The scenario at Moore Board and Care on Clinton Avenue S. unfolded before the eyes of a Health Department investigator on a Monday morning in early December, when she was met at the door by two clients among the six left unattended, the report said. One of the residents, suffering a “nicotine fit” waiting for her cigarettes, made a phone call, and an employee arrived about 30 minutes later.

Several residents told the investigator that they were often left alone, typically between the end of one employee’s overnight shift at 7:30 a.m. and when the next staffer arrived at 10 a.m., the report added. According to the report, a departing nurse would set up medication in individual containers for the clients to take while left on their own. At least once, a resident was “left in charge … and administered other clients’ medications,” according to the report, which was released this week.

Contacted by the investigator on the afternoon of the visit, facility owner Christine Moore said she could not find dependable help for her business, which serves women ages 55 and older.

An unannounced visit last week found that the residence in compliance, after the Health Department gave Moore 30 days to correct the violation.

Officials of the home did not return calls Thursday afternoon.

Moore Board and Care is licensed by the state as a Class F provider, which allows it to address a wide range of medical needs, including dementia care and pain management, along with assistance with various day-to-day tasks, such as feeding, dressing and bathing.

Class F providers are subject to periodic inspection by state health officials.

In March 2005, following an unannounced visit, the Health Department cited the home for several shortcomings, including a handful involving tracking and administration of prescription drugs.