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32 | Prior to this visit, LPA Cava ran a file review and observed an Incident Report (IR) pertaining to this allegation. The IR was received by Licensing on 06/12/26. Review of the IR reveal that on 06/09/26, at approximately 7:30am, staff noticed R1 was not in the facility. Staff searched for R1 immediately within parameters of the facility, but R1 could not be located. Law enforcement were called to report missing person, and R1's responsible person was notified.
Interviews with the administrator and staff confirm that R1 made their way outside of the facility on their own, but deny the allegation of lack of supervision as there was staff presence (1 staff to 3 residents) when this incident had occurred. Once it was realized that R1 was not in the facility, staff launched a search for the resident, and notified law enforcement and R1's family within an hour. R1 was eventually located, and was recovered at the hospital. There were no injuries noted. R1's responsible person expressed no concerns. Interviews with two (2) residents deny the allegation of neglect, stating there is anywhere between one to two staff, including the administrator, on duty at all times. Both residents had no complaints or concerns regarding the care and supervision provided. R1 could not be interviewed as as R1 no longer resides at the facility.
A review R1's records does not indicate any elopement or history of elopement. When both administrator and staff were asked if R1 had a history of eloping the facility since admission, both stated no.
In addition to interviews and record review, a physical plant inspection was made. The facility is a one story building with four (4) bedrooms designated for resident use. There is a total of five (5) exits in the building. All exits were checked during this investigation to have a functional auditory alert. R1 stayed in Room #2, which has no direct exit.
Although the resident did leave facility grounds on 06/09/26, based on the department’s observations, interviews and record review(s), it could not be proven that elopement was due to neglect. Therefore, the allegation is deemed Unsubstantiated at this time. |