Complaint Investigation Report

157206770-11-30-2022-24-AS-SPIY-CLTMPL-20221205084718

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

11/10/2022 and conducted by Evaluator Lady Cabrera

COMPLAINT CONTROL NUMBER: 24-AS-20221110085240

Residents are not being their medications as prescribed.

Licensing Program Analyst (LPA) L. Cabrera conducted the subsequent complaint investigation visit to the facility. LPA met Gracie Ramirez, Interim Administrator. During the course of this complaint investigation LPA interviewed staff on duty and obtained and reviewed facility records. It was determined based on the interviews and records review that the above allegation is SUBSTANTIATED. Per records reviewed and interviews, facility did not administer Resident’s (R1) prescribed medication on 11/04/2022-11/06/2022 a total of three days. Facility staff received R6's medication on 9/16/2022, however, did not administered R6's medication until 10/01/2022. Facility administered incorrect medication for R7's on 11/09/2022.R7 notified facility on 11/10/2022 regarding the medication error.

Based on LPAs observations and interviews which were conducted, and record reviewed, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. California Code of Regulations, (Title 22, Division 6 & Chapter 8), are being cited on the attached LIC 9099D.

Exit interview conducted. Appeal Rights were provided.