Complaint Investigation Report

157209373-7-8-2024-24-AS-SMOA-D6YVVJ-20240708164626

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

03/07/2024 and conducted by Evaluator Mai Yang

COMPLAINT CONTROL NUMBER: 24-AS-20240307144719

Staff are mismanaging residents medication

On 06/11/24, Licensing Program Analyst (LPA) M. Yang arrived unannounced to deliver complaint findings on the above allegation. LPA introduced self, stated the purpose of the visit and met with Administrator Kala Gibson.

During the course of the investigation, residents’ medications were audit and MARs were reviewed, medications audit showed staff did not administered R1 and R2 medications as directed by physician.

Based on observation, 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 6

are being cited on the attached LIC 9099D. An exit interview was conducted. A copy of this report and appeal rights was provided to the Administrator, whose signature on this form confirms receipt of this report.