345920108-2-11-2025-59-AS-MSEY-DDTPTZ-20250212103645

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 345920108
Report Date: 02/11/2025
Date Signed: 02/11/2025 02:27:12 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO NORTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

This is an official report of an unannounced visit/investigation of a complaint received in our office on
11/12/2024 and conducted by Evaluator Sabrina Calzada

PUBLIC

COMPLAINT CONTROL NUMBER: 59-AS-20241112093306

FACILITY NAME:	OAKWOOD MEADOWS ASSISTED LIVING		FACILITY NUMBER:	345920108
ADMINISTRATOR:	TORGERSEN, DANIEL		FACILITY TYPE:	740
ADDRESS:	7241 CANELO HILLS DR		TELEPHONE:	(916) 722-2800
CITY:	CITUS HEIGHTS	STATE: CA	ZIP CODE:	95610
CAPACITY:	78	CENSUS: 69	DATE:	02/11/2025
		UNANNOUNCED	TIME BEGAN:	11:05 AM
MET WITH:	Danny Torgersen, Administrator		TIME COMPLETED:	02:30 PM

ALLEGATION(S):

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Resident was left on floor for an extended period of time.
Staff did not report change of condition.
Staff left residents in soiled diapers for an extended period of time.
Resident is not receiving showers as scheduled.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Sabrina Calzada arrived unannounced to deliver investigative findings to a complaint received on 11/12/24. LPA met with Danny Torgersen, Administrator, and Karen Padilla, Director of Nursing, and stated the reason for the inspection.

During the course of the investigation, LPA interviewed the Administrator, Director of Nursing, Business Office Director, (3) staff, resident (R1) and a family member of (R1). LPA also reviewed documentation relating to (R1), including their physician's reports, appraisal/care plans, narrative charting notes, (2) incident reports (LIC624), shower schedules for months September- November 2024 and the Alarm Reset Report for 11/10/24 from 1200 hours through 23:59 hours. The results of the investigation are as follows:

(R1) moved to the community and has resided on the Assisted Living side since moving in on 12/27/23. (R1's) physician's report (dated 10/16/24) notes resident has a diagnosis of Dementia with agitation and is taking medications, Melatonin 3mg and Olanzapine 2.5 mg, to assist with related behaviors. (R1) has a secondary diagnosis of Type 2 Diabetes Mellitus and takes medications for it. *cont on 9099C-1..

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Maribeth Senty
LICENSING EVALUATOR NAME: Sabrina Calzada
LICENSING EVALUATOR SIGNATURE:	DATE: 02/11/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/11/2025

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

Page: 1 of 8

Control Number 59-AS-20241112093306

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO NORTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: OAKWOOD MEADOWS ASSISTED LIVING	FACILITY NUMBER: 345920108
	VISIT DATE: 02/11/2025

NARRATIVE

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9099C-1.. Per the physician's report,(R1) can be confused/disoriented, exhibit inappropriate behavior, including sundowning but is able to communicate needs and follow instructions.

Allegation: Resident was left on floor for an extended period of time. The allegation states on the evening of 11/10/24 (R1) had a fall in their apartment and waited an hour and a half for staff to assist, after pressing their pendant. (R1) then called their family member, and they were on and off the phone while (R1) was on the floor. The facility finally responded but it was a caregiver that (R1) does not like so they refused care until a Med-Tech came to help resident off the floor.

Staff (S1) confirmed she worked on the “pm” shift (2:00 pm- 10:30 pm) on Sunday, 11/10/24, and stated after dinner, she "moved (R1) from the dining room as they were being very verbal, cussing at me", and took (R1) to their room and offered them water. (R1) refused, was mad and then locked their door. (S1) returned to (R1's) room 15-20 minutes later, around 7:10-7:12 pm, and asked (R1) if they were okay and offered their scheduled dose of insulin, which (R1) said "No" to. (S1) stated that around shortly afterwards, she got a call on the house phone from (R1's) family member that (R1)was on the floor in her room. (S1) stated she checked on (R1) again around 7:20-7:30 pm, and "saw them on the floor". (S1) stated (R1) fell as they tried to transfer them self from their wheelchair to their bed and fell, and she and two other staff, (S4) and (S2), assisted her. (S1) asserted that "it was 10-15 minutes maximum that she was on the floor", and (R1) will "regularly push the call button if they are upset" and doesn't hesitate.

