Complaint Investigation Report

107208838-6-29-2022-24-AS-SMOA-CG8JSA-20220711071758

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

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

10/21/2021 and conducted by Evaluator Mary Garza

COMPLAINT CONTROL NUMBER: 24-AS-20211021101417

Resident fell resulting in an injury due to care and supervison.

Staff not seeking medical attention for resident in a timely manner.

Resident's medication was not properly administered by staff.

Staff forced resident to take medication.

On 6/29/22 Licensing Program Analyst (LPA) M. Garza arrived at facility unannounced to deliver findings on complaint. LPA was met by Administrator, Frances Hernandez. LPA explained reason for visit and was COVID pre-screened. LPA was permitted entry into facility. LPA toured facility inside and out. A health and safety check on residents were observed in common areas and in rooms.

During investigation records were reviewed and interviews with staff were completed. Administrator confirmed that R1 had a history of falls. R1 was on hospice and was not sent out for these falls. Injuries were treated by hospice. Although the allegation occurred it was not due to lack of care and supervision of resident. LPA reviewed R1’s file for medications that were being taken. MARS were reviewed for the months of October through December 2021 which shows that R1 was receiving medications as prescribed. R1’s file contained a prescription from R1’s PCP to crush R1’s medications. Although the allegations may or may not have occurred the perponderance of evidence does not meet the Departments standard. The above allegations are UNSUBSTANTIATED. Exit interview completed. A copy of this report was given.