Complaint Investigation Report

157209417-10-27-2025-24-AS-AWAN-DNDNUJ-20251113094627

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

10/23/2025 and conducted by Evaluator Jimmy Duarte

COMPLAINT CONTROL NUMBER: 24-AS-20251023155115

Staff not refilling residents medication prescription in timely manner.

On 10/27/2025, Licensing Program Analysts (LPAs) J. Duarte and M. Medina conducted an unannounced initial 10-day complaint visit. LPAs introduced self, stated purpose of visit, and allowed entrance by Administrator Jessica Pelaya.

This department investigated the above allegations. During the facility tour, LPAs observed the bathroom door in R1's room to be unlocked. During interviews and records review, it was stated that R1's family is obtaining newly prescribed medications and refilling medications from the pharmacy and delivering them to the facility. This department had insufficient information regarding the allegations listed above. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove or disprove that the allegations occurred therefore the allegations are UNSUBSTANTIATED.

No deficiencies issued during this complaint visit . Exit interview conducted. A copy of this report was provided to Administrator for facility records