complaint·May 13, 2025

On 05/13/2025, Licensing Program Analyst (LPA) Kesha Lewis arrived unannounced to deliver findings for the above allegations. LPA met with Executive Director Nicole Bacon and explained the purpose of today's visit. Based on record reviews and interviews, it is determined that there is not a preponderance of evidence to conclude that the staff mismanaged resident’s medication or that Staff are not preventing resident from engaging in inappropriate behaviors. Both the doctor’s directives and the client’s requests were followed as required. Staff had appropriate training in deescalating behaviors. Due to the above noted information, although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, and therefore the allegation is unsubstantiated. An exit interview was conducted, and a copy of this report was provided to the facility. An exit interview was conducted, and a copy of this report was given.