Complaint·July 11, 2025

Facility refused to warm residents' meal Based on the interviews conducted, 5 Out of 7 staff stated residents’ meals are warmed up when requested by residents. S2 states approximately 3 weeks ago, he/she started to not warm R1’s meals due to having to ask permission from facility administrator. S2 did not provide additional information. S4 stated he/she has never been asked to warm meals for R1. House Manager states he/she is not aware of staff having to ask permission from ADM to warm residents food in January 2025. LPA interviewed 4 residents. 4 Out of 4 residents stated staff warm up their meals when requested. W1 states facility staff warm up the resident’s meals when requested. Resident was retaliated by staff when talking with a former employee. Based on interviews, 6 out of 7 staff stated he/she has never observed a staff retaliating towards a resident when resident spoke with a former employee. S3 did not provide any information. LPA interviewed 4 residents (R1 to R4). 2 Out 4 residents stated he/she has no concerns with the facility staff. 2 out of 4 residents did not provide any information. W1 states he/she has no concerns with the facility staff or the care his/her loved one is receiving. Facility is not providing baths to residents. Based on interviews conducted on 02/03/2025 and 05/13/2025, 5 out of 7 staff stated residents are given showers based on resident’s shower schedule. 2 out of 5 staff did not provide any information. 4 out of 4 residents stated he/she are being bathed by facility staff based on his/her shower schedule. Based on record review of the facility’s shower schedule, from December 2024 to January 2025, residents are scheduled for shower 2 to 3 times a week. R1 is on the shower schedule, with 3 showers scheduled per week. S1 and S5 state that in December 2024, R1 became unable to stand with the assistance of 3 staff. Page 2 of 3 S1 and S5 stated R1’s responsible party was made aware that R1 would be given sponge baths to ensure the safety of R1 and staff. W1 stated that their family is showered based on their shower schedules. Based on record review of R1’s care plan dated 10/11/2024, R1 is non-ambulatory and R1s lower body strength has been declining. Based on interviews and record reviews, although the allegations may have happened or is valid, there is no preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegation is UNSUBSTANTIATED . An exit interview was conducted, with Manager Betzy Torres and a copy of this report was provided.