Incident investigation·March 3, 2026

Licensing Program Analyst (LPA) Martha Arroyo conducted a Case Management - Incident visit to follow up on a self-reported incident which took place on 02/25/2026. Upon arrival the LPA met with Executive Director (ED), Helen Lee and explained the reason for the visit. Entrance interview conducted. On 02/26/2026, the Department received an incident report (LIC 624) and SOC 341 regarding Resident #1 (R1) reporting to concierge at approximately 12:00 p.m., that Resident #2 (R2) had hit them in the face yesterday (02/25/2026) at lunch time in the dining room. Report states that incident was reported by R1 and was unwitnessed by any staff member. During today’s visit, between approximately 9:20 a.m. and 11:30 a.m., the LPA conducted interviews with the ED and three residents and reviewed and obtained copies of pertinent documents. No immediate health and safety concerns were observed during today’s visit. Interviews revealed that R1 reported the incident to the concierge the day after the alleged incident. R1 stated that R2 had been calling them names for several weeks. R1 reported feeling tired of hearing R2 call them names and stated that they stood up and placed both hands in front of R2. According to R1, R2 then slapped them in the face with an open palm. Report Continued on LIC 809C... Report Continued from LIC 809... An interview with R2 revealed that they only referred to R1 as the name of the city they were from. R2 stated that when R1 raised their hands in front of their face, their reaction was to push R1 away. R2 denied calling R1 any other names. R2 also denied hitting R1 in the face and expressed regret for anything that may have occurred that day. An interview with another resident, who is a mutual friend of both R1 and R2, revealed that although R2 may occasionally make rude comments to others, they have never witnessed R2 behave aggressively toward anyone while residing at the facility. The ED stated that they checked R1 for any visible marks or redness; however, no signs of injury or redness were observed on R1’s face the following day. Additionally, the police report indicated that R1 had no visible injuries and that their dentures were not damaged. Furthermore, record review and interviews revealed that there were no witnesses to the alleged incident. The ED reported conducting an internal investigation, following proper reporting protocols, and taking steps to ensure that R1 continues to feel safe within the facility. Although the allegation may have happened or is valid, there is not sufficient evidence to prove the alleged violation did or did not occur. No citations issued at this time. Exit interview conducted. Report was reviewed and a copy provided.