- Date
- 7/22/2025
- Report number
- 00415724-AP-367002
- Type
- Abuse: Neglect
- Level
- 3 - Moderate harm or potential for serious harm
- Allegation
- Failed to provide service
- Result
- Substantiated
- Findings
- The Alleged Victim (AV) relies on the facility for care and it is known that AV likes to spend time outside in the secure courtyard. AV is care planned for staff to document when AV refuses to come inside from the courtyard when there is inclement weather and to check on AV every 30 minutes. On or about July 22, 2025, AV was found unresponsive sitting on bench in the sun in the outside secure courtyard. AV was documented as being awake but not responding to directions. According to an investigation, AV was not checked on for approximately one and a half hours, and there were no documented refusal that staff attempted to get AV back inside the building due to the heat. AV was transported to the hospital where they were diagnosed with heat stroke, pneumonia and a first degree sunburn to AV's neck, arms, and extensively on AV's legs. The facility failed to provide services, to include implementing interventions and or care planning to mitigate AV’s behaviors and ensure resident safety, which is a violation of resident rights, is considered neglect of care and constitutes abuse.
- Sanction
- RCFCP26-00071 $1125.00 fine assessed