Complaint Investigation Report

157209373-2-22-2024-24-AS-SMOA-D2WN2H-20240229090445

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

01/08/2024 and conducted by Evaluator Mai Yang

COMPLAINT CONTROL NUMBER: 24-AS-20240108182624

Staff refused to take resident to the hospital.

Residents did not receive medications as prescribed.

On 02/12/24, Licensing Program Analyst (LPA) M. Yang arrived unannounced to conduct a subsequent complaint visit and delivered complaint findings on the above allegations. LPA introduced self, stated the purpose of the visit and met with Tasha Duncan. Administrator Kala Gibson was called and unable to attend meeting.

During the course of the investigation, the Department conducted interviews. It was confirmed that R1 had requested to be taken to the hospital and the staff refused for the resident to go. R1’s medications and Medication Administration Record (MAR) were reviewed and observed resident’s medication were not administered to resident as prescribed on multiple occasions. Based on interviews conducted, records reviewed, and observation, the preponderance of evidence standard has been met, therefore, the above allegations are found to be SUBSTANTIATED. California Code of Regulations, Title 22, Division 6 is being cited on the attached Lic 9099D. An exit interview was conducted. A copy of this report and appeal rights was provided to staff, whose signature confirms receipt of this report.