A second staff (S2) confirmed he was working on the "pm" shift on Sunday, 11/10/24, when resident (R1) was found on the floor. (R1) commented "(R1) doesn't like men to help her, and I think Med-Tech, (S1), called me to help pick (R1) up, and we went to her room. (S2) confirmed that he, (S1) and another caregiver, female, assisted (R1) to get up from the floor. (S2)stated staff "do rounds, I have no idea how long they were on the floor, but it was not (3) hours, “adding, "I think they pressed their pendant" which goes to all staff's pagers.

A third staff (S3) stated on 11/19/24 that she works "pm" shift but did not work on 11/10/24. (S3) explained that around 7:30/8:00 pm, caregivers will begin to put residents to bed, and staff will assist (R1) in the bathroom, change them into their pajamas, take off their dentures, comb their hair and put them to bed. (S3) stated staff will check on (R1) and all other residents again from 8:30/9:00 pm to make sure residents are in bed before 10:00 pm, when the shift change occurs. *cont on 9099C-2..

SUPERVISORS NAME: Maribeth Senty
LICENSING EVALUATOR NAME: Sabrina Calzada
LICENSING EVALUATOR SIGNATURE:	DATE: 02/11/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/11/2025

LIC9099 (FAS) - (06/04)

Page: 2 of 8

Control Number 59-AS-20241112093306

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO NORTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: OAKWOOD MEADOWS ASSISTED LIVING	FACILITY NUMBER: 345920108
	VISIT DATE: 02/11/2025

NARRATIVE

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9099C-2... On 11/19/24, resident (R1) stated to LPA that "probably fell" when asked if they fell on 11/10/24. (R1) commented that they "sometimes need help" transferring from their wheelchair to their bed and will use the mobility pole also, pointing to it. (R1) indicated they were certain they called for staff, using their pendant, after they fell and waited for 1.5 hours until "finally 3-4 people arrived late at night". (R1) indicated that all the staff who helped here were female.

Charting notes document that on 11/9/24 (9:59 pm) (R1) “slipped out of their chair in their bedroom” and was not observed to have any bruising or injuries following. Charting notes indicate that on 11/11/24 (12:40 pm) that a Med-Tech notified resident’s POA that (R1) had an unwitnessed fall at 10:30 pm (11/10/24). The LIC624 submitted for the fall on 11/10/24 (10:00 pm), indicates (R1) was found by care staff on the floor in front of their wheelchair. This report, completed by a Med-Tech, states (R1) stated they slipped off their wheelchair and on to their bottom and did not hit their head and (R1) was reminded on how to use the call button/pendant and staff will continue to monitor.

A family member of (R1) stated that (R1) fell on the evening of 11/10/24 (Sunday) around 8:45 pm- 9:00 pm., and (R1) waited 1.5 hours for help, after she fell. The family member indicated (R1) fell when trying to transfer from their wheel chair to their bed, and (R1) was waiting for staff to assist for (3) hours before she fell, and was pressing her pendant.

LPA was informed that any caller can call the main number and request to have the call routed to the Med-Tech's cell phone and the resident's room will be identified.

The Alarm Reset Report was reviewed for 11/10/24, from 1200 hours through 23:59 hours. The report shows (R1’s) call button was initially pressed at 1:28 pm (staff responded/re-set the button at 2:14 pm -45 mins later), and (R1’s) call button was pressed a second time at 2:15 pm (staff responded/re-set the button at 2:21 pm- 6 mins). The report does not reflect any other times on 11/10/24 when (R1’s) call button was activated and shows multiple times when other resident’s call buttons were pressed, with no significant time gaps, in between each call. The report shows the shortest time response was (1) minute and the longest time response was (45) minutes.

Based on information obtained, LPA finds allegation to be (US)Unsubstantiated - A finding that the complaint is Unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. *cont on 9099C-3..

