Complaint·August 18, 2025

(Continue from LIC9099) Review of R1’s records confirmed that R1 required assistance with all activities of daily living, including bathing, grooming, and incontinence care. R1’s care plan indicated that staff were to provide incontinence care every two (2) hours or more frequently as needed. Interviews with staff and outside sources revealed that Monday through Friday, staff assisted R1 at approximately 7:00 a.m. with incontinence care, grooming, and changing clothes before R1 ate breakfast and was transported to the outside agency. Facility records confirmed that R1 attended the outside agency daily, Monday through Friday, from 8:30 a.m. to 4:00 p.m. Staff reported that R1 may have experienced an incontinence episode during transport, which could explain R1’s condition upon arrival at the agency. Interviews with outside sources further indicated that during weekly visits to the facility, R1 was consistently observed clean and without signs of hygiene neglect. No odors were reported at the facility. In addition, interviews with other residents’ responsible parties revealed no concerns regarding incontinence care or staff meeting residents’ needs. The investigation did not yield evidence to support the allegation. Records also showed that during prior visits on June 28, 2022; May 18, 2023; September 7, 2023; and December 5, 2024, the facility was consistently observed to be clean, organized, and free of odors, with no concerns regarding incontinence care. Conclusion Based on the investigation—including record reviews and interviews with staff and external sources—there was insufficient evidence to substantiate the allegation. Therefore, the allegation is deemed unsubstantiated. An exit interview was conducted with Licensee Tapia and Administrator, Nunez. A copy of this report and the Licensee Appeal Rights (LIC 9058 03/22) were provided via email at SUNSETCOASTLIVING@GMAIL.COM , an electronic email receipt confirmed receipt of report.