Complaint Investigation Report

126803830-8-19-2025-21-AS-VBEI-DL8S7L-20250905133744

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

SANTA ROSA RO , 1450 NEOTOMAS AVENUE, STE. 100

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

07/31/2025 and conducted by Evaluator Christopher Arnhold

COMPLAINT CONTROL NUMBER: 21-AS-20250731094523

Facility staff did not dispense medications as prescribed

At approximately 10:30AM, Licensing Program Analyst (LPA) Chris Arnhold arrived at this facility unannounced, to conduct an investigation into the above allegations. LPA met with Executive Director Alma Peralta, interviewed staff and reviewed records. Based on records reviewed and interviews conducted, Resident returned from hospital with a prescription for Antibiotics. The medication arrived at the facility on 07/19/2025 but did not start the medication until 07/21/2025. Physician orders stated the medication was to begin 07/19/2025 but was not entered into the facility system until 07/21/2025.

Based on the Departments investigation, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED.

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 Alma Peralta and Appeal rights were given.