Complaint Investigation Report

157206916-2-27-2024-24-AS-MHON-D2Y2TA-20240301164026

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

10/20/2023 and conducted by Evaluator Melinda Medina

COMPLAINT CONTROL NUMBER: 24-AS-20231020094747

Food service requirements are not being met

Licensee does not ensure that staff receive medication training

On 1/29/24, Licensing Program Analyst (LPA) M. Medina conducted an unannounced subsequent complaint visit to deliver findings. LPA introduced self, stated purpose of visit, and allowed entrance by staff. Administrator was not available to conduct today's visit.

This department has investigated the above allegation. During the course of the investigation, LPA toured the facility, conducted interviews, and reviewed documentation.

Based on LPA observation of expired food in facility in both the pantry and refrigerator during facility tour on 12/14/2024. During record review, LPA observed documentation showing staff have insufficient hours of annual training for medication. The preponderance of evidence standard has been met; therefore, the above allegation is found to be Substantiated. Per California Code of Regulations, Title 22, Division 6, Chapter 8, a deficiency is being cited on the attached 9099-D.

Exit interview conducted and a copy of this report was provided for facility records.