed with the LPA’s assessment, confirming that the supplies available were sufficient to meet the residents’ needs. OA agency stated from their assessment the facility has sufficient staff to meet the needs of the residents. Based upon the foregoing, the above listed allegations are unsubstantiated. This finding means that the preponderance of the evidence standard has not been met and the allegations are not valid. An exit interview was conducted with Amanda Togia. A copy of this report along with licensee rights (LIC 9058, 3/22) was provided to Amanda Togia whose signature below verifies receipt of these right