complaint·February 27, 2025

Interviews with residents, including Resident 1 (R1) and facility management revealed that in April and May of 2024, the facility experienced a shortage of housekeeping staff resulting in housekeeping services being missed, with at least one resident experiencing two weeks between services. [Executive Director was provided with an LIC811 Confidential Names List to identify R1] According to residents, the facility did not provide any written or verbal communication regarding the housekeeping staff shortage. Interviews with the facility management confirmed that there was difficulty with hiring and maintaining housekeeping staff and during the months of April and May of 2024, the facility only had one full time housekeeper and the housekeeping supervisor was on restricted work duty. Those interviews with facility management also stated that maintenance staff were assisting housekeepers to clean resident rooms, which residents confirmed during interviews. Interviews with housekeeping staff revealed that when fully staffed, two housekeepers were assigned to split the facility’s four two-story buildings in assisted living, and one housekeeper was assigned to the memory care building. Staff estimated that a common daily workload was to clean approximately 5 to 10 resident rooms a day, which included: sweeping, mopping, vacuuming, dusting, taking out the trash, and general cleaning of the apartment’s living area, bathroom, and kitchenette. While housekeepers denied any difficulties with meeting the workload, all housekeepers interviewed by the Department were hired after April 2024 and the alleged timeline of the allegations. Residents stated in interviews that during April and May 2024, the housekeeping services that were provided often did not include all promised tasks, or the service was rushed. Interviews with R1 and housekeeping staff revealed that R1’s room would frequently contain items on the floor such as food wrappers, crumbs, and other clutter. Interviews with R1 and staff revealed that R1 used incontinence briefs and disposed of them in the trash in R1’s bathroom. Additionally, R1, housekeeping staff, and outside sources confirmed that during April and May 2024, soiled incontinence briefs caused R1’s room to smell strongly of urine. Review of the admissions agreement revealed that the facility also offered additional housekeeping services for a fee, and review of R1’s admission agreement addendum signed in 2019 revealed that R1 agreed to pay for an additional day of housekeeping services, totaling two housekeeping services a week. The Department has investigated the above-mentioned allegations and based on interviews, the preponderance of the evidence has been met, therefore, these allegations are deemed substantiated and noted on the attached LIC9099-D page. An exit interview was conducted with Executive Director Kristel Johnson , whose signature below confirms receipt of a copy of this report, the LIC811, and the Licensee Appeal Rights (LIC9058 3/22).