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- Policy To Promote Zero ToleranceAbuse & neglectOrder
The home did not protect a resident from physical abuse by other residents on three separate occasions between March and May 2026, in violation of its written zero-tolerance policy on abuse and neglect. Inspectors have ordered the home to provide training to all staff on abuse prevention, assess and update the resident's care plan with clear safeguards, ensure staff are informed of these protections at the start of each shift, and maintain records of all corrective actions.
- Plan Of CareCare planning
Inspectors found that a resident did not receive specific daily personal care on a particular day in May 2026 as outlined in their plan of care. Staff confirmed this care was not provided as directed.
- Plan Of CareCare planning
Inspectors found that the home's documentation of care provided to a resident did not match what actually occurred. On a specific day in May 2026, staff records stated a resident received a bath when the resident actually refused it, and records indicated personal hygiene care was given when staff said it was not provided.
- Duty To ProtectAbuse & neglect
Inspectors found that on one occasion in April 2026, a staff member did not intervene immediately when a resident initiated unwanted physical contact with a co-resident who, according to the care plan, does not have the capacity to consent. The home did not protect this co-resident from potential sexual abuse.