Complaint Investigation Report

157209192-9-11-2024-24-AS-SPIY-D9EME4-20240924093208

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

05/10/2024 and conducted by Evaluator Melinda Medina

COMPLAINT CONTROL NUMBER: 24-AS-20240510143647

Facility staff do not properly supervise residents after dispensing their medications

On 9/11/24, Licensing Program Analyst (LPA) M. Medina conducted a subsequent unannounced complaint visit to deliver findings. LPA introduced self, stated purpose of visit, and allowed entrance by staff. Staff, Gina Sadaro contacted by telephone and arrived a short time later to conduct visit.

This department investigated the above allegation, during the investigation, LPA toured facility, conducted interviews, and reviewed records.

Based on observation during facility tour, LPA observed Staff 3 (S3) dispensed medication into cups and had them placed in front of residents as they were seated at the dining room table and walked away, The preponderance of evidence standard has been met, therefore the allegation: facility staff do not properly supervise residents after dispensing their medication is found to be SUBSTANTIATED.

A deficiency is being cited in accordance to California Code of Regulations, Title 22, Division 6 on the attached 9099D.

Exit interview was conducted and a plan of correction developed and reviewed. A copy of this report provided to Administrator for facility records.