SUPERVISORS NAME: Maribeth Senty
LICENSING EVALUATOR NAME: Sabrina Calzada
LICENSING EVALUATOR SIGNATURE:	DATE: 02/11/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/11/2025

LIC9099 (FAS) - (06/04)

Page: 3 of 8

Control Number 59-AS-20241112093306

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO NORTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: OAKWOOD MEADOWS ASSISTED LIVING	FACILITY NUMBER: 345920108
	VISIT DATE: 02/11/2025

NARRATIVE

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9099C-3.. Allegation: Staff did not report change of condition. The allegation states that resident’s family member was not informed of (R1) having a change in behavior, specifically becoming more aggressive verbally and using inappropriate language towards care staff, until the facility sent (R1) out to the hospital in the beginning of October 2024.

Charting notes were reviewed from 4/19/24 through 12/29/24 . The first time behavior was documented as an issue was on 5/8/24, when (R1) refused to allow staff to take their blood pressure. Notes entered on 9/4/24 and 9/8/24 relate to the monitoring of Farxiga for Type 2 Diabetes. The next entry, on 10/6/24 (4:25 am) , document that (R1) was placed on alert charting after returning from the hospital and being diagnosed with a UTI and starting an antibiotic. POA was again notified.

Notes entered on 10/10/24 (5:17 pm) say (R1) was sent out again due to UTI symptoms and complaining of neck pain. Resident returned on 10/11/24 (2:00 am) with two new medications- Lidocaine and Olanzapine (Zyprexa 2.5 mg) and staff continued to monitor.

Notes made on 10/18/24 (3:49 pm) document (R1) was placed on alert charting to monitor the effects of Olanzapine, which was prescribed to help with agitation and behaviors related to Dementia.

Care staff (S1) confirmed that (R1) resided at the community when she started and she didn't observe any behaviors with (R1) until around October 2024, commenting she is not sure "what prompted it". (S1) stated (R1’s) behavioral problems started in October, 2024, when (R1) began using derogatory comments towards some of the staff.

(R1's) care plan, dated 11/30/23 was reviewed. On 11/2/24, (R1's) care plan was updated to include a change in (R1's) mental condition, specifically that (R1) has behaviors, will start screaming and fight with any resident/staff, and will call out names or say inappropriate words to both staff/residents.

Based on information obtained, LPA finds allegation to be (US) Unsubstantiated - A finding that the complaint is Unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred.

*cont on 9099C-4..

SUPERVISORS NAME: Maribeth Senty
LICENSING EVALUATOR NAME: Sabrina Calzada
LICENSING EVALUATOR SIGNATURE:	DATE: 02/11/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/11/2025

LIC9099 (FAS) - (06/04)

Page: 4 of 8

Control Number 59-AS-20241112093306

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO NORTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: OAKWOOD MEADOWS ASSISTED LIVING	FACILITY NUMBER: 345920108
	VISIT DATE: 02/11/2025

NARRATIVE

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9099C-4... Allegation: Staff left residents in soiled diapers for an extended period of time. The allegation states (R1) wears a brief but can still use the toilet, however staff rarely get to (R1) in time so (R1) has to use their brief and sits in soiled briefs for an extended period of time because no staff will assist.

(S1) explained that (R1) began using inappropriate language towards staff in October (2024), and (R1's) family member will randomly call and say "(R1) is complaining of not being changed" and will request that a female caregiver be provided. (S1) stated that there are (3) male caregivers currently and (1) works on the NOC shift and (2) work on the "pm" shift.

(S1) was asked if staff have ever left (R1) in soiled diapers for an extended period of time. (S1) stated "(R1) will usually tell us 50/50 when they have to use the bathroom". (S1) explained that dinner starts at 4:30 pm and (R1) "is usually done by 5:15 pm" and staff will take (R1) from the dining room to the front door area as (R1) "likes to see outside the front door". (S1) indicated she "has never seen (R1) soiled with or smell of BM" but (R1) has been soiled with urine before and (R1) will tell staff when they are.

A second staff (S2) indicated he didn’t have any information since men can’t provide incontinent care to (R1).

A third staff (S3) stated that around 7:30/8:00 pm, caregivers will begin to put residents to bed, and staff will assist (R1) in the bathroom. LPA asked (R1) if she is able to get to the bathroom independently- ? (R1) replied "sometimes I can get on the toilet".

Both the initial care plan (dated 11/30/23) and the updated care plan (dated 11/2/24) note (R1)requires one-person assistance due to being incontinent. Both physician's reports (12/11/23) and (10/16/24) note (R1) is incontinent (x2).

