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32 | The investigation revealed the following: Allegation #2- Staff did not allow resident to return back to the facility.
The details of the complaint alleged that the facility staff had resident (R1) placed on a 51/50 hold (Involuntarily held for mental health challenges) and did not allow the resident to return to the facility. On 5/21/2026, from 10:00am-2:00pm, the department interviewed staff (S1-S2), residents (R2-R10), and on 5/28/2026, the department interviewed resident (R1) regarding the allegation. 2 of 2 staff stated that the resident was exhibiting aggressive behavior towards staff and other residents in the facility. Staff also stated that due to the nature of the residents escalating behavior and concern for the staff, residents, and (R1), a 51/50 hold was initiated. Staff also stated that they had given a warning letter to the resident on 02/24/2026 for verbal abuse, offensive language, and aggressive behavior towards staff and residents but things did not get any better.
The department interviewed residents (R2-R10) about the allegation and 9 of 10 residents that were interviewed stated that they had left the facility but was allowed to return. They had no knowledge of why the facility might refuse them reentry. Resident (R1) stated that they believed their behavior did not warrant them from not returning to the facility.
The department reviewed the Application for 72-Hour Assessment & Evaluation (Dated: 03/12/2026) that detailed history and escalated behavior of the resident, Incident Reports (Dated: 03/13/2026, 11/09/2025, 11/13/2025), and Warning Notice (Dated: 02/24/2026) and observed that the resident had an increase in aggressive and escalating behavior that precipitated in the need for a 51/50 hold of the resident.
Based on interviews and records reviewed, there is insufficient evidence to support the allegation that Staff did not allow resident to return back to the facility without just cause. The department observed that the resident had escalating behavior that put the staff and other residents in danger, as noted in the application for a 51/50 hold. 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, therefore the allegation is Unsubstantiated.
The investigation revealed the following: Allegation #3- Staff refused to return items back to the resident.
The details of the complaint alleged that the facility staff refused to return items back to the resident (R1) after they left the facility. On 5/21/2026, from 10:00am-2:00pm, the department interviewed staff (S1-S2), residents (R2-R10), and on 5/28/2026, the department interviewed resident (R1) regarding the allegation. 2 of 2 staff denied allegation that Staff refused to return items back to the resident. Staff stated that the resident was given thirty days to get all of their belongings from the facility. Staff stated that the resident came and collected some of their items but left others. Staff also stated that they communicated through email advising the resident that if they did not get all of their belongings in thirty days, they could not hold them any longer.
Report Continued On LIC9099-C
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