Complaint Investigation Report

126803830-4-5-2024-21-AS-BMOS-D7ELQT-20240722085804

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

CCLD Regional Office , 1450 NEOTOMAS AVENUE, STE. 100

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

02/16/2024 and conducted by Evaluator Christopher Arnhold

COMPLAINT CONTROL NUMBER: 21-AS-20240216124504

Resident Medication was not administered per regulation

At approximately 8:30AM, Licensing Program Analyst (LPA) Chris Arnhold arrived at this facility unannounced, to conduct an investigation into the above allegation. LPA met with Administrator Charmin Bailey interviewed staff and reviewed records. Based on records reviewed, Resident (R1) did not receive medication as ordered. Records show the medication was out of stock, but there was no documentation to show facility followed up. Facility does not have a written procedure to ensure oversight for re-ordering medications. Based on the Departments investigation, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. This is a repeat violation, civil penalty of $250.00 is being issued.

Deficiencies are cited from the California Code of Regulations (CCRs), and/or the Health and Safety Code. Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

This report was reviewed with Administrator and Appeal rights were given.