Based on information obtained, LPA finds allegation to be (US) Unsubstantiated - A finding that the complaint is Unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred.

SUPERVISORS NAME: Maribeth Senty
LICENSING EVALUATOR NAME: Sabrina Calzada
LICENSING EVALUATOR SIGNATURE:	DATE: 02/11/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/11/2025

LIC9099 (FAS) - (06/04)

Page: 5 of 8

Control Number 59-AS-20241112093306

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO NORTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: OAKWOOD MEADOWS ASSISTED LIVING	FACILITY NUMBER: 345920108
	VISIT DATE: 02/11/2025

NARRATIVE

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9099C-5.. Allegation: Resident is not receiving showers as scheduled. The allegation states (R1) has not received a shower for 2+ days and the shower chair has been broken for at least 2 days.

One staff (S1) who works on the “pm” shift stated she is "not sure if (R1) receives showers on the "am" or "pm" shift, but (R1) never stinks", commenting "maybe (R1) is "am" because (R1) has their bed on the "A" side of the room. (S1) stated she puts (R1) in pajamas at night and resident is clean.

A second staff (S2) indicated he doesn’t know about showers as the female caregivers give (R1) a shower.

On 11/19/24, a third staff (S3) confirmed that (R1) hasn't missed any showers and will regularly accept them, confirming the last shower was the day before yesterday on Sunday. (S3) explained sometimes the "pilot light" goes out and there is "no hot water for a while". (S3) explained the light went out recently and staff are now checking for hot water before getting the resident undressed. (S3) confirmed staff will document when showers are given, (R1) doesn't typically refuse, and confirmed caregivers will rotate halls so they work with different residents. The Administrator stated the water heater was recently replaced in January 2025 as the prior water water (tankless) had factory defects.

LPA reviewed shower schedules for September -November 2024 (week ending 11/18/24). (R1) is scheduled for a shower twice weekly, on Mondays and Thursdays. The schedules showed staff initialed that (R1) received a shower on the following days:

Monday, 9/2/24, 9/9/24, 9/16/24, 9/23/24 and 9/30/24 and on Thursday, 9/5/24, 9/12/24, 9/19/24 and 9/26/24.

Monday: 10/7/24, 10/21/24 and 10/28/24 and on Thursday: 10/3/24, 10/10/24, 10/24/24 and on 10/31/24.

Staff notes indicate (R1) was “out” of the facility on Monday, 10/14/24 and on Thursday, 10/17/24.

Monday, 11/4/24 and 11/11/24 and on Thursday, 11/7/24 and 11/14/24.

The Director Of Nursing stated (R1) has a new shower chair and never missed a shower. On 11/19/24, (S3) looked in the bathroom and confirmed with LPA the shower chair was not currently there, commenting it is typical for staff to borrow chairs, and (R1's) roommate's daughter just brought a new chair in that has wheels and stated (R1) had a shower chair without any wheels before.

Based on information obtained, LPA finds allegation to be (US) Unsubstantiated - A finding that the complaint is Unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred.

Exit interview. Copy of report provided.

SUPERVISORS NAME: Maribeth Senty
LICENSING EVALUATOR NAME: Sabrina Calzada
LICENSING EVALUATOR SIGNATURE:	DATE: 02/11/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/11/2025

LIC9099 (FAS) - (06/04)

Page: 6 of 8

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO NORTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

This is an official report of an unannounced visit/investigation of a complaint received in our office on
11/12/2024 and conducted by Evaluator Sabrina Calzada

PUBLIC

COMPLAINT CONTROL NUMBER: 59-AS-20241112093306

FACILITY NAME:	OAKWOOD MEADOWS ASSISTED LIVING		FACILITY NUMBER:	345920108
ADMINISTRATOR:	TORGERSEN, DANIEL		FACILITY TYPE:	740
ADDRESS:	7241 CANELO HILLS DR		TELEPHONE:	(916) 722-2800
CITY:	CITUS HEIGHTS	STATE: CA	ZIP CODE:	95610
CAPACITY:	78	CENSUS:	DATE:	02/11/2025
		UNANNOUNCED	TIME BEGAN:	11:05 AM
MET WITH:	Danny Torgersen, Administrator		TIME COMPLETED:	02:30 PM

ALLEGATION(S):

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Illegal eviction.

