Complaint Investigation Report

015600532-4-21-2023-15-AS-KHOS-CRFQ5C-20230502115143

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

CCLD Regional Office , 1515 CLAY STREET, STE. 310

This is an official report of an unannounced visit/investigation of a complaint received in our office on

03/24/2023 and conducted by Evaluator Gregory Clark

COMPLAINT CONTROL NUMBER: 15-AS-20230324105604

Staff are mismanaging residents' medications.

On 4/21/23 at 2:10 p.m., Licensing Program Analyst (LPA) Greg Clark arrived unannounced to deliver findings in regard to the allegation above. LPA met with Lydia Alvarez and explained the purpose of the visit. LPA also spoke to Licensee Wardell Jackson on the telephone.

At 2:00 p.m. on 4/2/23, LPA observed that medications were pre-poured into paper cups to be administered at later times today.

This agency has investigated the allegation above. We have found that the allegation is substantiated. Based on LPA's observations the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. Deficiencies are being cited per California Code of Regulations (Title 22, Division 6, Chapter 8), are being cited on the attached LIC 9099D.CCLD1515

Exit interview conducted, a copy of this report and appeal rights provided.