INVESTIGATION FINDINGS:

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LPA arrived unannounced to deliver findings to a complaint received on 11/12/24. During the investigation,
LPA interviewed the Administrator, the Business Office Manager, and a famly member of resident (R1). LPA also reviewed charting notes and a 30-day eviction notice, dated 10/17/24. The results are as follows:

The allegation states that the facility is requesting (R1) to move out of the facility by 11/21/24 due to resident's change in behavior, but the facility has not issued a 30-day written notice but did issue an email on 11/8/24.

On 11/19/24, the Administrator stated an eviction notice was isued on 10/17/24 due to (R1) being "Verbally aggressive always" and making inappropriate comments to staff. The Administrator also stated on this day that he is not enforcing the eviction for (R1) to move out by 11/21/24. On 11/19/24, the Business Office Manager confirmed that (R1's) rent has been paid in advance, thru 12/31/24, and the reason for the eviction was due to behavioral reasons and confirmed she has witnessed (R1) make coments are are offensive to staff. *cont on 9099A-C-1...

Unfounded

Estimated Days of Completion:

SUPERVISORS NAME: Maribeth Senty
LICENSING EVALUATOR NAME: Sabrina Calzada
LICENSING EVALUATOR SIGNATURE:	DATE: 02/11/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/11/2025

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

Page: 7 of 8

Control Number 59-AS-20241112093306

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO NORTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: OAKWOOD MEADOWS ASSISTED LIVING	FACILITY NUMBER: 345920108
	VISIT DATE: 02/11/2025

NARRATIVE

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9099A-C.1...(R1's) family member stated the care home wants (R1) to move on 11/21/24 due to a "change in behavior", specifically (R1) is being more verbally aggressive, commenting she didn't know about the aggression until they sent (R1) to the the hospital on 10/5/24, for an apparent UTI.

The family member stated she did not receive a written notice as it was sent to her local address, which she has not been to so since injuring her foot a few weeks ago. The family member stated she informed the Administrator and he then emailed her the notice on 11/11/24. Emails were not provided to the Department between the facility Administrator and the responsible person, as requested.

There were several notes made in (R1's) file for October regarding behavior changes and new medications.
Charting notes say resident returned from ER on 10/6/24 and was diagnosed with UTI. Family notified. (R1) sent out again to ER on 10/11/24 (5:00 pm) UTI symptoms and neck pain. POA notified. Notes made on 10/6/24 indicate (R1) was placed on alert charting after returning from the hospital on 10/6/24, being diagnosed with a UTI and began an antibiotic. POA was notified. Notes entered on 10/10/24 (5:17 pm) say (R1) was sent out again due to UTI symptoms and complaining of neck pain. Resident returned on 10/11/24 (1:40 am) with two new medications- Lidocaine and Olanzapine (Zyprexa 2.5 mg) and staff continued to monitor. Notes made on 10/18/24 document (R1) was placed on alert charting to monitor the effects of Olanzapine- prescribed to help with agitation and behaviors related to Dementia.

Additional charting notes document (R1) continued to have behavioral expressions towards staff on 11/26/24, 11/28/24, 12/3/24, 12/4/24, 12/5/24 (4:12 pm, 4:30 pm and 8:30 pm).

LPA reviewed the 30-day notice, dated 10/17/24, issued to (R1) and their responsible person. Based on Regulation 87224/Eviction, the letter contained a valid reason- behavioral care need not previously identified- and all other required elements were contained in the letter.

On 11/19/24, the Administrator stated he is not enforcing R1')'s eviction to be moved out by 11/21/24. (R1) has remained living at the community. The Administrator confirmed on 2/10/25 that the eviction notice was “rescinded”, due to (R1’s) behavior improving some; however, a letter to that effect was not issued.

Based on information obtained,LPA finds the allegation to be UNFOUNDED-A finding of unfounded means that the allegation is false, could not have happened, and/or is without a reasonable basis.

Exit interview conducted.

SUPERVISORS NAME: Maribeth Senty
LICENSING EVALUATOR NAME: Sabrina Calzada
LICENSING EVALUATOR SIGNATURE:	DATE: 02/11/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/11/2025

LIC9099 (FAS) - (06/04)

Page: 8 of 8